Bruno Lucet – Stockholm october 30th 2016 Risk indicators for quality and safety of health care : External input from France Bruno Lucet – Stockholm october 30th 2016

01 Introducing Quality account

Quality account A four steps approach for each of the major process of the hospital’s organization : an analysis of the results available (indicators, evaluations, accreditation results, …) a risk based appraisal : Frequency Severity Criticality level of proficiency

Quality account An assessment of the room for improvement, and an involvement to drive improvement plans. The analysis of the quality account aims to design the survey template and to define customized objectives for each of the key process.

02 Accredit ation survey

New survey methods : process audit (PDCA driven) P1/ definition of policy (risk control) P2/ Internal organization, control, roles and responsibilities, resources, interface management; D1/ Mobilization of teams for operational implementation; D2/ Availability of resources: skills, materials, equipment, ... D3/ Effectiveness of the implementation (including traceability) C1 / Evaluation of the efficiency of the process; A1/ Implementation of improvement plans; communication on results. 22/11/2018

03 Healthcare Quality and Safety Indicators

Mission - HAS works in conjunction with health professionals, users of the healthcare system and patients to develop health care quality and safety indicators (QSI). - The indicators assess the process or the outcome of care. They are set up to be used by healthcare organizations as quality improvement tools. - Data sources: patient records or ad hoc surveys (for process indicators) and administrative databases (for outcome indicators). 22/11/2018

Objectives of QSIs development QSIs developed for internal quality management by healthcare organisations are also used: in the accreditation program of healthcare organizations; for public reporting; to help the reporting and steering of interventional policies at national and regional level; as financial incentives for quality improvement programs. 22/11/2018

Cross-functional indicators Quality of the patient record - Applicable to medicine, surgery  and obstetrics; follow-up and rehabilitation care; home care hospitalization; and psychiatry Quality of anaesthesia record Multidisciplinary team meeting in oncology Nosocomial infection dashboard Satisfaction/Experience of patients hospitalised in medicine, surgery and obstetrics Radiology report Day surgery 22/11/2018

Speciality indicators Prevention and care of postpartum haemorragia; Initial care of stroke; In-hospital care of myocardial infarction; Care quality of chronic haemodialysis patients; Pre-operative care  for bariatric surgery in adults; Rate of deep vein thrombosis and pulmonary embolism after total hip or knee replacement. 22/11/2018