1. Continuing Professional Development of Health Professionals & Patient Safety 28 October 2016
Caroline Hager Team Leader Cross Border Cooperation Healthcare European Commission Health and Food Safety Directorate-General

2. Patient safety high on EU agenda:
2009
EU health ministers adopt Council conclusion on patient safety and quality of care, June 2014
European Parliament report on safer healthcare, April 2015
Council Recommendation on patient safety, 2009
2014
2015

3. Recognition of Professional Qualifications Directive & CPD
Under the PQD Directive, Member States are required to:
Ensure that professionals update knowledge, skills and competences to maintain safe and effective practice and to keep abreast of professional developments. (Article 22)
Report measures to the European Commission
by January 2016
Exchange information and best practice to ‘optimise’ CPD development – role of the Group of Coordinators

4. Mapping national approaches to CPD of health professions – January 2015
Comprehensive & comparative overview of CPD for health professionals in 31 European countries
Share good practice & facilitate a discussion: policy-makers, regulatory and professional bodies

5. - Financing and transparency - Barriers and incentives
EU Mapping Study on CPD
- CPD systems
- Accreditation
- Financing and transparency
- Barriers and incentives
- Patient safety and quality of care
- Trends in CPD structures
- European cooperation

6. 4 CPD systems in the EU
CPD is mandatory for all professionals practising
in a country. This is the most common situation for most health professions in most countries surveyed.
a voluntary CPD framework is in place
a voluntary CPD framework may in addition co-exist with a mandatory CPD requirement
No formal CPD structures exist . This is the least common situation
NOTE: Marked differences across the professions

7. CPD – Linked to licence review

8. CPD Systems - Conclusions
There is no evidence that one CPD structure is preferable to another
Mandatory and voluntary CPD encompass many different arrangements
Formal and informal CPD activities co-exist

9. CPD and Patient Safety
Very few studies, so lack of evidence on the impact of CPD on patient safety, care outcomes, clinical and professional practice. Out of 150 respondents to study survey, only 6 were able to share such studies.
CPD activities on patient safety are available to professionals, but mandatory content only in a minority of cases.
15 countries had a formal requirement to include patient safety modules in one or more types of education.
However, offer of CPD activities on patient safety seems to be increasing.

10. Recommendations CPD & Patient Safety
Exchange of best practice should be further supported – European cooperation should facilitate this.
Further research at European level on the impact of CPD activities on patient outcomes and patient safety should be undertaken.
Prioritise areas in CPD training where a clear patient safety issue has been identified such as the use of new technologies or recorded incidents of patient harm.
Patient safety should be embedded within the basic education of health professionals and be part of the working culture and environment.
Employers have an important role to play

11. Ticking the Boxes or Improving Healthcare? – Workshop 11 February 2016
What can we learn from research evidence, education and clinical practice?
What can we learn from national CPD models – England, Ireland, Sweden, France

12. What can we learn from research evidence, education and clinical practice?
measuring the effectiveness of CPD difficult to capture
CPD credits – no evidence of effectiveness
contextual variables need to be taken into account
evaluation of learning outcomes must focus on professional performance in real clinical practice
Audit and feedback → performance improvement
CPD activities may need to be prescribed:
structured peer-to-peer dialogue or coaching
can improve performance
Challenging for the regulators!
How to measure CPD effectively?
Evidence-based outcome research – lack of scientific evidence (Cochrane), but still! We need Parameters to measure → quantifiable components

13. What can we learn from research evidence, education and clinical practice?
Inter-professional education, multidisciplinary cooperation, coordinated care plan, improve communication, reduced risk, better care quality
Self-assessment tool: Interprofessional Practice and Education Quality Scales
Belgian intervention study in ICU
System change to overcome
professional resistance
IPE requires a system change to breakdown the barriers to IPE learning, overcome strong professional resistance and fears over loss of professional identity.
A short-term intervention study in a Flemish intensive care unit showed that high staff satisfaction and better communication through interprofessional collaborative practice led to a higher quality outcome, reducing the risk of errors and improving patient safety

14. What can we learn from research evidence, education and clinical practice?
Jeroen Bosch Hospital, Netherlands
new nursing leadership programme for continuous education for nurses
→ shared organizational vision + multiprofessional working context
Spanish “Zero project”
reduce hospital infections in intensive care units
training module for doctors & nurses
→ decreased incidents
NL outcome: They changed their behavior!
Spanish training module explaining the clinical recommendations and patient safety guidelines, targeted three areas “bactermia zero”, “neumonia zero” and “resistencia zero”.

15. What can we learn from national CPD models?
England
New system of revalidation of the nurses’ licences
Key success factor: Regulators work in partnership with the health professionals
Ireland
New system of revalidation for pharmacists
Key success factor: partnership between the regulated and regulator
The system aims to promote the integrity of nurses: nurses and midwives need to demonstrate that they are abiding by the Professional Code of Practice and Behaviour and that they undertake at least 35 hours of CPD every three years in order to re-register. The key to an effective revalidation process is the regulator working with the nurses and midwives in their mutual interest.

16. What can we learn from national CPD models?
Sweden
Creation of a learning environment to link professional development to better system performance & better patient outcomes
Key success factor: collaboration of different actors participating the „development dialogue”
France
Reform CPD system: High Council of CPD to update knowledge, evaluation of professional practice & risk management
Key success factor: Government working with national professional councils
Support to improve patient safety and quality of care

17. Workshop Conclusions: Lessons Learned (1)
Learning comes from the practice itself & no best method of learning to ensure better patient safety and quality of care.
Measuring the impact of CPD should focus on real clinical performance, not on attitude and skills. The quality of the CPD programme is not the only factor for success.
Difficult to find long-term indicators
on improved patient outcomes by CPD
due to the many dependent variables.
Real success when professionals start using the learnt skills

18. Workshop Conclusions: Lessons Learned (2)
Improving the patient safety culture depends on a range of factors – working environment, behavioural change
Collaboration & shared organisational vision – success factors
Revalidation links CPD hours with
peer support, practice-related
feedback & reflective process
Real success when professionals start using the learnt skills

19. European Cooperation
sharing expertise and knowledge to support national systems – "food for thought", inspiration and action
European health professional organisations
Social Dialogue in the hospital sector: European employer and trade unions
Real success when professionals start using the learnt skills

20. For further information http://ec. europa