case study A BIG STEP IN HEALTHCARE client: danish national Board of Health
The administration of DPSD was subsequently transferred to an independent authority under the Danish Ministry of Health called the National Agency for Patients Rights and Complaints. Denmark implements first comprehensive national incident reporting system in Europe Client: Danish National Board of Health Potential reach: 122 hospitals, 6000 private practices (doctors, midwives, dentists, therapists, etc.) and 5.5 million private citizens. USERs: More than 2500 risk managers in Denmark OrganiSational Snapshot: Denmark s National Board of Health in Denmark covers five regions and 98 municipalities. As the country s highest healthcare authority, it assists and advises the Ministry of Health and other authorities with the administration of healthcare services, and keeps Danish citizens informed on specific health issues. Products: RL6:Risk for Government Client Since: 2010 Quick Facts: First country in the EU to have a national adverse incident system accessible to everyone, including citizens Submissions increased tenfold with the enhanced risk management system that includes specialised modules for governments Comprehensive forms help Denmark s Board of Health identify risks, develop strategies for improvement and gain a complete picture of patient care
The Challenge Reporting system that only captures event data from hospitals Since January 1, 2004, the National Board of Health in Denmark has required health professionals to report errors and unintended incidents that have taken place at its hospitals. The Board had an electronic reporting system called the Danish Patient Safety Database (DPSD) for its hospitals and regions; this system allowed health professionals to report incidents that happened at their local facilities to their respective regions. DPSD allowed the regions to analyse incidents and forward them to the Board of Health in a de-identified form (i.e., all private patient data was removed). However, DPSD was only capable of processing reports that came from the hospital service. The Danish government wished to expand the system to allow the entire Danish healthcare system including the public to report medical incidents. The Board of Health considered several options and eventually chose to replace the DPSD completely, as this was the most financially advantageous solution. The Board of Health sent out a request for proposals for a new incident reporting system that would allow for the registration of errors and unintended incidents from all areas of the Danish healthcare system. The Danish Board of Health ultimately chose to implement RL Solutions web-based risk management system, RL6:Risk, as part of a joint bid with Computer Sciences Corporation (CSC Scandihealth). RL6:Risk for Government automatically scours through records, enabling us to compile reports tailored to the type, time and location of incidents. Now, we can give the authorities the most relevant and up-to-date recommendations possible. Jorgen Hansen Senior Medical Officer, Denmark s National Agency for Patient Rights and Complaints
The Solution Adverse event reporting software optimised for government Denmark is the first country in the European Union to have a national adverse incident system that is accessible to all relevant healthcare professionals as well as the public. RL6:Risk for Government is a version of RL Solutions risk management software that accommodates for the unique needs of a government-sized initiative. It includes specialised modules for authentication, location lookups, workflows and language support, and can handle a large number of simultaneous users. Compared to the DPSD reporting system, forms created in RL6:Risk are more comprehensive and can be created, maintained and modified directly by the Board of Health s staff. This allows the Board of Health to tune the forms to capture additional details, helping them identify risks and develop national strategies for improvement. This enhanced flexibility was just what the Board of Health was looking for to gain better insight into the incidents that affect its hospitals and citizens. Any event that may compromise the safe treatment of patients in the health system is logged and then analysed at local, municipal and national levels, where it can be quickly resolved. This empowers the Board of Health to communicate lessons learned in one part of the healthcare system to other regions, preventing healthcare professionals from repeating adverse events and helping them share best practices for patient care. CSC Scandihealth, a local implementation company, partnered with RL Solutions to implement RL6:Risk for Government throughout Denmark. CSC provided all of the project management, and first-level and upgrade support during the implementation. CSC also manages the ongoing relationship with the government and translated the software and all relevant documentation into Danish. Patient safety is obviously the number one concern in any healthcare service. This system allows everyone involved to learn from incidents noted country-wide by other healthcare workers. Freddy Lykke Managing Director, CSC European Healthcare Solution Centre Computer Science Corporation
The Result Locally implemented solution with comprehensive qualitative and quantitative reporting The number of submissions in 2010 was about 10 times greater than in 2004, the first year of mandatory reporting for healthcare professionals. In September 2011, the public was granted access to the reporting system. During the first 3 months of access, patients and relatives submitted about 700 adverse events, primarily focused on communication issues, to the Board of Health. Submissions also increased sharply in 2011 because reporting incidents that occurred in the municipal health sector was made mandatory. Luckily, the Board of Health can handle up to three times as many reports in RL6:Risk, without hiring additional central-level staff, because the system is so robust. SUBMISSIONS TO THE NATIONAL BOARD OF HEALTH (2004-2011) The types of incidents that occur vary between sectors. In the municipal sector, medication is the single most overwhelming issue wheras in the hospital sector, 4 event types (of about equal size) are the biggest issues: clinical processes, administrative processes, medication and communication. Demark is targeting these issues with a number of local initiatives and partnering with universities and scientific societies at the national level. The Board of Health uses information captured in RL6:Risk for Government to undertake qualitative and quantitative analyses. They have also published multiple reports on the trends, themes and statistics revealed. In addition, the system has helped the government identify new and significant patient safety issues for alerts. In turn, the government has developed and shared solutions for patient safety issues with healthcare workers, politicians and relevant decision-makers. The system also saves administrative time for caseworkers by automatically generating reports. These reports can be customised to only include information that is relevant to individual caseworkers such as event classification, a specific time, the departments that were affected and the event location.
What is tracked in RL6:Risk for Government? Patient safety events in RL6:Risk for Government are classified using an adapted version of WHO s International Classification for Patient Safety. The system records many types of incidents including: Medication errors Medical devices & equipment Surgical Infection control Communication and teamwork Infrastructure Treatment/procedure Access, admission, transfer and discharge Transfusion Suicide
Next Steps With RL6:Risk for Government, Denmark now has a complete picture of the overall patient care of its citizens. Going forward, Denmark plans to work with RL Solutions and CSC Scandihealth to supplement RL6:Risk for Government with a solution that will combine reporting for compensation and insurance. They will integrate past patient data from the DPSD, current data from RL6:Risk, patient complaints and appeals against decisions made by the patient insurance system. Merging all of the channels and opening up the data between the current silos could further the benefits of the reporting system, making it possible to analyse and disseminate knowledge about the causes of risky situations from all four sources. Jorgen Hansen explains, If we have access to this additional information, we re sure we can learn a great deal more to pass on to the healthcare authorities. By allowing caregivers and patients alike to contribute directly to national patient safety efforts through RL6:Risk for Government, Denmark has positioned itself as a leader in innovative health service delivery. Please contact RL Solutions for more information Phone: 1 888 737 7444 Email: sales@rlsolutions.com Web: www.rlsolutions.com
RL Solutions designs innovative healthcare software for patient and resident feedback, incident reporting and risk management, infection surveillance and claims management. At RL Solutions, nurturing long-lasting relationships with our clients is what we do best. We have over 800 clients, including healthcare networks, hospitals, long-term care facilities and more. RL Solutions is a global company with offices in Canada, the United States, Australia and the United Kingdom. Want to know more? Please contact RL Solutions for more information Phone: 1 888 737 7444 Email: sales@rlsolutions.com Web: www.rlsolutions.com