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Australia - Patient Safety in Primary Health Care. Discussion Paper and Consultation

The Australian Commission on Safety and Quality in Health Care is seeking to clarify its understanding of patient safety issues in primary health care, including identifying key priorities and solutions both nationally and internationally that could be applied to the Australian primary health care context. A draft discussion paper on Patient Safety in Primary Health Care has been developed for public consultation. The findings of this consultation process will be used to inform the Commission's consideration of activities it could undertake or support to strengthen patient safety in primary health care in Australia.

Canada - The Case for Investing in Patient Safety in Canada

This analysis by the Canadian Patient Safety Institute (CPSI) determines that Canada experiences an average of 400,000 patient safety incidents each year that kill around 28,000 Canadians and generate $2.75 billion in extra healthcare costs. After describing Canada’s situation, the analysis discusses successful patient safety initiatives in the US, Scotland and Holland, and shows how increased investment would benefit patient safety in this country.

Canada - 2010 Canadian Health Accreditation Report: Through the Lens of Qmentum - Exploring the Connection between Patient Safety and Quality of Worklife

Accreditation Canada's 2010 national report on health care in Canada explores the connection between quality of work life and patient safety in health organizations. The report also examines the relationship between health care staff perceptions of work climate and patient safety culture in their own organizations, and how those perceptions are useful in identifying patient safety issues.

Europe - Patient safety: progress made, more needed

A patient safety package published on June 19, 2014, by the European Commission highlights how the Commission and EU countries are addressing the challenge of patient safety, progress made since 2012 and barriers to overcome to further improve patient safety. Systems are being put in place for patients to report adverse effects, but progress must still be made in patient empowerment and the education and training of healthcare workers.

UK - Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives

This study conducted at 46 British healthcare sites describes the reactions of primary care staff to a new Patient Safety Toolkit comprised of six tools: a system of rapid note review, a staff survey, a patient safety questionnaire, prescribing safety indicators, a medicines reconciliation tool, and a safe systems checklist. Study participants favoured tools that provided relevant information with a minimal impact on resources.

International - Safer Healthcare. Strategies for the Real World

In this book, the authors argue that we need to see safety through the patient’s eyes, to consider how safety is managed in different contexts and to develop a wider strategic and practical vision in which patient safety is recast as the management of risk over time. The authors, Charles Vincent from the University of Oxford and René Amalberti from the HAS in France, conceived of the book as they looked at the considerable safety implications inherent in technological and organizational changes underway in health care.

Europe - Costs of unsafe care and costeffectiveness of patient safety programmes

This European Union (EU) study investigates the costs of unsafe care and the cost-effectiveness of patient safety programs. It finds that up to 17% of EU patients experience adverse events, up to half of which are preventable, at a cost of €21 billion. Calculating the return on investment for two safety programs suggests EU-wide savings of €300 million for a program to reduce adverse events and €6 billion for an electronic medication ordering system.

Ireland - Minister for Health announces major package of patient safety reforms

Ireland’s Minister of Health has announced plans to increase the powers of the Irish patients’ ombudsman’s office and introduce comprehensive patient safety legislation. The measures also include proposals for an annual patient experience survey and the creation of a national patient safety office and patient advocacy service.

Improving and measuring quality of care

Brief analytical summaries or syntheses #8 Improving and measuring quality of care Summary This publication presents new data on patient safety in OECD countries and shows that significant variations in quality of care persist in cancer, acute myocardial infarction and stroke, as well as in services provided by family physicians. The report looks at how countries can improve the measurement of quality, the balance between privacy and transparency in matters of quality and safety, and links between quality indicators and policies to improve the performance of physicians, hospitals and the health system as a whole. Background Health systems face important challenges today an increasingly complex case mix, greater demand for health care services (especially for chronic diseases) and an economic context in which improvements in care must come at the lowest possible cost. Measuring the quality of care becomes increasingly important in this context. Poor quality care undermines the goals…

Medical Tourism: Treatments, Markets and Health System Implications: A scoping review

Brief analytical summaries or syntheses #28 Medical Tourism Treatments, Markets and Health System Implications A scoping review Summary This broad OECD review examines what is currently known about the flow of medical tourists between countries and discusses the interaction of the demand for, and supply of, medical tourism services. It highlights the different organisations and groups involved in the industry. It highlights treatment processes (quality, safety and risks) and system-level implications for countries of origin and destination (financial issues, equity and the impact on providers and professionals of medical tourism). Background The global growth in the flow of patients and health professionals as well as medical technology, capital funding and regulatory regimes across national borders has given rise to new patterns of consumption and production of healthcare services over recent decades. A significant new element of a growing trade in healthcare has involved the movement of patients across borders in…

