National Goals of the Danish Healthcare System 2018
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NATIONAL GOALS OF THE DANISH HEALTHCARE SYSTEM 2018 CONTINUITY 3 FOR THE PATIENT THE DANISH HEALTHCARE QUALITY PROGRAMME 4 A DYNAMIC HEALTHCARE SYSTEM – CONTINUED WORK ON NEW INDICATORS 7 DEVELOPMENT OF GOALS AND INDICATORS 8 FOCUS AREAS 12 EXAMPLES OF INDCATORS 13 BROAD ANCHORING AND LOCAL OWNERSHIP 17 DEVELOPMENT IS FOLLOWED CROSS-REGIONALLY 19 MUNICIPALITIES ARE WORKING TO ATTAIN NATIONAL GOALS 20 PSYCHIATRIC SERVICES – LOCAL ANCHORING AND COHERENCE 21 CASES 22 CONTINUITY FOR THE PATIENT The National Goals ensure a shared, ambitious direction for healthcare development, for the beneft of the patients. This is a key focal point for a new management of our healthcare system, with focus on quality, continuity of care, and patient safety. Since our collaboration on the eight national goals for the Danish healthcare system, as part of the Danish Healthcare Quality Programme in 2016, municipalities and regions have been making targeted eforts to implement and embed these goals in specifc actions for healthcare personnel. These goals mark a shift from process and registration requirements to a greater focus on more professional and meaningful goals and results, which will improve the quality of services. The development of national goal indicators must be an ongoing process, to underpin the intended progression of the healthcare system, and to highlight the values that the healthcare system creates for each individual patient. This year’s status for the national goals has had a special focus on local anchoring of quality and improvement measures for psychiatric services. New indicators have also been developed for targeted measures in general practice. The regions are utilising the national goals in management information and in hospitals in their eforts to improve quality and efciency. The municipalities are also working to implement the nation- al goals and indicators in healthcare services, and to integrate quality improvements in practice. We must continue to bolster eforts to gain a strong foothold in local policies, including local health- care services. It is therefore essential that positive experiences are carried forward in the continued work on securing national goals through locally defned goals and measures in both regions and municipalities, and in the interaction between municipalities, general practices and hospitals. Through communication of knowledge, use of data and transparency, we will continue to ensure that these goals are supported by local measures. These goals will become guidelines for quality improvement measures in the Danish healthcare system, e.g. in hospital wards, municipal health and care services, and for the beneft of the patients. Ellen Trane Nørby Jacob Bundsgaard Stephanie Lose Minister of Health Chairman of KL Chairman of Danish Regions (Local Government Denmark) NATIONAL GOALS OF THE DANISH HEALTHCARE SYSTEM 3 THE DANISH HEALTHCARE QUALITY PROGRAMME IS PART OF A BROADER RESTRUCTURING OF QUALITY IMPROVEMENT MEASURES National The essence of the new Danish Healthcare Quality management programme programme is to create greater value for the patient. The programme is meant to facilitate the development of the healthcare system, and deliver higher quality treatment and rehabilitation, with emphasis on results that have relevance for patients. The programme will Learning and Studies on patient quality teams also help to ensure cost efcient healthcare. experienced quality Securing national goals at the local level is only one element of the Danish Healthcare Quality Programme, which also consists of many other initiatives. A network of learning and quality teams has been established, consisting of clinicians and leaders from relevant departments and units, and an expert group to Dialogue Patient panel involvement ensure quality improvement in certain areas where quality NATIONAL GOALS has been unsatisfactory, or where changes are needed. AND LOCAL Thus far, learning and quality teams have been estab- FOOTHOLDS lished for palliation (care and treatment of the terminally ill), apoplexy, upper femur hip fractures, and the rational use of antibiotics. These three learning and quality teams aim to ensure that positive experiences with quality Systematic Physician improvement measures are rapidly communicated patient responsibility between healthcare professionals (or staf) to the beneft involvement for for patient of the patient. Several more learning and quality teams PRO data are being planned, including teams that also involve the municipalities, with emphasis on inter-sectoral coopera- tion. This will ensure coherence and continued progres- Better use Value-based sion of quality in patient pathways across sectors, so that of data management patients receive continuity of care throughout the system. 