QUALITY CARE FOR QUALITY AGING: EUROPEAN INDICATORS FOR HOME HEALTH CARE Pisa, September 30-31, 2010 Dario Zanon Azienda ULSS 10 “Veneto Orientale“ Veneto Region The Future of Primary Health Care in Europe III

Quality Care for Quality Aging: European Indicators for Home Health Care EU Consortium EU Consortium :12 partners 7 EU Countries Duration Duration: 18 months from January 2009 to June 2010 no cost extension of 3 months for dissemination Coordinator Coordinator: Regione Veneto / ULSS n.10 Veneto Orientale Co-funder Co-funder: EC DG Employement, Social affairs and Equal Opportunities Budget Budget : € EU contribution EU contribution: €

3 Decentralization Outsourcing Variety of providers Public Administration needs  better define the delegated services  define the quality expected from the services Societal challenges and services quality

The Project target 4 Home Care formal services :  Home Assistance  Home Health Care provided by Public Org. or by Private Org. on the basis of protocols and contracts with the public sector Targeted to non self sufficient individuals aged 65 and over

5 Project- Operational Objectives  Improve the knowledge base and the exchange of information about the HHC Systems in each Country Partner  Disseminate and transfer across countries, the best practices of quality assessment in HHC  Develop a set of monitoring, assessment and performance indicators on quality delivered in HHC

Theoretical Framework set of indicators Quality Dimensions Concepts Access Process … Satisfaction … Efficiency… Affordability Information and communication Needs assesment …… Indicator 1Indicator 2Indicator 3Indicator … 6 Access Efficacy Satisfaction Input Outcome Output Process Macroareas/ Concept Dimensions 40 dimensions Access procedure Access rate Affordability Assessment Continuity of care Coordination Coverage Data protection

Dimensions of quality in HC Access procedure CoverageHealth services Plan (individual care plan) Suitability of support services Access rateData protection HR (Human Resources) Plan fulfilmentSuitable HR AffordabilityDischarge Information and communication Prevention Support services Assessment Economic assistance IntegrationRecovery Supporting tools Assessment of needs Education (of staff) Lifelong learning Skilled HRTimeliness Bureaucratic barriers for asking the service Empowerment Maintaining at home Social assistance Tools (for case management) Continuity of care EqualityMonitoring Social capital, social network and trust in the system Turnover Coordination Evaluation of results PertinenceSocial servicesVisits

Level of analysis baseline assessment in-depth measurement

The set of the indicators  Not quality standards but quality indicators (and measures) to be used at local, regional and national levels  Only a “road map” to quality, a source of useful elements for measuring and improving quality  Must be adapted to local contexts 9

Home Care Indicators & Balanced Scorecard 10 The Learning & Growth Perspective (home-care workers) The Business Process Perspective (processes) The Customer Perspective The Financial Perspective framework for a full strategic planning and management system

Conclusion: other important issues Irregular work of care Technologies Structure Management Main quality

Conclusion: results Integrated social and health information systems are recommended to have quality indicators. The person and the assessment of the situation of the person’s multiple needs of care are the starting points for the development of the HC system as an integrated organizational system able to face the need of the continuity of care and to pursue a good, individualized efficacy of care. Job satisfaction, empowerment, multi-professional collaboration of the HC workers is crucial Prevention is an issue becoming more and more important. Quality and accessibility are strictly related.

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