Canada - Alberta: Quality and Patient Safety Dashboard Indicators

Alberta Health Services announced a new “dashboard” of measurements designed to gauge its performance and drive improvement throughout the health system. The Quality and Patient Safety Dashboard will measure 26 quality- and safety-related indicators and identify potential areas for improvement. The Alberta Health Services Board, through its Quality and Safety Committee, will monitor the dashboard on a regular basis. About half of the dashboard indicators will be reported in 2010, with the remainder reported by 2013, as some indicators require the implementation of a program or data collection processes.

Canada - Effective Governance for Quality and Safety

Commissioned by the Canadian Health Services Research Foundation in partnership with the Canadian Patient Safety Institute, this report, prepared by a team of researchers led by Ross Baker, explores the structures, processes and tools used by effective governing boards of healthcare organizations, and the strategies and tactics that can be employed by boards in their efforts to improve governance for quality and patient safety. The report also offers recommendations for board members and executives of healthcare organizations and for policy makers.

International - The economics of patient safety. Strengthening a value-based approach to reducing patient harm at national level

Using WHO data to estimate the international health and economic costs of patient harm, this paper finds that one in 10 of the world’s patients are harmed by health care. After examining patient safety measures in 34 OECD nations, the authors conclude that organizational and local initiatives are vital, as is a culture conducive to safety.

Australia - Expanding healthcare quality and patient safety reporting across Queensland’s health system

Prepared for the government of the Australian state of Queensland, this paper discusses the benefits of increasing healthcare quality and safety reporting across the state’s health system. Using Australian and international comparators, it provides evidence that expanded reporting will positively affect health outcomes, professional practice, system administration and cost-effectiveness. The paper proposes extending common reporting measures to Queensland's network of private hospitals.

International - Visibility: The New Value Proposition for Health Systems

One of the main challenges facing healthcare systems is patient safety: medical errors are now the third leading cause of death in North America. This report from the World Health Innovation Network (WHIN) proposes a new direction to improve patient safety and performance.

France – National program for patient safety

The Ministre des affaires sociales et de la santé of France has launched a multi-year 2013-17 program to unite the activities of public authorities around four priorities in the field of patient safety.

Ireland - Minister for Health and Children, Mary Harney, launches Patient Safety First Initiatives

The Minister for Health and Children, Mary Harney, T.D along with other key participants, recently announced a number of significant initiatives including the establishment of a new National Framework to drive Clinical Effectiveness through which patients will be assured of the provision of high-quality care based on established best practice. The Minister and other stakeholders also signed the ‘Patient Safety First’ declaration of commitment as part of the National Framework for Clinical Effectiveness.

USA - Leading a Culture of Safety: A Blueprint for Success

This guide was developed to provide healthcare leaders a tool for assessing and advancing their organization’s culture of safety. It can be used to help determine the current state of an organization’s journey; inform dialogue with the boards and leadership teams; and help leaders set priorities. The guide contains both high-level strategies and practical tactics.

Lunch hour conferences 2013

22_mai_2013.pdf Towards greater equity and better results in mental health in Québec perspective of the Commissaire à la santé et au bien-être regarding improvements in the performance of the health and social services system. March 13, 2013 By Jacques E. Girard, Deputy Commissioner for Assessment and Analysis The CSBE’s 2012 Report on the Performance Appraisal of the Health and Social Services System includes 5 major recommendations and 15 specific actions to improve the performance of the health and social services system in this sector, with the aim of consolidating knowledge gained in recent years and better responding to the needs of persons with mental disorders, in particular, with regard to front-line services. Following an outline of the key findings, the presentation will highlight the need to re-examine the allocation of mental health resources for an optimal supply of services, with an emphasis on continuity, collaborative health care and the provision…

UK - How is success achieved by individuals innovating for patient safety and quality in the NHS?

In this study, researchers interviewed 15 National Health Service (NHS) professionals who had received a national award for developing healthcare innovations improving patient safety or quality. Four themes emerged from the data: personal determination, an ability to broker relationships and navigate organizational culture, and the effective use of evidence to influence others. Focus and persistence were important personal characteristics.

