Strengthening Health Care Quality in Slovakia: Results 2004-2005

1. Building Quality Development Programme in SlovakiaProject Results 2004-2005 Project financed by the Netherlands Government through EVD INTERNATIONAL MAT03/SK/9/1

2. Project purpose The purpose of the project is to strengthen the capacity of the Section Health Care of the Slovak Ministry of Health to guarantee that care providers can be monitored in a proper way Final Conference

3. Consortium working in project • Public Health Consultants/ Interaction in Health • University of Amsterdam/ Department Social Medicine • AGIS health insurance company • Trnava University/ Department of Health Management • Health Management School Bratislava Final Conference

4. Project results • Inventory and analysis of current situation in monitoring quality in health services • Development of process and institutional indicators • Development of guidelines and clinical indicators • Advice to MoH on implementation of quality monitoring in the Slovak Republic Final Conference

5. 1. Inventory and analysis • Overview legislation • New legislation in 2004 including quality • Health Care Surveillance Authority • Quality indicators required per law • Overview guidelines • Assessed with AGREE instrument • Overview indicators • PATH project Final Conference

6. 2. Development of process and institutional indicators • OECD indicators accepted for monitoring hospital performance • Ministry of Health indicators monitored • General Practitioners (Dalhuijzen) • Standards for practices developed in pilots and workshops Final Conference

7. 3. Development of guidelines and clinical indicators • Hospital and GP indicators (de Koning) • Tested in pilots • Agreed in workshops • Presented to MOH • Annual Quality Report Hospitals (Heijdelberg) • Guideline handbook (Rusnak) • Methodology for developing guidelines • Structure for NIKI institute (Lenartova) Final Conference

8. 4. Advice to MoH on quality monitoring in the Slovak Republic • Indicators presented • MOH meetings on indicators • World Bank report comments recommendations • Structure and functions NIKI • Laid down in Guidelines Handbook • Quality system advice • Presented to MOH Final Conference

9. Advice quality system in health • National level • Guidelines and standards • External quality assessment • Law enforcement • Institutional level • Quality systems in place • Monitoring and reporting • Individual level • Certification and registration • Continuing professional development Final Conference

10. National level quality system • Guidelines and standards • Minimum standards: certificate or licence to operate • Clinical Practice Guidelines consensus of practitioners • External quality assessment • Accreditation system (organisation to be formed under control of Health Care Surveillance Authority) • ISO certification • Law enforcement • Legal powers of HCSA to suspend or terminate Final Conference

11. Institutional level quality system • Quality systems in place • Quality coordinator • Quality committee • Quality systems (protocols, etc.) • Monitoring and reporting • Selection of indicators - monitoring system • Annual quality report Final Conference

12. Individual level quality system • Certification and registration • Re-registration after 5 years • CPD mandatory • Continuing professional development • Individual (literature) • Internal (clinical meetings, etc.) • External (courses, which are accredited) Final Conference

13. Final remarks quality of care • Governments can regulate, monitor, and… • Professional organisation can build capacity, provide information, but… • Individuals implement! Quality is a personal ambition! Final Conference