Professor Sue Hill OBE, Chief Scientific Officer for Englandrightcare
We are excited to introduce the NHS Atlas of Variation in Diagnostic Services, the latest publication in the series of impressive NHS Atlases, which have highlighted variation in the provision of healthcare services.
Diagnostic services are of great importance in the NHS because, when used correctly, they support or rule out potential diagnoses, and underpin the effective and efficient management of patient pathways.
Unwarranted variation in the rates of diagnostic testing is of the utmost relevance to individual patients with the over-use, as well as under-use, of diagnostic tests being potentially serious issues. For example, effective capacity planning in imaging services should enable improved patient access balanced against the need to avoid over-use of interventions that have the potential to cause harm, such as ionising radiation.
Insights from the National Diabetes Registry: User SatisfactionArunah Chandran
The National Diabetes Registry (NDR) is a web-based application to register diabetes patients in Malaysia. It is used in all Ministry of Health (MOH) health clinics and selected hospitals.
User satisfaction is an important factor to determine quality and effectiveness of service delivery to clients of a particular product or service.
Our objective was to examine user satisfaction towards NDR system usage.
Integrated Disease Surveillance Project (IDSP) was launched by Hon’ble Union Minister of Health & Family Welfare in November 2004 for a period upto March 2010. The project was restructured and extended up to March 2012. The project continues in the 12th Plan with domestic budget as Integrated Disease Surveillance Programme under NHM for all States with Budgetary allocation of 640 Cr.
A Central Surveillance Unit (CSU) at Delhi, State Surveillance Units (SSU) at all State/UT head quarters and District Surveillance Units (DSU) at all Districts in the country have been established.
Objectives:
To strengthen/maintain decentralized laboratory based IT enabled disease surveillance system for epidemic prone diseases to monitor disease trends and to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs)
Programme Components:
Integration and decentralization of surveillance activities through establishment of surveillance units at Centre, State and District level.
Human Resource Development – Training of State Surveillance Officers, District Surveillance Officers, Rapid Response Team and other Medical and Paramedical staff on principles of disease surveillance.
Use of Information Communication Technology for collection, collation, compilation, analysis and dissemination of data.
Strengthening of public health laboratories.
CHC15 - EHR adoption in a european environment and public management hospital...Carlos Sousa
SOURCE:
Invited speaker for CERNER HEALTH CONFERENCE, Educational Session, held during Oct 11-14 in Kansas City (MO) - US.
ABSTRACT:
After 13 years under private management, Hospital Prof. Fernando da Fonseca (HFF) committed to invest a solid EHR strategic approach aligned with best practices, due to management shift as public management hospital within the NHS network. HFF focused on creating a Clinical Commission for information that could support and lead the change on workflow and mindset of the hospital culture. This team combines the knowledge and experience of multidisciplinary roles, designing a EHR model that fully responds to the needs. Thus ensuring a successful phased implementation which started in the emergency department and was then deployed throughout the rest of the hospital. After three years of project, the hospital has achieved a high level (superior to 85%) of EHR adoption and has proven outcomes in the delivery of quality of care and Social ROI (e.g. direct data interoperability with medical emergency before hospital admission, algorithm implementation to improve organ donor and collection, integration with private clinics for outsourcing auxiliary services, including Lab and radiology prescriptions and results/reports). HFF continues to strongly work on this project and are dedicated to implementing their roadmap with the short term aim of achieving HIMSS Stage 6.
John Appleby, Chief Economist at The King's Fund, looks at the good, the bad and the inexplicable of NHS health care variations alongside our new report.
A decentralized system of disease surveillance for timely and effective public health action with a focus on functional integration of surveillance components of various vertical programmes.
Professor Sue Hill OBE, Chief Scientific Officer for Englandrightcare
We are excited to introduce the NHS Atlas of Variation in Diagnostic Services, the latest publication in the series of impressive NHS Atlases, which have highlighted variation in the provision of healthcare services.
Diagnostic services are of great importance in the NHS because, when used correctly, they support or rule out potential diagnoses, and underpin the effective and efficient management of patient pathways.
Unwarranted variation in the rates of diagnostic testing is of the utmost relevance to individual patients with the over-use, as well as under-use, of diagnostic tests being potentially serious issues. For example, effective capacity planning in imaging services should enable improved patient access balanced against the need to avoid over-use of interventions that have the potential to cause harm, such as ionising radiation.