New Zealand - New health data will help drive improvements in patient safety

This report from the Health Quality and Safety Commission of New Zealand provides data on the quality and safety of care in each District Health Board (DHB). Measures include falls, healthcare-associated infections, hand hygiene and perioperative harm and enable comparison between different DHBs and a view of progress made in each against baseline measures.

USA - National patient safety efforts save 87,000 lives and nearly $20 billion in costs

This report by the Department of Health and Human Services (HHS) estimates that 87,000 fewer US hospital patients died and nearly $20 billion in healthcare costs were saved as a result of a reduction in hospital-acquired conditions between 2010 and 2014. The data shows demonstrable progress in improving patient safety in hospital settings.

Canada - How to Effectively Engage Patients in Patient Safety: New Guide available

Written by patients and providers for patients and providers, the Guide was developed in collaboration with patients and patient engagement experts from across Canada. It is designed for use in all healthcare settings. Published by the Canadian Patient Safety Institute, the guide includes four sections: evidence, challenges and enablers that support patients as partners; patient engagement at the point of care; patient engagement at organization and system levels; and evaluating patient engagement.

Canada - Safer cancer care for Ontarians

The 2017 Cancer System Quality Index (CSQI), released May 17, 2017 by the Cancer Quality Council of Ontario, identifies several improvements to safety this year within the cancer system. There were fewer perforations during colonoscopies, better drug ordering for chemotherapy, and increasing use of peer review among radiation oncologists across Ontario, increasing quality assurance and safety within the system.

UK - Health Secretary Jeremy Hunt recently set out the Government’s plans to help prevent future failures of care and safety at NHS hospitals

Hospitals in the National Health Service (NHS) with the highest standards of patient care and safety will be partnered with hospitals placed under "special measures" due to high mortality rates, and will be reimbursed for the time spent bringing their partner up to standards. Additional measures are also foreseen to deal with hospitals that do not achieve good ratings.

Sweden - A Star Performer in the Eyes of an Emerging Health Leader. Lessons in Quality and Patient Safety

Every year, the Canadian College of Health Leaders (CCHL) takes Canadian health sector leaders on study tours of Sweden’s healthcare system. This report on the 2012 tour provides an overview of Swedish health care, compares health indicators, and discusses lessons learned from Sweden’s performance in the areas of quality and patient safety.

International - How to do better health reform: a snapshot of change and improvement initiatives in the health systems of 30 countries

This article discusses a book entitled "Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships and Prospects in 30 Countries" that analyses the impact of reform initiatives on the quality and safety of care in low, middle, and high-income countries. Reforms in less well-off countries include boosting equity, providing infrastructure, and reducing mortality. Richer countries largely focus on developing new information technology systems and innovative funding models.

USA - HHS Health IT Safety Plan open for public comment

In December 2012, the US Department of Health and Human Services (HHS) released the Health IT Patient Safety Action and Surveillance Plan, a report on the ways health information technology can eliminate medical errors, improve quality of care, and make health care more efficient. The plan builds on a 2011 report from the Institute of Medicine (IOM).

International - Contribution of quality management systems for patient safety: international panorama

This systematic review, published in Pratiques et Organisation des Soins, aimed to identify the contribution of international quality management systems in patient safety.

USA - The Evolving Role of Emergency Departments in the United States

This RAND Corporation project was performed to develop a more complete picture of how emergency departments (EDs) contribute to the US health care system. It explores the evolving role that hospital EDs play in evaluating and managing complex and high-acuity patients, serving as the major portal of entry to inpatient care, and providing “the safety net of the safety net” for patients who are unable to get care elsewhere.

International Profiles of Health Care Systems

Brief analytical summaries or syntheses #32 International Profiles of Health Care Systems Summary This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the U.S. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views. Background The Commonwealth Fund is a private foundation that promotes a high performance health care system providing better access, improved quality, and greater efficiency. The Fund carries out…

International - WHO launches global effort to halve medication-related errors in 5 years

The WHO has launched an initiative to reduce medication-associated harm in all countries by 50% over the next five years. The Global Patient Safety Challenge on Medication Safety lays out ways to improve how medicines are prescribed, distributed and consumed. The global cost of medication errors has been estimated at $42 billion US annually.

