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Lithuanian Patient Safety Platform and Quality: a New Proposal!” Lithuania Tautos Jėga Vienybėje Strength of People Is in Unity

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Lithuanian Patient Safety Platform and Quality: a New Proposal!” Lithuania Tautos Jėga Vienybėje Strength of People Is in Unity Den Haag, 10 ‐12 June 2013 HOPE Exchange Programme 2013 PATIENT SAFETY IN PRACTICE HOW TO MANAGE RISKS TO PATIENT SAFETY AND QUALITY IN EUROPEAN HEALTHCARE “Lithuanian Patient Safety Platform and Quality: a new proposal!” Lithuania Tautos jėga vienybėje Strength of People is in Unity Lithuania facts Lithuania Italy Spain Live births 10,7 9,3 10,6 Crude death rate per 1000 pop. 12,8 9,8 8,3 Natural increase per 1000 pop. ‐1,9 ‐0,5 2,3 Life expectancy at birth, in years 73,6 82,1 82,3 Infant deaths per 1000 life births 4,3 3,6 3,2 % of population aged 65+ years 16,3 20,2 17 SDR, diseases of circulatory system, all ages per 100000 494,5 167,7 137,6 SDR, malignant neoplasms, all ages per 100000 187,3 159,9 152,4 SDR, external cause injury and poison, all ages per 100000 113,1 26,9 23 Tuberculosis incidence per 100000 54,2 3,3 13 HIV incidence per 100000 5,2 5,7 6 % of regular daily smokers in the population, age 15+ 21,8 23,1 26,2 Pure alcohol consumption, litres per capita, age 15+ 12,6 6,9 11,4 Persons killed or injured in road traffic accidents per 100000 137,8 507,3 266,6 Average amount of fruits and vegetables available per person 171,9 312,4 231,8 per year HOPE 2013 Lithuania Hospital of Lithuanian University of Health Sciences Kauno Klinikos Hospital of Lithuanian University of Health Sciences Kauno Klinikos Children Main hospital Oncology Tuberculosis Rehabilitation hospital hospital hospital rehabilitation 34 clinics hospital Area: 37874,9 m2 Outpatients (2012): 1132989 23 buildings (area 135612 m2) Inpatients discharges (2012): 94873 Medical departments : 35 (+4 subsidiaries) Average length of stay (2012): 6,26 Total number of beds: 2421 61.500 surgeries/year 7.401 employees 293 functional days of one bed ~350 mil. LTL annual budget Palanga Rehabilitation Hospital Office for Acreditation • The Programme for the Quality of Health care Assurance for 2005‐ 2010, approved by the Ministry of Health covers tools in tackling with the following tasks: – Developing patient‐centered healthcare; – Improving quality, safety and access of health care services; – Improving health carequality management systems. • The patient safety is defined as a type of process or structure whose application reduces the probability of adverse events resulting from exposure to the health care system. Juozas Vytautė Galdikas Lukoševičiūtė Director Deputy Director National Patient Safety Platform MISSION •To improve health care quality and safety. www.vaspvt.gov.lt VISION •To ensure high quality and safe healthcare structures and processes, special attention given to patient safety, healthcare quality and safety improvement. MAIN ACTIVITIES 1.Licensing of the health care organizations (mandatory) 2.Licensing of the health professionals (mandatory) 3.Accreditation of health care organizations (voluntary) 4.Competent authority for medical devices (due to EU regulations) 5.Regulation and management of medical devices (national level) 6.Health technologies assessment 7.Supervision and control of quality of health procedures (national level) 8.Supervision of patients rights (due to the law) Quality and Safety in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics • Establishment of Internal audit department • Internal organizational improvements • Implementation of Quality Management System according to the requirements of International Standard ISO 9001:2008 • Continuous quality improvement • Quality and safety goals – Infection prevention – Medication safety – Radioactivity control – Blood transfusion control – Transplant control Reda Ambrazeviciene, Lolita Sileikiene – Medical equipment safety Internal Audit Team and Senior quality HOPE participants manager Medication Safety • ISO 26825:2008: Aneaesthetic and respiratory equipment. User applied labels for syringes containing drugs used during anaesthesia‐ Colour design and performance • ASTM D4267. Standar Specification for labels of small volume parenteral drug containers • D6398: Standard Practice to Enhace Identification of Drug Names on Labels Medical Equipment safety • Surgical equipment checklist Infection prevention Epidemiological surveillance Incidence studies, Prevalence studies (Epine) Greta Gailiene Head of the Dept. of Infection Control Radiation control •Sources of ionizing radiation State Health • Occupational exposure Care •Medical exposure Accreditation • Personnel (professional) exposure Agency • Accidental and emergency exposure situations. Hospital Accreditation PET Radiation Protection Inga Cibulskaite Head Centre of the Radiation ISO 9001:2008 safety Department ISO 17025:2005 The complexity of quality of life Health Income Age WellBeing Family Society Distress Job Education Lifestyles Sir Samuel Luke Fildes (3/10/1843 – 28/02/1927) The Doctor (1891) 18 By the year 2030 WHO projects that mental illness will be the most important, the largest burden of our societies. Not cancer, not heart disease, but DEPRESSION! by Cory Keyes Mortality (the peak) Phisical problems (the evidence) Mental problems (the waterline) Social problems (“vulnerable” people) Sometimes “evidence” is only a little part of the problems; many times…not the more dangerous ! By Vicente Navarro, “the iceberg of the disease” www.vaspvt.gov.lt National Patient Safety Platform LIETUVA: Country of the rain ? Sunnnig Lithuania Conclusion A Problems Measures • Mistakes in drug • Different coloured labels for administration different kind of drugs • Too much patients in E.R. • Triage (Australian) and Family Doctors in E.R. (white code) • Rehabilitation • The excellence of Palanga and Birstonas Rehabilitation Centers • Infective diseases (Hospital • Infection Control and Acquired Infection, TBC) Epidemiological evaluation we find we find we find similitaries differencies communicating strength creativity answers Conclusion B Successfull ! Could be transferred ? • Family doctors in E.R. for • YES: if overflow of patients white and green code in E.R. (> 150 daily) • Coloured labels for drugs, • YES: mainly in E.R. and from the tag (label) to operatory rooms syringe • Excellence in rehabilitation • YES: the professional occupational therapy in disability…, but … Experiences to be “exported” all over E.U. • National Patient Safety Platform • Professional Occupational Therapy in disability • Colour labels for drugs: ISO 26825:2008 • Family Doctors in E.R. for White and Green code Patients • … and the last suggestion of … Here we return with … HOPE because sometimes is better … Lithuania import from the E.U. Patients in Palanga Rehabilitation Hospital … as the beautiful Birutè, the Palanga’s pagan queen, wife of Kestutis in Trakai and mother of Vytautas the Great. She came back to Palanga after the death of her husband to live in peace near nature, sun and wistful landscape. Vytautas the great 1352 -1430 GreatDuke of Lithuania 1401-1430 The Kaunas “stars’ sower” (?) during the night and with “quality” light ! thanks for your attention, and... Mr. Carlo BAGLIANI & Mr. José Manuel Fdz CARREIRA [email protected] & [email protected] iki pasimatymo Mr. C. Bagliani & Mr. J. M. F. Carreira [email protected] & [email protected] .
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