Insights from the National Diabetes Registry: User SatisfactionArunah Chandran
The National Diabetes Registry (NDR) is a web-based application to register diabetes patients in Malaysia. It is used in all Ministry of Health (MOH) health clinics and selected hospitals.
User satisfaction is an important factor to determine quality and effectiveness of service delivery to clients of a particular product or service.
Our objective was to examine user satisfaction towards NDR system usage.
Integrated Disease Surveillance Project (IDSP) was launched by Hon’ble Union Minister of Health & Family Welfare in November 2004 for a period upto March 2010. The project was restructured and extended up to March 2012. The project continues in the 12th Plan with domestic budget as Integrated Disease Surveillance Programme under NHM for all States with Budgetary allocation of 640 Cr.
A Central Surveillance Unit (CSU) at Delhi, State Surveillance Units (SSU) at all State/UT head quarters and District Surveillance Units (DSU) at all Districts in the country have been established.
Objectives:
To strengthen/maintain decentralized laboratory based IT enabled disease surveillance system for epidemic prone diseases to monitor disease trends and to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs)
Programme Components:
Integration and decentralization of surveillance activities through establishment of surveillance units at Centre, State and District level.
Human Resource Development – Training of State Surveillance Officers, District Surveillance Officers, Rapid Response Team and other Medical and Paramedical staff on principles of disease surveillance.
Use of Information Communication Technology for collection, collation, compilation, analysis and dissemination of data.
Strengthening of public health laboratories.
CHC15 - EHR adoption in a european environment and public management hospital...Carlos Sousa
SOURCE:
Invited speaker for CERNER HEALTH CONFERENCE, Educational Session, held during Oct 11-14 in Kansas City (MO) - US.
ABSTRACT:
After 13 years under private management, Hospital Prof. Fernando da Fonseca (HFF) committed to invest a solid EHR strategic approach aligned with best practices, due to management shift as public management hospital within the NHS network. HFF focused on creating a Clinical Commission for information that could support and lead the change on workflow and mindset of the hospital culture. This team combines the knowledge and experience of multidisciplinary roles, designing a EHR model that fully responds to the needs. Thus ensuring a successful phased implementation which started in the emergency department and was then deployed throughout the rest of the hospital. After three years of project, the hospital has achieved a high level (superior to 85%) of EHR adoption and has proven outcomes in the delivery of quality of care and Social ROI (e.g. direct data interoperability with medical emergency before hospital admission, algorithm implementation to improve organ donor and collection, integration with private clinics for outsourcing auxiliary services, including Lab and radiology prescriptions and results/reports). HFF continues to strongly work on this project and are dedicated to implementing their roadmap with the short term aim of achieving HIMSS Stage 6.
John Appleby, Chief Economist at The King's Fund, looks at the good, the bad and the inexplicable of NHS health care variations alongside our new report.
A decentralized system of disease surveillance for timely and effective public health action with a focus on functional integration of surveillance components of various vertical programmes.
Research on consequences of cancer and its treatment on quality of life, symp...Nata Chalanskaya
Susanne Oksbjerg Dalton, Group Head, consultant, Danish Cancer Society Research Center, Danish Cancer Society, presentation at the Second International Scientific and Practical Conference «Improving the quality of life of cancer patients through the development of cooperation between state, commercial and non-profit organizations». 2018-01-23, Minsk. Belarus.
BPS DCP SIGOPAC Good Practice Guidance in Demonstrating Quality and Outcomes ...Alex King
This report outlines a rigorous, multidimensional framework for evaluating quality and outcomes in psycho-oncology services, which can be flexibly adapted to local needs and priorities.
It aims to challenge psycho-oncology services to develop and standardise procedures that address the clinical and operational aspects of quality, while maintaining a firm focus on the experiential.
The proposed framework focuses on six key domains of service quality:
- Is this service safe?
- Is this service equitable, while also focused on those most in need?
- Is this service timely and responsive?
- Is this service respectful, collaborative and patient-centred?
- Is this service offering effective interventions?
- Is this service contributing to efficient multidisciplinary care?
To address these domains, psycho-oncology services need to draw on multiple, convergent sources of data, including key performance indicators, activity levels, patient self-report measures, feedback from professional colleagues, etc.
Professor Kamlesh Khunti - Introduction to CLAHRC East MidlandsCLAHRC-NDL
Professor Kamlesh Khunti, Director of NIHR CLAHRC East Midlands - Introductory presentation given at CLAHRC East Midlands launch event, 14 February 2014, Loughborough.