International - Regulating quality and safety of health and social care. International experiences

This report provides an overview of regulatory strategies and actors that different systems employ to govern safety and quality in health and social care. The countries reviewed provide examples of systems that vary in the way that health and social care services are organised and financed.

International - Improving Value in Health Care. Measuring Quality

This report gives new evidence on patient safety across OECD countries, and shows that large variations in quality of care remain for cancer, stroke, heart attacks, and services provided by family doctors. It addresses the various ways countries can improve measuring quality; the need for a balance between privacy concerns and transparency on quality and safety and how links can be made between quality indicators and policies to improve the performance of physicians, hospitals and the health care system as a whole.

Europe - Health and safety at work: Strategic Framework sets out EU objectives for 2014-2020

In this document, the European Commission sets out a plan to better protect workers in the European Union from work-related accidents and disease. Three major challenges are to improve implementation of existing health and safety rules, improve the prevention of work-related diseases, and take account of the aging of the workforce.

UK - Consultation on proposed regulations on “duty of cooperation” relating to sharing information about the conduct or performance of health care workers to protect patient safety

The UK Department of Health is consulting on draft regulations which will impose duties on designated bodies, including employers and contractors of health care workers, in all sectors, and regulatory bodies, relating to sharing information about the conduct or performance of health care workers to protect patient safety.

France - Out-of-Pocket Maximum Rules under a Compulsory Health Care Insurance Scheme: A Choice between Equality and Equity

Using the microsimulation model ARAMMIS, this study attempts to measure the impacts of introducing an out-of-pocket (OOP) maximum threshold, or a safety net threshold, on consumer copayments for health care financed by the abolition of the Long-term Illness Regime (ALD) in France. The analysis is based on a comparison of different safety net threshold rules and their redistributive effects on patients’ OOP payments.

Canada - Never Events for Hospital Care in Canada

This report published by Health Quality Ontario presents the collective work of the National Patient Safety Consortium to identify, for the first time, a list of 15 never events for hospital care in Canada. Never events are patient safety incidents that result in serious patient harm or death and that are preventable using organizational checks and balances.

Canada - Home Care in Canada: Advancing Quality Improvement and Integrated Care

This report from Accreditation Canada and the Canadian Home Care Association tracks the evolution of home care in Canada and highlights results achieved in the context of Accreditation Canada's QMENTUM program. It features tools to assess governance and safety culture, presents best practices and looks at future directions.

Canada - Accelerating Health System Transformation in Saskatchewan: Lessons Learned from the Saskatchewan Surgical Initiative

In 2010, the Saskatchewan government set out to transform the surgical patient experience through an ambitious multi-year, system-wide strategy. While the Saskatchewan Surgical Initiative (SkSI) placed strong emphasis on wait time reduction for elective surgery, the breadth of the initiative also gave priority to quality, safety, patient experience, and sustainability. Through the systematic exploration of a single policy case study—the SkSI—this research published by the Foundation for Healthcare Improvement identifies the critical factors that facilitate and inhibit major health system change.

Canada - Ambulatory EMR Use Delivers Health System and Patient Benefits

According to a study by Canada Health Infoway, electronic medical record (EMR) use in ambulatory care is yielding benefits in improved patient safety and clinic efficiency. The study found that 57% of clinics using EMRs report quality improvements and that 1.2 million additional patient visits in 2015 resulted from enhanced efficiency.

Canada - Greater efficiencies realized in Ontario's cancer system

The Cancer Quality Council of Ontario has released findings from the 2016 Cancer System Quality Index (CSQI) that measures the performance of the province’s cancer system. The findings indicate that efficiencies, such as new cancer treatment centres, have begun improving patient outcomes and safety by enabling greater capacity in the system.

UK - Public health responses to an ageing society: opportunities and challenges

This British article outlines the opportunities and challenges faced by England’s aging society and public health structures. It provides examples of both good practice and potential pitfalls, and stresses eight local public health policies to reduce costs and improve older peoples’ health. The policies concern smoking, exercise, nutrition, road safety, housing, loneliness, immunization and falls.

Canada - Portrait of rural emergency departments in Québec and utilization of the provincial emergency department management Guide: cross sectional survey

Rural emergency departments (EDs) constitute crucial safety nets for the 20 % of Canadians who live in rural areas. Pilot data suggests that the province of Québec appears to provide more comprehensive access to services than do other provinces. A difference that may be attributable to provincial policy/guidelines “the provincial ED management Guide”. The aim of this study was to provide a detailed description of rural EDs in Québec and utilization of the provincial ED management Guide.

