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Annual Supervision Report 2010. Norwegian Board of Health Supervision

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Annual Supervision Report 2010. Norwegian Board of Health Supervision Annual Supervision Report 2 0 1 0 A n n u A l S u p e r v i S i o n r e p o r t 2 0 1 0 A n n u A l S u p e r v i S i o n r e p o r t 2 0 1 0 Content Use management systems actively! . 3 Municipal services for frail elderly people: Are they adequate? . 4–7 Regional supervision of specialized health services . 8–9 Mixing roles . 10–11 Management of medication – what can go wrong? . 12 Health care personnel who cross borders . 13 When deficiencies in the health service affect elderly people and other people with comprehensive needs for care . .14-19 More speedy supervision after unnatural death or serious injury . .20-21 Countrywide Supervision 2011 . 22 The first supervision of the regulations relating to handling human cells and tissue . 23 Facts and figures . 24–33 Published by the Norwegian Board of Health Supervision Editor: Lars E. Hanssen Editorial Group: Berit Austveg, Magne Braaten, Helge Høifødt, Sverre Nesheim, Finn Pedersen (leader), Mariann Aronsen, Anne Solberg and Nina Vedholm. English translation: Linda Grytten Graphic layout and printing: 07 Gruppen. Illustrations: Inger Sandved Anfinsen Kobolt Design Font: Times New Roman 10.6/12.2 point ISSN 1501-8083 Comments and questions can be sent to: [email protected] The Annual Supervision Report 2010 is also available in English on the website of the Norwegian Board of Health Supervision: www.helsetilsynet.no. A n n u A l S u p e r v i S i o n r e p o r t 2 0 1 0 A n n u A l S u p e r v i S i o n r e p o r t 2 0 1 0 Use management systems actively! Welfare services in Norway are based organization. An adequate manage- on the premise that everyone shall ment system must be suitable for daily have equal access to sound and use, and at the same time it must be adequate services. The state, the anchored in the top leadership and the municipalities and the county committee. It must show what the authorities have responsibility for requirements are and it must be ensuring that this aim is achieved. suitable as a basis for sharing experi- Resources are allocated from central ence both within the organization and funding through the public budget. between different organizations. Therefore, an understanding of fairness and equity in a Norwegian The management system is the context is based on the ability and the leaders’ tool for ensuring that the will to achieve solidarity for all groups requirement to provide sound and in the population in all parts of the adequate services, along with other country. For many decades, here in requirements, is met. It must be based Norway there has been political on the requirements laid down in the agreement about these main legislation. But if the system is not principles. based on daily activities, it is not a «An adequate useful tool. It is important that leaders In order to ensure equal access to management system investigate nonconformities and learn services that are sound and adequate, from them. The management system comprehensive legislation has been must be suitable for must be continually adapted according developed. An important aim of the to experience gained within the legislation is that services shall be safe daily use, and at the organization and in other organiza- and predictable for clients. Meeting same time it must be tions. Experience gained from supervi- the statutory requirements and sion and from adverse events is also providing services within the anchored in the top useful. It is worth noting that in the economic constraints involves two documents from the Ministry of different management principles. In leadership and the Health and Care Services defining the order to succeed, the leadership must committee.» tasks for 2011, the health trusts are be able to understand the principles directed to learn from adverse events and requirements that form the basis and system failure both at the leaders- for Norwegian welfare services, and We are particularly concerned that the hip level and at the committee level. at the same time provide services in organizations should have a clear The same challenge can just as well be a way that utilizes resources as conception of what can be regarded as given to the municipalities. effectively as possible. sound and adequate services. The aim of both planned supervision and We see that supervision works. The Norwegian legislation contains few incident-based supervision is often to effect can be even greater if the requirements about how services shall assess whether service providers have findings we report from supervision be organized, but contains relatively planned and carried out their work in and from the complaints we deal with strict requirements about the content such a way as to ensure that the are also used by other service provi- of the services. Therefore, in order to services that are provided are sound ders. We are pleased to see the assess how resources are utilized, it is and adequate. This is the essence of progress being made by the municipa- not sufficient to base management on the concept of quality in order to lities and the health trusts. A summary economic data. Leadership, the ensure patient safety. of our findings from supervision municipal councils and the executive carried out in 2010 is presented in this committees of the health trusts must The management system can just as publication. More can be found on our have a continuous overview of the well be called the internal control web site: www.helsetilsynet.no. quality of the services that they system or the patient safety system. provide. Based on the findings from But the system must be able to detect supervision, we know that there is new professional and clinical know- much to be done in this area. ledge and ensure that this knowledge is made known and used in the Lars E. Hansen A n n u A l S u p e r v i S i o n r e p o r t 2 0 1 0 A n n u A l S u p e r v i S i o n r e p o r t 2 0 1 0 3 4 A n n u A l S u p e r v i S i o n r e p o r t 2 0 1 0 A n n u A l S u p e r v i S i o n r e p o r t 2 0 1 0 Municipal services for frail elderly people: Are they adequate? In 2010, as part of our focus Supervision of municipal provided, and changes in the way on supervision of services for health and social services for personnel provide care, can make elderly people, we carried out elderly people with dementia clients more confused. We found that supervision of municipal Many people suffer from dementia, some clients had had as many as 26 health and social service. We and the prevalence increases with different service providers in one carried out supervision of increasing age. Figures from the month. We expect municipalities to nursing homes, the home Norwegian Directorate of Health introduce measures and arrangements nursing service, general show that about 17 per cent of people that ensure that the special needs of practitioners, and the aged 80-84, and about 41 per cent of people with dementia are met. For administrative routines of people aged 90 and over, suffer from example, the leadership must evaluate the municipalities. We used dementia. This disease also affects the measures to limit the number of care several different types of elderly person’s family and friends. providers. Sound reporting and methodology. Altogether, we documentation shall ensure that carried out supervision of 294 In 2010, supervision was carried out helpers always know what care each services. Here, we present a in 48 municipalities. The aim was to individual client needs and what other selection of our findings. identify, investigate and follow up colleagues have done, planned and We will continue this elderly people with dementia living in observed. supervision in their own homes, and cooperation 2011. with general practitioners. Breaches of the legislation were found in 32 of the municipalities. «Frequent changes in Many municipalities lacked adequate personnel, changes in the routines for identifying patients with time care is provided, and dementia, for ensuring that they receive adequate medical care, and for changes in the way identifying changes in patients’ needs. Cooperation with general personnel provide care, practitioners was not always can make clients more adequately planned. When there is no common understanding confused. We found that of how tasks shall be carried out, it is up to some clients had had as the individual how things shall be done. many as 26 different Such a practice leaves service providers in one things to chance and increases the risk that month.» services are inadequate. The result may be that people with dementia are Knowledge about dementia is impor- not identified and tant in order to provide sound services investigated as they to people with this diagnosis. Several should be, and that they municipalities lacked training plans, do not receive the help they need. and staff training was inadequate in This can have serious consequences many services. Lack of qualified for people with dementia, who cannot personnel can result in people with express their needs.
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