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Better Care
Germain Bukassa Kazadi
Slides to accompany presentation by Prof Jourik Gietema, University of Groningen, Netherlands @UnivGroningen, as part of the "Examples of patient-oriented apps" panel.
Survivor Care: an app to enhance survivors’ quality of life
mHealth can help in innovating cancer care pathways: Prof Giatema’s app is a perfect example of how to mix scientific validated medical recommendations with the latest mHealth technology to provide cancer patients with state of the art and cost-effective survivorship care.
----
This was presented at the "Unleashing the mHealth potential for cancer patients" event held on Wednesday 25th May 2016 (16:30-18:30pm) in the European Parliament.
#mHealthCancer
"mHealth and eHealth are becoming realities in Europe: this is demonstrated by the growing size of mHealth apps’ market, by the raising investments in eHealth infrastructures and by the fast adoption, at various degrees, of mHealth applications by patients.
The burden of cancer is also raising: more than 10 million EU citizens are affected by cancer, incidence and prevalence are growing, and the socio-economic impact of cancer heavily burdens both healthcare systems and cancer patients.
The recent political agreement on the text the General Data Protection Regulation and the production of the Privacy Code of Conduct mHealth apps further stir the debate regarding the use of new mHealth technologies within cancer care pathways.
Are cancer patients enjoying the benefits of mHealth?
In which field can cancer patients profit the most from mHealth apps?
Is the regulatory framework supporting the development of useful and safe mHealth apps for cancer patients?
Are there other structural obstacles to the full integration of mHealth apps in the cancer patients’ journey?"
The event will be hosted by MEP Cristian-Silviu Busoi (EPP, Romania), one of ECPC closest champions within the European Parliament and a knowledgeable supporter of the development of eHealth/mHealth in Europe.
The event was followed by a cocktail reception.
Join the discussion on Twitter using #mHealthCancer The event is part of the initiatives for the
2016 European Week Against Cancer #EWAC2016
More information can be found on the European Cancer Patient Coalition's website:
http://www.ecpc.org/pressroom/events/icalrepeat.detail/2016/04/26/61/-/-
Children and Young People with Diabetes A National Approach to Improving Care and Outcomes
Dr Fiona M Campbell
Consultant Paediatric Diabetologist
Leeds Teaching Hospitals Trust & NHS Diabetes Clinical Lead for Paediatric Diabetes Network Development
NHS Improving Quality held an event in London on 31 July 2013 to progress the children and young people transition to adult services work with a focus on turning the rhetoric into practice entitled “Working to Define a Generic Service Specification for Transition”
Improving Care: More Method, Less Uncertainty, Impact summit 30 October 2013NHS Improving Quality
Improving Care: More Method, Less Uncertainty, Impact summit
30 October 2013
Improving Care: More Method, Less Uncertainty – Impact Summit, the second full day event in the Measurement Masterclass series, took place at the Central Hall Westminster in London on 30 October. The event was opened by Professor Sir Bruce Keogh and NHS IQ’s own Professor Moira Livingston, and included contributions from experts from across England and a virtual appearance by Dr Bob Lloyd.
This series for senior clinical leaders was developed to help increase the understanding of the principles of measurement for improvement. Designed to stimulate and challenge, it is supporting clinical leads in holding influential discussions with policy makers and data collectors.
To take the series forward and promote measurement for improvement more widely, NHS Improving Quality is setting up an advisory group to design and develop more learning resources for senior clinicians and their teams
More information: http://www.nhsiq.nhs.uk/capacity-capability/measurement-masterclass.aspx
Julie Henderson (Acting Head of Clinical Services) discusses the Clinical Audit Service:
- Clinical Leadership and Engagement
- Inclusive Approach
- Audit Measurement
This presentation includes two case studies:
1) National Diabetes Audit
2) National Lung Cancer Audit
Kirsimarja Raitasalo, THL: Miksi päihdehaittoja on tärkeää ehkäistä kouluissa ja oppilaitoksissa - Nuorten päihteidenkäytön yleiskuva. Ehkäisevä päihdetyö lasten ja nuorten hyvinvoinnin tukijana kouluissa ja oppilaitoksissa -verkkoaineisto sujuvamman työn tueksi -webinaari, 10.10.2022
Marke Hietanen-Peltola & Johanna Jahnukainen, THL: Miten opiskeluhuoltopalvelut tukevat hyvinvointia ja ehkäisevät päihdehaittoja. Ehkäisevä päihdetyö lasten ja nuorten hyvinvoinnin tukijana kouluissa ja oppilaitoksissa -verkkoaineisto sujuvamman työn tueksi -webinaari, 10.10.2022.