International - Public reporting on quality, waiting times and patient experience in 11 high-income countries

This article published in Health Policy maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, the authors found that the data most commonly made available to the public are on waiting times for hospital treatment, with Information on patient experience at hospital level also made available in many countries.

Canada - Variations in Quality Indicators across Ontario Physician Networks

This chartbook from the Institute for Clinical Evaluative Sciences (ICES) in Ontario reports performance levels for a set of quality indicators that reflect health care delivery across settings of primary and specialty care, acute hospital care and long-term care, as well as shared care and transitions from one setting to another. The quality indicators include screening and prevention, evidence-based medications, drug safety, hospital to community transitions, adverse outcomes, imaging and cancer end-of-life care.

Belgium – Implementation of Hospital at Home: Orientations for Belgium

This scientific report from KCE analyses the effectiveness and the safety of different international models of hospital at home (HAH). It explores practical considerations regarding the coordination of the care plan, patient and family empowerment, as well as workforce, financing, information technology and other supports required to implement HAH in Belgium.

Belgium - Publicly Funded Practice-Oriented Clinical Trials

This report by KCE researchers looks at the advisability and feasibility of the Belgian healthcare system financing practice-oriented clinical trials. The definition of clinical trial is broadened out to include not just registered trials, but also those concerned with safety and efficacy, medical devices, lifestyle interventions, surgical techniques, diagnostic technologies, etc. The authors consider that the sustainability of public healthcare systems increasingly relies on making evidence-based choices about what to cover.

USA - A Framework for Safe, Reliable, and Effective Care

This white paper from the Institute for Healthcare Improvement describes the framework's two foundational domains: culture and the learning system. The paper defines key strategies for developing leadership, psychological safety, accountability, teamwork and communication, negotiation, transparency, reliability, improvement and measurement, and continuous learning. It further discusses the engagement of patients and families as the engine that drives progress toward safe and effective care.

International - Learning from high risk industries may not be straightforward: a qualitative study of the hierarchy of risk controls approach in healthcare

The hierarchy of risk control approaches (HRCA) is used in high-risk industries to rank the effectiveness of safety interventions. This study in four UK hospitals examined whether HRCA could be fruitfully applied to health care.

International - The Impact of Supply Chain Transformation in Global Health Systems

Changing supply chain processes improves safety, quality and performance in health systems. Examining the impact of transformations to health system supply chain infrastructure in Canada, the UK and the US, the research reveals that substantial savings can be achieved through inventory optimization and waste reduction, while automation can increase clinician time for patient care.

UK - Thinking on its own: AI in the NHS

Commissioned by the National Health Service (NHS), this report examines areas where artificial intelligence (AI) could help the NHS become more efficient and deliver better outcomes for patients. It highlights the main barriers to the implementation of AI across NHS providers and services, and makes 15 recommendations for potential solutions. The report addresses public safety and ethical questions relating to AI.

France – Government adopts the 2018-2022National Health Strategy

The national strategy, adopted in autumn 2017, will be implemented in national plans and in programs and projects defined by regional health agencies (ARS) on each territory. It focuses on four priority areas: the development of a health promotion policy; the fight against unequal access to health; quality, safety and pertinence of care; and innovation to transform the system by reasserting the role of users.

Canada - National Survey of Nurses' Perspectives on Safe Home Care

The Canadian Federation of Nurses’ Unions (CFNU) has released a nation-wide survey of nurses’ perspectives on home care. The survey of 1,116 home care and long-term care nurses provides insight into the home care client population and service quality. Most of the surveyed nurses agreed that there are safety concerns in home care at present.

UK - New shift worker guidance

Healthcare employees are often assigned shift work that can affect sleeping patterns. The UK National Health Service (NHS) developed this guidance that highlights key health, safety and wellbeing issues associated with the risks of shift work. The guidance includes information on organizational and individual management of risk and ways to optimize workers’ wellbeing.

UK - NHS launches plan to improve patient care by cutting long hospital stays

The National Health Service (NHS) in England has announced plans to cut unnecessarily long hospital stays by 25%, freeing up more than 4,000 beds. Nearly 350,000 patients spend more than three weeks in hospital each year, taking up a fifth of all available beds.

