Qualidade do Cuidado de Saúde e Segurança do Paciente (Healthcare quality and patient safety)

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Aula de Tracey Cooper, Presidente da International Society for Quality in Health Care (ISQua) no II Seminário Internacional sobre Qualidade em Saúde e Segurança do Paciente - evento do Qualisus - que ocorreu dias 13 e 14 de Agosto de 2013, no Ministério da Saúde, em Brasília.

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Qualidade do Cuidado de Saúde e Segurança do Paciente (Healthcare quality and patient safety)

  1. 1. Healthcare Quality and Patient Safety Brasilia August 2013 www.isqua.org
  2. 2. ISQua Background  Non-profit, independent organisation founded 1985, international office moved Australia to Dublin in 2008  Members from 70 Countries (Individual and Institutional)  Governed by Board of 10: North America, South America, Europe, Asia / Pacific regions  Honorary Advisors: patients, accreditation, education, research, low and middle income countries  Board Committees (Editorial Committee, Accreditation Council: CBA, Brazil)
  3. 3. International Reach
  4. 4. ISQua Accreditation Activity in South America 4  Health Accreditation Service, Columbia  CBA, Brazil 2013/2014  ONA, Brazil 2013
  5. 5. Strategic Alliances 5  WHO – Official Relations  Health Technology Assessment International (HTAi)  URC/USAID  International Hospitals Foundation  Institute for Healthcare Improvement (IHI)
  6. 6. High Reliability Healthcare
  7. 7. WHO Facts about patient safety  In developed countries up to 10% of patients may be harmed while receiving hospital care  Risk of health care-associated infection in some developing countries is up to 20 times higher than in developed countries  In some countries, proportion of injections given with syringes/needles reused without sterilization is up to 70%. Unsafe injections cause 1.3 million deaths annually. 300,000 die in India from dirty syringes and 30% are reused  > 50% of medical equipment in developing countries is unusable, or only partly usable, and can result in serious injury or death  There is a 1:1,000,000 chance of a traveller being harmed in an aircraft. There is a 1:300 chance of a patient being harmed during health care
  8. 8. Key Ingredients Safety Quality Reliability Culture of Learning Informed Decision-Making It’s all about….
  9. 9. “Systems and processes are only as good as the people who work within them”
  10. 10. COMMUNICATIONS RELATIONSHIPS BEHAVIOURS MULTI-DISCIPLINARY TEAM WORKING CULTURE LEADERSHIP
  11. 11. Title Slide • Bullet Point 1 • Bullet Point 2 • Bullet Point 3 • Bullet Point 4
  12. 12. Leadership – Country Level  Understanding the population priorities for health and ‘social’ care  Aligning policy, strategy and resources for maximum overall population benefit  Developing and planning the workforce – building capacity and capability  Engaging with managers, clinicians and patients to mobilise for safety and quality improvement  Liberating the patient to safeguard their care and clarify expectations for safe services  Effective regulatory framework - responsive, pragmatic and proportionate
  13. 13. Global Context
  14. 14. Global Trends 1: Demographic  Economic slowdown  Globalization of diseases  Urbanization  Global mobility: professionals and patients (Regional strategies, health tourism)  Aging population: By 2050: - people over 65 ~= children < 14 - >50’s population increase from 1.4 to 3.1 billion  Social care and support: older people, children, people with a disability
  15. 15. The Speed of Population Aging Time required or expected for percentage of population aged 65 and over to rise from 7 percent to 14 percent Source: Kinsella K, He W. An Aging World: 2008. Washington, DC: National Institute on Aging and U.S. Census Bureau, 2009.
  16. 16. Global Trends 2: Quality and Safety  Universal health coverage and integrated care  Reducing inequalities  Quality and safety frameworks: standards, measurement and evaluation – accreditation, licensing  Informed decision-making: Cost, clinical and comparative effectiveness. Health Technology Assessment: We should treat where there is evidence of benefit and not treat where there is evidence of no benefit (or harm)  Measuring performance and outcomes  Optimising technology solutions
  17. 17. Regulating for Improvement
  18. 18. Regulating for Improvement  Core element to quality and safety agenda  Clear coherent quality and safety framework: legislation ~ standards ~ guidance  Outcome-based standards and assessment  Focus on the important…support…and persist  Not there to manage the system’s comfort zone  ‘Safety ripple-effect’ in everything we do: wider system learning  ‘Minding the safety gap’ between Regulators
  19. 19. Get it safe.. ..keep it safe.. ..and then we’ll build quality
  20. 20. “The future depends on what we do in the present.” Mahatma Gandhi

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