Riina Länsikallio, OPH: Päihdekasvatus ja ehkäisevä päihdetyö kouluissa ja oppilaitoksissa. Ehkäisevä päihdetyö lasten ja nuorten hyvinvoinnin tukijana kouluissa ja oppilaitoksissa -verkkoaineisto sujuvamman työn tueksi -webinaari, 10.10.2022
Jaana Markkula, THL, Ehkäisevä päihdetyö lasten ja nuorten hyvinvoinnin tukijana kouluissa ja oppilaitoksissa -verkkoaineisto sujuvamman työn tueksi -webinaari, 10.10.2022
What is the current Synthetic opioid situation in Europe? How can countries be better prepared and equipped for a continued rise in synthetic opioid prevalence, use, and incidents?
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
The Danish Experiences in Developing and Using National Quality Registries
1. The Danish Experiences in Developing and Using
National Quality Registries
Jan Mainz
Professor, Director, MD., Ph.D., MPA
2. Jan Mainz
• M.D., Ph.D., MPA
• Professor of Health Services Research and Quality
Improvement, Aalborg University Hospital
• Director, Psychiatry Region NorthDenmark
• Affiliated Professor, University of Haifa, Israel
• Affiliated Professor of University of Southern
Denmark
• Member, OECD Health Care Quality Indicator Expert
Group
• Member of WHO Strategic Planning Group on Quality
and Patient Safety
3. The Danish Healthcare system
• The Danish Health Care System is mainly
public owned and run
• The public health care services is financed by
taxes
• It is a fundamental principle, that all citizens
should have free and equal access to health
care services
• Freedom of choice of hospitals and general
practitioner
4. Denmark has unique opportunies for
quality measurement and benchmarking
• Denmark has Unique Personal Identifier
(UPI)
• Denmark has developed Health and National
Quality Registries
5.
6.
7. National quality improvement initiatives
• National clinical guidelines
• National clinical quality registries (databases)
• National patient satisfaction surveys in somatic
and psychiatic hospital and ambulatory care
• National relatives satisfaction surveys in psychiatic
hospital and ambulatory care
• National Agency for Patients` Rights and
Complaints and reporting of Adverse Events
• The Danish Health Quality Programme
• Public disclosure of quality of care data
8. Public disclosure of quality of care data
• The Danish e-health portal, sundhed.dk, is a
public, internet based portal that collects and
distributes health care information and
information on the quality of care,
• including waiting times at all hospitals and ratings
of hospitals, departments and clinical units among
the Danish residents and health care professionals
• At country, regional and hospital level
9. DK Clinical Quality Registries - Mission
• Improving prevention, diagnostics, treatment and
rehabilitation Improvement
• Documentation for clinical governance and
organisational priority setting Management/
Accountability
• Information for citizens and patients
Transparency
• Research infrastructure Innovation
10. Danish Clinical Registries - framework
• Mandated by law
• Mandatory national coverage (Record completeness)
• Contain information about individual patients
• Fulfilment of national criteria for functionality, data safety and
methodology
• Clinical ownership of and responsibility for content and analysis and
interpretation and ACTION (professional board for each registry)
• Financed by the Regions
• Information can be used for surveillance and improvement of
quality (and research)
• Provide accountability and transparency
11. The history of clinical quality registries
• 1976 First national registry (breast cancer)
• 2000 The National Indicator Project (10 diseases)
• 2010 Quality Improvement Programme (RKKP)
established
• 70 clinical registries
• Public funding
• Measuring the quality of care
• Public disclosure
12. Capture of relevant
data or direct
reporting by
responsible
clinicians
Clinical Registry
Real or virtual
Data analyses by
clinical
epidemiologists
Data transmission
via Internet
Clinical activities and
data registration Monthly/quarterly feedback to all
clinical departments and MIS
Feedback of risk adjusted data
once a year
National clinical audit -
or
Regional clinical audit
– or…
Quality
improvement
Important phases in the Danish Clinical Registries
Public release
13. Basic principles – Professional
ownership
• Health professionals develop evidence
based standards and indicators for major
diseases
• Health professionals assess and interpret
results before public release of data
• Based on scientific and transparent methods
17. Lung cancer survival rates 2003-2011
