1. Empowering Patients in Patient Safety Anna Skat Nielsen The Danish Ministry of Interior and Health ani@im.dk

2. Danish Health Care System Three administrative levels National - Ministry of Interior and Health Regional - 5 regions (hospital owners) Municipal - 98 municipalities (home nursing, public health care, school health service, prevention and rehabilitation) The health care service organisation seen from the patient’s point of view:

3. Empowering Patients in Quality and Patient Safety Preconditions: Informed consent Right to information regarding filing complaints and insurance claims Quality and PS - joint effort between the three administrative levels and corporation with NGOs (e.g. Danish Society for Patient Safety and patient organisations)

4. Patient Empowerment Quality Improvement and Patient Safety Quality initiatives Patient Safety Reporting System Patient reporting of side-effects of medicinal products Other initiatives regarding patient empowerment – the Danish regions are planning initiatives using IT (e.g. patient’s acces to e-journal, letter to patients through the citizens’ electronic mailbox, text-messages regarding appointments with hospitals, etc.).

5. Webpage regarding Quality of Health Care The webpage www.sundhedskvalitet.dk (Quality of Health Care) gives both professionals and citizens the opportunity to compare the Danish hospitals.www.sundhedskvalitet.dk Purpose: To give the patients a better basis for choosing a hospital To present data regarding quality in an accessible way

7. Indicators at sundhedskvalitet.dk for Hospitals Coverage: 217 hospitals and clinics in Denmark 88 public hospitals (60 somatic, 28 psychiatric) 129 private hospitals and clinics (128 somatic, 1 psychiatric) 14 different indicators for hospitals 2 about the facilities 4 about hygiene 2 about patient-perceived quality 3 about patients’ satisfaction 3 about patients’ rights Total = grade for the hospital (*****)

8. Indicators at sundhedskvalitet.dk for treatment Data for 176 treatments/diseases with 1-14 specific indicators per treatment Grades for some treatments (*****)

9. Developing sundhedskvalitet.dk Aim of revision: attract more users – currently about 7.000 hits per month Revision in order to create a better tool for patients, patient health care guides/counsellors and general practitioners by making the layout of the webpage more accesible and by writing more explanations regarding the choosen indicators Will be coordinated with the webpage www.venteinfo.dk, where citizens can see the waiting time for treatments at the public hospitalswww.venteinfo.dk

10. Patient Safety Reporting System National reporting system Mandatory reporting of adverse events from secondary and primary health care sector, also including pharmacies, emergency medical services, nursing homes (2004/2010-implementation) Blame-free – the reporting individual may not as a consequence of reporting be submitted to disciplinary investigations and measures by the employer, the National Board of Health or penal sanctions by the courts

11. Reporting of Adverse Events Regions and municipalities handle and analyse the reports locally and afterwards forward them to the the National Agency for Patients' Rights and Complaints (anonymized) The National Agency for Patients' Rights and Complaints is responsible for the administration of the system for reporting adverse events within the health service, and helps to make sure that the knowledge gained from these incidents and patient and liability suits is used preventively.

12. Reporting from Patients and Relatives From September 1, 2011: Reporting from patients and relatives on the website www.dpsd.dkwww.dpsd.dk Information to patients and relatives through posters, leaflets and information from health care professionals.

13. Reports from Patients and Relatives Which information: 1.What happened (title and description) 2.Where and when 3.What was the consequence of the adverse event 4.Suggestions for improvement/prevention, including the patient’s opinion regarding the health care persons reaction to the adverse event 5.Information about the reporting patient/relative 6.Enclose documents if one prefers

15. Waiting for the First Results Regarding Reporting from Patients and Relatives Same categories? New suggestions for improvement and prevention?

16. Patients’ Reporting of Side-Effects of Medicinal Products Side-effect of a medicinal product or other healthcare product (e.g. blood product, tissues, cells or a medical device) Reporting from patients as well as health care professionals The Danish Medicines Agency evaluates the reports. The instructions on how to take the medicine may be changed as a result. Information is passed on to pharmaceutical authorities in all countries of the EU.

18. Reporting of Side-Effects National campaign at pharmacies and in cooperation with patient organisations – ”Report a side-effect” focusing on serious and unexpected side-effects of medicinal products Result of reporting of side-effects from patients and relatives – from approximately 560 in 2008 to 1,160 in 2010.

19. Campaigns by the Danish Society for Patient Safety Feedback postcards – write your opinion (local campaign) ”In the footsteps of a patient” – a management tool to watch the organisation through patients’ eyes Patients guide to Safer Health Care – ”Tools and tips for patients” and ten tips for patients (translated to English, available on www.patientsikkerhed.dk)www.patientsikkerhed.dk

20. Ten Tips for Patients 1 Speak up if you have any questions or concerns 2 Let us know about your habits 3 Take notes during your stay 4 More ears listen better 5 You can let somebody else handle your consultation 6 Check your personal data 7 Ask about your operation 8 Tell us if it hurts 9 Before discharge from hospital, remember to ask about how the treatment is to continue 10 Know the medication you are taking

21. Useful Links: The National Agency for Patients' Rights and Complaints: http://www.patientombuddet.dk/ http://www.patientombuddet.dk/ National Board of Health: http://www.sst.dk/http://www.sst.dk/ The Danish Society for Patient Safety: http://patientsikkerhed.dk/http://patientsikkerhed.dk/