France - Healthcare establishments - 2018 edition

Les établissements de santé - édition 2018 This annual publication provides a summary of data on healthcare establishments in France. It offers key figures on hospital activity and capacity, personnel and remuneration. Quality and safety indicators are detailed alongside financial results. Information is presented in 35 thematic sections, with tables and charts.

UK - The Promise of Healthtech

This report examines how digital innovators are transforming the National Health Service (NHS) via the development and adoption of cloud computing, 3-D printing and genomics. The authors surveyed hundreds of private health technology start-up companies to determine key barriers to new technology acquisition by the NHS. Slow procurement policies, undefined safety standards, limited digital skills, poor interoperability and lack of clarity about evidence were all factors.

Europe - Health system performance assessment in the WHO European Region: which domains and indicators have been used by Member States for its measurement?

Health systems performance assessment (HSPA) varies across Europe. This WHO review summarizes 14 HSPA domains and 1,485 indicators used in European HSPA reports. All countries had indicators of service delivery and health outcomes. Other domains, such as safety, efficiency, coverage or responsiveness, were included in only 30% of the documents. The review concludes that further refinement of frameworks is warranted.

Europe - Health diplomacy: European perspectives

Health diplomacy is central to health governance at global and regional levels, and integral to foreign policy in many countries. This book published by the WHO presents case studies of health diplomacy in action in Europe. Chapters review road safety in Russia; experience with integrated health diplomacy in Malta and Switzerland; and efforts by the Balkan countries to improve capacity.

International - New report offers global resource on using the law to improve health

This WHO report looks at how health laws can make a crucial difference for public health. The report features case studies from around the world on how legislation has improved the health and safety of populations, providing a resource for countries to learn from each others’ experiences.

Canada - International Comparisons at CIHI

This report from the Canadian Institute for Health Information (CIHI) presents various measures of how health care in Canada compares to that in other countries, and discusses CIHI's contribution to international data and knowledge production. The report highlights some key comparisons in clear graphic form: Canada spends 10% of its GDP on health, compared to the OECD average of 9%; Canada is above average in reducing premature mortality, especially among men; Canada is in the middle of the pack on combined measures of health status, determinants of health, quality of care, patient safety and access to care.

Canada - Measuring Patient Harm in Canadian Hospitals

A national picture of patient harm in acute care hospitals (outside Quebec) is now available, thanks to a new measure developed by the Canadian Institute for Health Information (CIHI) and the Canadian Patient Safety Institute (CPSI). The joint report Measuring Patient Harm in Canadian Hospitals, reveals that in 2014–2015 harm was experienced by patients in 1 of every 18 hospital stays, or 138,000 hospitalizations. Of those, 30,000 (or 1 in 5) involved more than 1 form of harm. The rate (5.6%) has remained stable over the past few years.

UK - Formal launch of MyNHS

Launched in November 2014, MyNHS is a website where people in the UK can compare their local National Health Service (NHS) hospital, health authority, and health services on a number of performance indicators. MyNHS includes searchable data on hospital food quality, staffing, patient safety and mental health, along with many other areas of care.

USA - Health Care Quality Continues to Improve, But Disparities Persist

According to a new report, the quality of American health care has improved steadily since 2000, with notable gains occurring in patient safety. However, disparities in care have not improved. Hospital visits for mental health care, for example, have increased among the poor — from 1,400 per 100,000 in 2007 to 2,000 per 100,000 in 2014.

Canada - A Better Prescription: Advice for a National Strategy on Pharmaceutical Policy in Canada

Building on published research and international frameworks, this article proposes that the pharmaceutical policies of federal, provincial, and territorial governments be coordinated around a core health-focused goal. It strongly suggests policy action on four core objectives: universal access to necessary medicines; appropriate prescribing and use of medicines; value for money spent on medicines; and patient safety.

Australia - Second Atlas highlights opportunities for healthcare improvement

This report by the Australian Commission on Safety and Quality in Health Care shows large variations in the provision of common health treatments across Australia. It examines variations in care for hysterectomy, cataract surgery, knee replacement and potentially preventable hospitalizations.

Canada - Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study

The patient-centred medical home (PCMH) approach emphasizes integrated care, relationships with a regular physician, holistic self-care and a focus on quality, safety, and access. This paper compares current primary care across Canada with the goals of the PMH model. After surveying 1,172 patients and 772 primary care practices in 10 provinces, the paper found little evidence of consistent implementation of PCMH goals.

