1. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Overall Introduction to Project Professor Hanne Tønnesen MD PHD & Nermin Ghith, MPH, PHD Student Shu-Ti Chiou MD PHD MSc Oliver Groene MSc PHD

2. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Overview Study aim Scope and purpose –Background Framework –WHO HPH Standards / Indicators –HPH DATA Model –HPH Doc Act Model –Other evaluated tools

3. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Study aim To evaluate whether a Recognition Process generates better health gain for patients and staff.

4. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Main hypotheses Hospitals departments allocated to the Recognition Process would after 1 year: –Improve health gain for patients and staff –Deliver more health promotion services compared to the departments allocated to the control group continuing routine clinical practice

5. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Background Clinical Health Promotion is a patient-centred approach in health care services. Improves the effect of treatment results and contributes to improved patient safety

6. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital HP effect on treatment outcome Postop complications (BMJ 1999) Alcohol cessation int. Colorectal Resection Postop recovery (Clin Rehab 2010) Physical exercise int. Spine Surgery Postop complications (Lancet 2002) Smoking cessation int. Hip/Knee Replacement

7. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Background HP is a key dimension of quality in hospitals, along with clinical effectiveness and patient safety World-wide, Hosp & HS implement QM, accreditation, certification and recognition

8. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Background Cont. Sparse literature on accreditation and quality improvement –1 Randomised Clinical Trials (RCT) evaluating impact of hospital accreditation on the quality of care at the national level in South Africa (Salmon JW, Heavens J, Lombard C, Tavrow P. Operations Research Results 2003;2:17)

9. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Background Cont. South African study: –2 x 10 hospitals Structural and process variables –Periodic measurement –Feedback to each hospital –Technical assistance Results: –Control 37% to 38% –Intervention 38% to 76% (Salmon JW, Heavens J, Lombard C, Tavrow P. Operations Research Results 2003;2:17)

10. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Background Cont. South African study: Nurse perception p=0.031 Patient satisfaction p=0.484 Medical evaluation p=0.395 MR accessibility p=0.492 MR completeness p=0.014 MR operation completeness p=0.489 Ward stock labelling p=0.112 Hospital sanitation p=0.641 (Salmon JW, Heavens J, Lombard C, Tavrow P. Operations Research Results 2003;2:17)

11. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Question Does accreditation improve the health service delivery and outcome ?

12. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Framework 1.Management policy of HP 2.Patient Assessment 3.Patient Intervention and Info 4.Promoting a healthy workplace 5.Continuity and cooperation Hospitals: Useful recommendable (Groene O, Jorgensen SJ, Fugleholm AM, Garcia Barbero M. Int J Health Care Qual Assur Inc Leadersh Health Serv 2005;18:300-7.

13. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Framework HPH DATA Model (St. 2) HPH Doc. HP Activities (St. 3) HPH Clinicians: Understandable, applicable & sufficient for our patients (high reliability) (Tonnesen H et al, BMC Health Serv Res 2007 + 2011 accepted)

14. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Other evaluative tools Short Form Health Survey (SF36): Physical, mental and social conditions (McHorney, Colleen A.; Ware, John E.; Raczek, Anastasia E. Med Care 1993; 31: 247-263)

15. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Design An RCT with hospital departments allocated to one of the two groups –Undergo the Recognition Process immediately = Intervention group –Continue their usual routine = Control group

16. WHO Collaborating Centre Evidence-Based Health Promotion in Hospitals & HS Bispebjerg University Hospital Overview Study aim Scope and purpose Background Framework WHO HPH Standards / Indicators HPH DATA Model HPH Doc Act Model Other evaluated tools