1. Quality of Health Care in Slovenia Results of Quality assesment in operative gynecology and perinatology. Quality of Health Care in Slovenia Results of Quality assesment in operative gynecology and perinatology. prof.dr. Marjan PAJNTAR prof.dr. Marjan PAJNTAR Medical chamber of Slovenia

2. 2 Providing quality of health service in the Republic of Slovenia on the whole is a basic component of stability and perspective of the entire health service system development and shall be a distinctive preferential strategic aim of this area.

3. 3 The first operative step is recognition of the problem or imperfection. This requires continuous or periodical quality assessment.

4. 4 Our assessment is based on Quality Indexes, which can be calculated from data gathered and processed for this purpose.

5. 5 The quality indexes, as a system of control, provide distinction among individual institutions and individual doctors, issue guidelines to take measures.

6. 6 Project "Quality of health care in Slovenia" Medical Chamber of Slovenia Medical Chamber of Slovenia Ministry of Health Ministry of Health 1999 the begining, pilot study 1999 the begining, pilot study 2002 regular collection of the data. 2002 regular collection of the data.

7. 7 Scheme system

8. 8 Zagotavljanje kakovosti v zdravstvu, Okulistika: Operacija presenilnih in senilnih katarakt 01. Ime in priimek pacienta: 02. Številka popisa: 03. Ustanova in šifra ustanove:/ 04. Datum rojstva: // 05. Spol1 moški2 ženski Bolezni pacienta 06. Sladkorna bolezen1 da2 ne 07. Retinopatija diabetika neproliferativna1 da2 ne 08. Retinopatija diabetika proliferativna1 da2 ne 09. Krvni pritisk: / 10. Antikoagulantna terapija1 da 2 ne 11. Ostrina vida pred operacijo: 12. Očesni pritisk – tonus aplanacijsko: Spremembe na očesnem ozadju 13. Oftalmoskopski pregled1 da2 ne 14. Degeneracija makule1 da2 ne 15. Krvavitev mrežnice 1 da2 ne 16. Odstop mrežnice1 da2 ne Komplikacije operacije 17. Tip vstavljene intraokularne leče: 18. Poškodba zadnje lečne ovojnice: 1 da2 ne 19. Padec lečnega jedra v steklovino:1 da2 ne 20. Fibroza zadnje lečne ovojnice:1 da2 ne 21. Vnetje očesa po operaciji: zunanje 1 da2 ne notranje 1 da 2 ne 22. Sekundarni glavkom: 1 da2 ne Rezultati operacije 23. Vidna ostrina po operaciji brez korekcije: s korekcijo: 24. Zdravnik:št. Sheet protocol

9. 9 Internet (WWW) protocol

10. 10 Data communication with the server is secure (SSL protocol). Data are collected in the central SQL database. Data input and protection Each user has a username and a password for access to his own internet protocol.

11. 11 From year 1999 we have collected more than 200.000 questionaries

12. 12 We begane in 1999 with pilot study in 47 medical branches. Regular collection is from 2002 in 35 medical branches, 20 are doing well. Except for perinatology the data are collected voluntarily in 34 medical branches.

13. 13 Collection of perinatal data in NPISS is running from 1986. We are collecting more than 300 items of genetic data, pregnancy, delivery and neonatal period in all maternity hospitals (14) in Slovenia and is obligatory by law.

14. 14 Each department get results in statistical and grafical way for their department and with comparision with average result of all other departments. Analysis of quality indicators are made also for results of individual doctors with comparision to other doctors results. Each department get results in statistical and grafical way for their department and with comparision with average result of all other departments. Analysis of quality indicators are made also for results of individual doctors with comparision to other doctors results. Processing of the data

15. 15 We are collecting data in all departments in Slovenia for: Perinatology Gastrosurgery - Gall bladder Gynecologyc surgery (hysterectomy, adnexal lap.op.) Reproduction Torakal surgery (Ca Pullmonum) Infantile diabetes

16. 16 We are collecting data in many departments in Slovenia for: Internal intensiv care Operative intensive care Pneumonia – hospital aquired Nuclear medicine Oculistic-Operative cataracta Brest cancer surgery Pediatric nefrology Plastic surgery – carpal syndrom Psychiatry - sch Traumatology- hip op Urology, op benig. tumor prostatae Otolaringology- nasal polyp op Med. genetic

17. 17 In the last 5 years we have collected: More than 17.300 operative gynecological cases More than 76.000 perinatal cases

18. 18 q004 Gynecological operations Hysterectomy, laparoscopic adnexal operations

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24. 24 q028Perinatology

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28. 28 Measures Individual position, Individual position,

30. 30 Study Results of comparission between all deliveries with deliveries of healthy primipara Study Results of comparission between all deliveries with deliveries of healthy primipara

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34. 34 The best obstetricians

35. 35 Compliments for good work! For best departments For best departments For best individual doctors For best individual doctors Compliments for good work! For best departments For best departments For best individual doctors For best individual doctors Measures

36. 36 On-line collection

37. 37 Problems Motivation.Motivation. It is still great problem with motivation for partitipation. Many doctors are not aware that collected data serve themselves to asses their own results and to compare their results with other doctors with the other departments. Especially bad is in the departments where heads are not aware of importance of quality assesment. It is still great problem with motivation for partitipation. Many doctors are not aware that collected data serve themselves to asses their own results and to compare their results with other doctors with the other departments. Especially bad is in the departments where heads are not aware of importance of quality assesment. Financial problems of the project.Financial problems of the project.

38. 38 Conclusion There is no one who would do things in such a way that they could not be done better, and there is nothing that could not be still perfected. https://kakovost.mf.uni-lj.sikakovost@zzs-mcs.si Vesoljski teleskop Spitzer NGC 7293, objavljeno 12.02.2007