USA - Improving the Health Care System: Seven State Strategies

State legislatures play an important role in cutting healthcare waste and improving health systems. This briefing note from the National Conference of State Legislators (NCSL) describes healthcare improvement strategies showing results in Connecticut, Hawaii, Massachusetts, Minnesota, New Hampshire, Rhode Island and Vermont. The state strategies highlight new payment models, patient-centred integrated care, reliance on data, and investments in prevention and safety.

Canada — To relieve the congestion of the health system - The Ordre des pharmaciens du Québec calls for legislative changes by the end of 2011

The Ordre des pharmaciens du Québec has submitted a proposal to the Ministère de la Santé et des Services sociaux to enable pharmacists to contribute more effectively to the health system. The proposed changes will require legislative amendments, however, so the Order is calling for a bill to be passed. The proposed changes would enable pharmacists to : 1. Extend some prescriptions in accordance with precise criteria, in stable clinical situations; 2. Adapt a prescription when necessary, for example, based on the patient's weight or allergies; 3. Help resolve simple health problems like cold sores and seasonal allergies; 4. Order certain laboratory tests, for example, to monitor the safety of a course of treatment (e.g., kidney function); 5. Administer certain medications for the purpose of teaching patients how to do it (e.g., asthma inhalers) or meeting public health objectives.

UK — Maintaining and Improving Quality during the Transition: safety, effectiveness,

This report is the first in a two-phase review about maintaining and improving quality during the transition and beyond. Focusing on 2011/12, it describes the key roles and responsibilities for maintaining and improving quality; suggests practical steps to safeguard quality during the transition; and emphasises the importance of the effective handover of knowledge and intelligence on quality between old and new organisations.

UK - Reshaping the System: Implications for Northern Ireland's Health and Social Care Services of the 2010 Spending Review

This document provides the Minister for Health, Social Services and Public Safety with possible plans that would deliver high quality, cost effective health and social care services for Northern Ireland in the coming years taking account of the likely reduced funding levels anticipated in the Current Spending Review.

China - Equity and Public Governance in Health System Reform. Challenges and Opportunities for China

In early 2009, China’s Ministry of Health (MoH) announced a comprehensive set of health system reforms (HSR) designed to rectify the widely acknowledged and increasing inequity that characterized China’s health services. The reforms aim to provide “safe, effective, convenient and affordable” healthcare to all urban and rural residents through five main pillars: strengthening public health functions and services, enhancing primary care delivery, establishing universal basic health security (insurance), ensuring the safety of and access to essential medicines, and optimizing the management of public hospitals. The authors of this paper explore whether the government’s actual expenditure on health across levels support China’s HSR objectives.

USA - Going 'Green' May Cut Hospital Costs

Implementing practical, environmentally friendly practices in operating rooms and other hospital facilities could reduce health-care costs without compromising patient safety, says a new study. In the United States, health-care facilities are a major source of waste products, producing more than 6,600 tons per day and more than 4 billion pounds a year. Nearly 70 percent of hospital waste is produced by operating rooms and labour-and-delivery suites.

Europe — Cross-border health care in the European Union. Mapping and analysing practices and policies

Cross-border health care is a growing phenomenon in the European Union. This book explores this trend, looks at the legal framework and examines the legal uncertainties surrounding rights, access, reimbursement, quality and safety. The information and analysis presented mark an important step in the continuing debate on a legal framework for cross-border health care and will be of considerable use to policy-makers and those with an interest in key aspects of cross-border health care.

USA — Partnership for Patients: Better Care, Lower Costs

The Obama Administration has launched the Partnership for Patients, a new public-private partnership that will help improve the quality, safety, and affordability of health care for all Americans. Using as much as $1 billion in new funding provided by the Affordable Care Act and leveraging a number of ongoing programs, the Department of Health and Human Services (HHS) will work with a wide variety of public and private partners to achieve the two core goals of this partnership – keeping patients from getting injured or sicker in the health care system and helping patients heal without complication by improving transitions from acute-care hospitals to other care settings.

France - Additional costs of adverse events associated with hospital care

This study by the Institut de recherche et documentation en économie de la santé provides the first national estimates of the cost of caring for some of the adverse events associated with hospital care, using routinely collected hospital data. Nine patient safety indicators on which it is possible to intervene upstream were selected to enable the identification of adverse events requiring special attention.