• 1 year survival 36,6 – 42,7 %
• 2 years survival 19,8 – 24,3 %
• 5 years survival 9,8 – 12,0 %
18. Improving the quality of schizophrenia
care in Denmark 2004-2014
Source:
1. Jørgensen M. Mainz J. Nordentoft M. Voldsgaard I. Johnsen SP. Improving quality of care
among patients hospitalized with schizophrenia: A nationwide initiative . 2015:
Psychiatric Services
19. 01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Psychopathology; specialist
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Psychopathology; interview
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Cognitive function
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Social worker
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Antipsychotic treatment
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Contact with relatives
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Psychoeducation
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Professional support
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Psychiatric aftercare
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Ongoing contact
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Suicide risk assessment
01
Proportion
2004
2005
2006
2007
2008
2009
2010
2011
Year
Overall quality of care
RESULTS – INDIVIDUAL INDICATORS 2004 -
2011
20. The lessons from Denmark
• The quality of care can be improved in a public
health care system
• No economic incentives
• But involvement and ownership of health
professionals
• Increasing political and management focus
• Transparency and accountability
• Danish Clinical Registries is part of the new
Danish Quality Program
21. CONCLUSION
The Quality of care has improved
substantially since systematic
monitoring and auditing was initiated in
Denmark.
26. Inequalities: Time of admission and
stroke mortality
Ref.: Kristiansen NS. Stroke. 2014;45:3663-9.
27. All criminal offences Nonviolent Violent
Total received
processes of
care, %
HR 95 CI HR 95 CI HR 95 CI
< 50 Reference Reference Reference
50-74 0.99 0.86-1.14 1.12 0.93-1.36 0.90 0.76-1.07
>= 75 0.86 0.75-0.99 0.93 0.76-1.14 0.81 0.68-0.97
Quality and Criminal incidents
Kilde: Gjørup Pedersen, C.; Olrik Wallenstein Jensen, S.; Paaske Johnsen, S.;
Nordentoft, M.; Mainz, J.: Processes of in-hospital psychiatric care and subsequent
criminal behaviour among patients with schizophrenia: A national population-based
follow-up study, The Canadian Journal of Psychiatry, 2013
28. Quality of care for medical comorbidities
among patients with schizophrenia
A Danish nationwide perspective
PhD defense by Mette Jørgensen
AALBORG UNIVERSITY HOSPITAL
PSYCHIATRY
Quality of care for medical comorbidities
among patients with schizophrenia
A Danish nationwide perspective
PhD defense by Mette Jørgensen
29. What the literature indicates regarding the medical
consequences of schizophrenia
• Excess mortality
• Excess morbidity
• Unfavorable lifestyle behaviors
• Insufficient care for medical comorbidities
30. Excess mortality in patients with schizophrenia
• Equivalent to a 10-20 years shortened life
expectancy than the general population
Brown S., Br J Psychiatry 1997
Crump C. et al., Am J Psychiatry 2013
Laursen TM. Schizophrenia Research 2011
31. Summary of all findings
• Small differences in the quality of diabetes,
heart failure and COPD care between
patients with and without schizophrenia
• Predictors of poor medical care included
patient- and system-related factors
• High mortality rates of heart failure and
COPD among patients with schizophrenia
32.
33. OECD review 2013
• Denmark is rightly seen as a pioneer in health care quality
initiatives among OECD countries. Over many years, it has
developed a sophisticated array of quality assurance
mechanisms.
• Denmark has impressive quality monitoring and
improvement initiatives.
• It has extensive databases on the processes and outcomes
of care.
• It can also boast many local clinical guidelines, national
guidelines and standards developed as part of disease
management programmes and pathways.
Source:
1. OECD reviews of Health Care Quality. Denmark. Raising Standards, OECD 2013.
34. OECD review 2013
• Primary care is a particular area of concern.
• At present, the lack of data on primary care
activity, compared to other health care sectors,
makes it difficult to know how effectively GPs
and other primary care professionals are
meeting community health care needs.
Source:
1. OECD reviews of Health Care Quality. Denmark. Raising Standards, OECD 2013.
35. JAN MAINZ
PROFESSOR - DIRECTOR -
MD - PHD - MPA
M: JAN.MAINZ@RN.DK
T: +45 25 57 90 33
35