4 NATIONALE MÅL FOR SUNDHEDSVÆSENET National management programme Systematic patient involvement Daily operations are the best testing ground for strategic Work is being carried out at both a national and local level, measures, where management will have an impact. This with a stronger focus on systematic patient involvement is where the measures will be anchored, to ensure lasting and the collection of data on patients’ own experiences and meaningful improvements. This is the reason for (PRO) from their treatment and rehabilitation pathways. implementing a national management programme. Its The Danish government, KL (Local Government Denmark) purpose is to enhance the competency of local operations and Danish Regions collaborated on the “Strategy for managers with regard to quality and improvement eforts. Digital Health 2018-2022”, to establish a framework for A focus on management is therefore essential for contin- cross-cutting digital technology in the feld of healthcare, ued improvement, for the beneft of the patients. aimed at bolstering the eight national goals. The parties The frst group of 40 managers from municipalities have specifed national goals for each of the Strategy’s and regions completed the management programme fve focus areas, which can be attained through shared in February 2018. The aim is for managers to act as digital solutions and new technology. The strategy spearheads in the implementation of quality programmes involves better opportunities for patients to actively in the daily operations of hospitals and municipalities. The participate in their own treatment pathways, by providing second group in the national management programme them with greater insight into their own medical and began their training in March 2018. health information, and to ensure a more fexible contact with the healthcare system, including services provided in the patient’s own home. Measures are also underway to ensure a more active use of health data, through a National Health Data program and through local initiatives in regions and municipalities. This includes the development of Danish Clinical Registries (RKKP), which will support activity and quality data in real time for hospital staf, municipal health meas- ures, and patients. New management and billing models are being tested in all regions based on value-based management, where efective, high quality treatment for the patient is key. All for the beneft of the patients. NATIONAL GOALS OF THE DANISH HEALTHCARE SYSTEM 5 NATIONAL GOALS: BETTER QUALITY, CONTINUITY OF CARE, AND GEOGRAPHICAL EQUALITY IN THE HEALTHCARE SYSTEM BETTER STRONGER HIGHER HIGH QUALITY QUICK GREATER ADDITIONAL MORE CONTINUITY OF MEASURES FOR SURVIVAL RATE TREATMENT ASSESSMENT PATIENT HEALTHY LIFE EFFICIENT PATIENT CARE CHRONICALLY AND IMPROVED AND INVOLVEMENT YEARS HEALTHCARE IN CLINICAL ILL AND ELDERLY PATIENT TREATMENT SYSTEM PATHWAYS PATIENTS SAFETY INDICATORS ACUTE SOMATIC/ ACUTE HOSPITAL 5-YEAR SURIVIVAL ATTAINMENT OF WAITING TIME PATIENT AVERAGE LIFE AVERAGE LENGHT OF PSYCHIATRIC ADMISSIONS PER RATE AFTER CANCER QUALITY GOALS IN FOR PLANNED SATISFACTION EXPECTANCY STAY PER HOSPITAL READMISSIONS COPD/DIABETES CLINICAL QUALITY HOSPITAL SURGERY, (SOMATIC AND ADMISSION WITHIN 30 DAYS PATIENT CARDIOVASCULAR DATABASES AND PSYCHIATRIC CARE) DAILY SMOKERS IN MORTALITY FOR PSYCHIATRIC THE POPULATION HOSPITAL PRODUC- WAITING TIME FOR PREVENTABLE USE OF BELT CARE PATIENT TIVITY REHABILITATION ADMISSIONS AMONG MENTAL ILLNESS RESTRAINTS EXPERIENCE OF ELDERLY PATIENTS AND EXCESS ON PATIENTS SOMATIC/ INVOLVEMENT NUMBER OF MORTALITY* ADMITTED TO PSYCHIATRIC (SOMATIC AND HOSPITAL DAYS USE OF ANTI- HOSPITAL- PSYCHIATRIC WARDS PATIENTS ASSESSED PSYCHIATRIC CARE) AFTER COMPLETION PSYCHOTIC WITHIN 30 DAYS OF SOMATIC/ MEDICATION FOR ACQUIRED PSYCHIATRIC PATIENTS WITH INFECTIONS CANCER TREATMENTS DEMENTIA SURVIVAL AFTER PATHWAY PACKAGE COMPLETED WITHIN UPDATED MEDICINE OVER-OCCUPANCY SUDDEN CARDIAC ARREST THE PREDETERMINED INFORMATION IN MEDICAL TIME FRAME (GENERAL PRACTI- DEPARTMENTS DISPENSED TIONER) PRESCRIPTIONS FOR ACCESS TO THE ANTIBIOTICS WORKFORCE (FOR IN GENERAL SOMATIC AND PRACTICE* PSYCHIATRIC PATIENTS) ACCESS TO EDUCATIONAL SERVICES FOR YOUNG PEOPLE WITH MENTAL ILLNESS*, ** REGIONAL / MUNICIPAL LOCAL INTERMEDIATE GOALS * ** Indicator presented without fgures. Possible links to the workforce indicator will be explored. 6 NATIONAL GOALS OF THE DANISH HEALTHCARE SYSTEM A DYNAMIC HEALTHCARE SYSTEM – CONTINUED WORK ON NEW INDICATORS Indicators• for the national goals must be continuously Dispensed prescriptions for antibiotics in general developed, to ensure that they refect the desired direc- practice tion for the healthcare system and value for each individu- • At least one additional