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THE ORGANISATIONAL CHANGES OF THE EXECUTIVE AGENCY FOR MEDICAL AUDIT BULGARIA

THE ORGANISATIONAL CHANGES OF THE EXECUTIVE AGENCY FOR MEDICAL AUDIT BULGARIA. Helsinki, 29-30.09.2015. Bulgaria. Territory: 111 000 km2 Population: 7  202 198 (2014) Ethnic distribution: Bulgarians: 83.0% Turks: 9.0% Roma: 3.0% Others: 6.0%. Republic of Bulgaria.

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THE ORGANISATIONAL CHANGES OF THE EXECUTIVE AGENCY FOR MEDICAL AUDIT BULGARIA

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  1. THE ORGANISATIONAL CHANGES OF THE EXECUTIVE AGENCY FOR MEDICAL AUDIT BULGARIA Helsinki, 29-30.09.2015

  2. Bulgaria • Territory: 111 000 km2 • Population: 7 202 198 (2014) • Ethnic distribution: • Bulgarians: 83.0% • Turks: 9.0% • Roma: 3.0% • Others: 6.0%

  3. Republic of Bulgaria In south-eastern Europe - part of the Balkan Peninsula Bordered: North Romania East Black sea West Serbia and The former Yugoslav Republic of Macedonia South Greece and Turkey

  4. Bulgaria Economic development • GDP (BGN): 82.16 billion leva (2014) • GDP: 42 billion Euros (2014) • GDP per capita: 5 832 Euros (2014) • Health expenditures per capita: 283 Euros (2014) • Health expenditures as % of GDP: 3.98% (2014)

  5. Health Population:7.2 million (2014) Live births:9.4 per 1,000 population (2014) Crude death rate:15.1 per 1,000 population (2014) Life expectancy:74.95 years Males at birth (2013): 71.3 years Females at birth (2013): 78.6 years

  6. Executive Agency for Medical Audit (EAMA) • Established in January, 2010 with Decree of the Council of Ministers as governmental institution under the MoH’s power • The EAMA supervises: • all types of healthcare establishments in the country • the National Health Insurance Fund (NHIF) with its 28 regional offices • the voluntary health insurance funds

  7. EAMA – Mission Continuous improvement of health care quality and safety. Constant control and monitoring of health care providers’ activitiesand also of the activities of compulsory and voluntary health insurance funds and motivates them to continuous improvement of their professionalism

  8. EAMA – Vision To stimulate changes in health care in order to guarantee accessof BG’s citizens to health care services of good quality, safety, efficiency and effectiveness

  9. EAMA – Values OurValues Innovations Arrangement M oral Otgovornost (responsibility)

  10. EAMA – Strategic Goals • To develop a system for total quality management at a national level; • To initiate the legislation for quality management; • To avoid the dissemination of corrupt health care practices; • To develop data base in the field of health care quality; • To develop medical errors’ reporting system; • To motivate all health care partners to work for quality improvement of health care services, etc.

  11. EAMA – Staff • The number of people working in the organisation – 68 • 4 Specialized and 1 Administrative Directorates • No regional offices

  12. EAMA Executive Director Deputy Director Chief Secretary Quality Assurance Directorate Medical audit of HC establishments Directorate Insurance & Patients Rights Directorate Administrative Directorate Financing & IT Medical audit of hospitals Insurance Rights Administration & Legislation Medical audit of out-patient care Patients Rights

  13. EAMA – Three stages in the development of the EAMA Ist stage: 2010 – 2013 • Q & PS issue; Q Strategy 2010-15; Q analyses • Patients Rights • Register of medical errors based on people’s complaints • Training of staff • Collaboration w/ other HC partners • Open to the public

  14. EAMA – Three stages in the development of the EAMA IInd stage: 2013 – 2015 • Administrative structure to the MoH • No Q & PS issue • No Q analyses • No collaboration w/ other HC partners • Limited staff training • Limited openness to the public

  15. EAMA – Three stages in the development of the EAMA IIId stage: 2015 – • Q & PS issue; up-date Q Strategy; Q analyses; Q indicators • Patients Rights • Medical Errors Reporting System at national level w/ UBGPs • Training of staff & HC professionals • Collaboration w/ other HC partners

  16. EAMA – Three stages in the development of the EAMA

  17. EAMA – Collaboration with HC Partners • The EAMA works with the following institutions and partners: • Ministry of Health; • Regional Health Authorities – 28; • NHIF/ RHIFs; • Executive Transplantation Agency; • Scientific Societies of Medical Professionals; • Union of BG Physicians / of BG Dentists; • Prosecutor’s Office of Bulgaria; • National Ombudsman; • Ministry of Justice; • National Social Security Institute; • Patients’ Organizations.

  18. EAMA – Q & PS • The Role of the EAMA for Q & PS monitoring • Developed checklists and inspects the performance of the health care establishments to assess the compliance to the requirements of the medical standardsand Health Care Act; • Periodically develops Q analyses related to a specific issue (i.e. AG, children, etc.) with recommendations for improvement; • Works with the Scientific Societies of Medical Professionals to implement improvement activities in their domains.

  19. EAMA – Q & PS • The Role of the EAMA for Q & PS monitoring • Future activities: • To work on development of Medical Errors Reporting System at national level together with the Union of the BG Physicians; • To work on development of List of Q & PS Indicators; • To work on methodology for hospital ranking; • To organize training and train HC professionals towards Q & PS

  20. EAMA – Organizational good practices • Organisational good practices: • Legislative initiatives for changes of the legislation towards Q & PS; • Very good collaboration with other HC partners; • Q improvement initiatives together with the Scientific Societies of Medical Professionals; • Openness to the public and media; • Questionnaire on the website for assessment of our clients’ satisfaction • Cons: • One centralized structure at national level w/o regional offices

  21. EAMA – Openness to the public and media • Publications of Q analyses and annual reports on the website: www.eama.bg; • Proactive to the media – flyers, explicative campaigns, press conferences; • Visiting hours to meet inspectors – every Thursday from 1 pm to 4 pm; • Questionnaire on the website for assessment of our clients’ satisfaction

  22. EAMA – Pros and Cons of the organizational solutions • Cons • Increased number of complaints • Increased workload of the inspectors • No increase of the human and financial resources • Pros • Put the Q & PS issue at the national level; • Involves HC partners in Q & PS initiatives; • Increases the awareness of the public and media towards Q & PS; • Legislative initiatives; • Increased trust

  23. EAMA – Conclusion The most important result from the EAMA’s activities is that fear and mistrust of the health care professionals from that institution were replaced by gratitude and appreciation because the aim of the EAMA is not punishment but to guarantee access to health care of good quality and safety, protection of patients’ rights and dissemination of good practices.

  24. THANK YOU FOR YOURATTENTIONwww.eama.bg

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