Evaluation program for supervision of public health, health care en medical product An example: Dutch health care inspectorate Evaluation program –Background –Content –Process –Results Collaboration

Mission and ambition Mission: the Health Care Inspectorate exists to promote public health by effectively enforcing the quality of care, prevention and medical products. Ambition: legitimate faith in Dutch health care by the public.

Four inspection priorities Promote quality of care (especially patient safety) Making prevention more effective Make the quality of delivered care more transparent Devote more – and more targeted – attention to vulnerable groups

The Health Care Inspectorate Relatively small inspectorate (approximately 370 FTE’s, including some 110 inspectors) professional practitioners, 3000 institutions, addresses 25 Acts of Parliament Costs: two euros per person per year

Background of the evaluation programma Supervision at the heart of political and public debate –Accountability –Legitimacy Supervisory authorities themselves ask about the effect of their work –Improvement of methods –Professionalizing inspectors

Does supervision works, what works, how does it work 3 themes –The role of supervision in the field of health care policy –Supervisory methods and instruments –Effects: (intermediate) outcome InspecteeInspectorateSociety Final Outcome InputTroughputOutputOutcome

Process Part of the long and short-term policy plans of the inspectorate Budget ( ,--) and Staff (3 FTE) Publication of results in scientific journals Learning organization Employee support and involvement –Inspectors have a change to write a thesis –Reservations about evaluation °Judging their work °Harming the authority of the inspectorate °Tranparancy paradox

Results 1 Completed Occupation of inspector Customer satisfaction survey, IGZ counter Quality reports. Effectiveness of IGZ limited by modest quality of reports. The effectiveness of supervision in coercive treatment by mental healthcare The IGZ and handling of reports of medical errors from members of the public Supervising the quality of heath care. An international comparison

Results 2 Studies in progress The role of inspectorates in suicide reports Study of the role of the medical Code of Practice in health care inspections Intra- and inter-assessor reliability of IGZ inspectors Study of the role of IGZ supervision in a changing legal/administrative context The effectiveness of Thematic Supervision and Risk based supervision.

Collaboration training placements for 8 master students Free University of Amsterdam and Erasmus University of Rotterdam –Special chair in ‘effectiveness of health care supervision’ Enforcement en Behavior research program of the Ministry of Justice Council of Dutch Inspectorates: long-term program ‘Effects of supervision’ EPSO???????