Healthcare Quality and Patient Safety

Brasilia August 2013

www.isqua.org

ISQua Background Non-profit, independent organisation founded 1985,

international office moved Australia to Dublin in 2008

Members from 70 Countries (Individual and Institutional)

Governed by Board of 10: North America, South America, Europe, Asia / Pacific regions

Honorary Advisors: patients, accreditation, education, research, low and middle income countries

Board Committees (Editorial Committee, Accreditation Council: CBA, Brazil)

International Reach

ISQua Accreditation Activity in South America

4

Health Accreditation Service, Columbia CBA, Brazil 2013/2014

ONA, Brazil 2013

Strategic Alliances

5

WHO – Official Relations Health Technology Assessment International (HTAi) URC/USAID International Hospitals Foundation Institute for Healthcare Improvement (IHI)

High Reliability Healthcare

WHO Facts about patient safety In developed countries up to 10% of patients may be harmed

while receiving hospital care Risk of health care-associated infection in some developing

countries is up to 20 times higher than in developed countries In some countries, proportion of injections given with

syringes/needles reused without sterilization is up to 70%. Unsafe injections cause 1.3 million deaths annually. 300,000 die in India from dirty syringes and 30% are reused

> 50% of medical equipment in developing countries is unusable, or only partly usable, and can result in serious injury or death

There is a 1:1,000,000 chance of a traveller being harmed in an aircraft. There is a 1:300 chance of a patient being harmed during health care

Key IngredientsSafety

Quality

Reliability

Culture of Learning

Informed Decision-Making

It’s all about….

“Systems and processes are only as good as the people who work

within them”

COMMUNICATIONS

RELATIONSHIPS

BEHAVIOURS

MULTI-DISCIPLINARY TEAM WORKING

CULTURE

LEADERSHIP

Title Slide

• Bullet Point 1• Bullet Point 2• Bullet Point 3• Bullet Point 4

Leadership – Country Level Understanding the population priorities for health and

‘social’ care Aligning policy, strategy and resources for maximum

overall population benefit Developing and planning the workforce – building

capacity and capability Engaging with managers, clinicians and patients to

mobilise for safety and quality improvement Liberating the patient to safeguard their care and

clarify expectations for safe services Effective regulatory framework - responsive,

pragmatic and proportionate

Global Context

Global Trends 1: Demographic

Economic slowdown Globalization of diseases Urbanization Global mobility: professionals and patients

(Regional strategies, health tourism) Aging population: By 2050:

- people over 65 ~= children < 14

- >50’s population increase from 1.4 to 3.1 billion

Social care and support: older people, children, people with a disability

The Speed of Population AgingTime required or expected for percentage of population aged 65 and over to rise from 7 percent to 14 percent

Source: Kinsella K, He W. An Aging World: 2008. Washington, DC: National Institute on Aging and U.S. Census Bureau, 2009.

Global Trends 2: Quality and Safety

Universal health coverage and integrated care

Reducing inequalities Quality and safety frameworks: standards,

measurement and evaluation – accreditation, licensing

Informed decision-making: Cost, clinical and comparative effectiveness. Health Technology Assessment:

We should treat where there is evidence of benefit and not treat where there is evidence of no benefit (or harm)

Measuring performance and outcomes Optimising technology solutions

Regulating for Improvement

Regulating for Improvement Core element to quality and safety agenda Clear coherent quality and safety framework:

legislation ~ standards ~ guidance Outcome-based standards and assessment Focus on the important…support…and persist Not there to manage the system’s comfort

zone ‘Safety ripple-effect’ in everything we do:

wider system learning ‘Minding the safety gap’ between Regulators

Get it safe..

..keep it safe..

..and then we’ll build quality

“The future depends on what we do in the present.”

Mahatma Gandhi