Governing public hospitals. Reform strategies and the movement towards institutional autonomy

Brief analytical summaries or syntheses #33 Governing public hospitals. Reform strategies and the movement towards institutional autonomy Summary This study by researchers at the World Health Organization (WHO) explores major developments in the governance of public hospitals in Europe and looks at their implications for national and European health policy. Individual hospitals have been given varying degrees of semi-autonomy within the public sector and have been empowered to make key strategic, financial and clinical decisions themselves. The study includes an in-depth assessment of eight different country models of semi-autonomy. Background For hospital governance to be effective, it must incorporate two powerful and well-developed lines of health sector logic on the one hand, national health policy and objectives; on the other, operational hospital management. One sphere is political, the other technical. One is subjective and value-based, the other is objective, with performance that can be measured both clinically and financially. The…

Canada - McGuinty Government Releases e-Health Progress Report

The 2011 eHealth Progress Report, released August 19, showed that more than 7,000 doctors, who care for 6.5 million Ontarians, now manage their patients' health information with an electronic medical record — more than any other province. The report points to significant cost and wait-time savings as well as better safety resulting from the use of electronic health records.

The U.S. Health System in Perspective:A Comparison of Twelve Industrialized Nations

Brief analytical summaries or syntheses #26 The U.S. Health System in Perspective A Comparison of Twelve Industrialized Nations Summary This paper analyzes 2010 OECD health data for Australia, Canada, Denmark, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Health care spending in the U.S. towers over the other countries and findings suggest opportunities for cross-national learning to improve health system performance. Background Findings from this cross-national comparison of health care systems can inform public policy, highlight areas where nations could improve, and yield benchmarks for high performance. The Organization for Economic Cooperation and Development (OECD) annually tracks and reports on more than 1,200 health-system measures across 34 industrialized countries, ranging from population health status and non-medical determinants of health, to health care resources and utilization. Since 1998, The Commonwealth Fund has sponsored an analysis of cross-national health systems based on OECD health data…

UK - Quality 2020 - A 10-year Quality Strategy for health and social care in Northern Ireland

A 10 year Quality Strategy for Health and Social Care has been developed for Northern Ireland. It is intended that the Strategy will protect and improve quality and aim to achieve excellence, in terms of safety, effectiveness and patient/client experience in the period up to 2020. A consultation document is available online.

Useful links

Association latine pour l’analyse des systèmes de santé Centre collaborateur de l'OMS du Québec pour la promotion de la sécurité et la prévention des traumatismes Centre collaborateur de l'OMS pour l'évaluation et la surveillance des impacts sur la santé de l'environnement et du milieu de travail Centre d'étude sur la pauvreté et l'exclusion Centre québécois collaborateur de l'OMS pour le développement des Villes et Villages en santé Commissaire à la santé et au bien-être du Québec Conseil national des Secrétaires municipaux à la Santé du Brésil Conseil national des Secrétaires d'État à la Santé du Brésil Institut national de santé publique du Québec Institut de la statistique du Québec Institut national d’excellence en santé et en services sociaux Ministère des Relations internationales et de la Francophonie Observatoire de l’administration publique (ENAP) Observatoire européen des systèmes et des politiques de santé Observatoire ibéro-américain des politiques et des systèmes de santé Observatoire…

New Zealand - National Health IT Board - Draft National Health IT Plan

On Friday (23/4) the DRAFT national Health IT plan was introduced at a Partnership Summit for key stakeholders. The National Health IT Board will be completing the national Health IT Plan for Ministerial approval before 30 June 2010. The plan will define and monitor the development of a sustainable, effective nationwide information and technology environment that fosters safety and quality care, is person-centred, is provider-friendly and increases productivity of the system as a whole.

UK - International benchmarking of healthcare quality: A review of the literature

The report focuses on the three quality domains identified as important by the NHS Next Stage Review High Quality Care for All, namely effectiveness of care, patient safety and patient experience.

Canada - Quality of Healthcare in Canada: A Chartbook

The Canadian Health Services Research Foundation has released Canada’s first-ever chartbook on healthcare quality. Providing both domestic and international data, the chartbook reports on six key domains of quality: the effectiveness of the healthcare sector; access to healthcare services; the capacity of systems to deliver appropriate services; the safety of care delivered; the degree to which healthcare in Canada is patient-centred; and equity in healthcare outcomes and delivery.

Australia - Building a 21st Century Primary Health Care System. Australia's First National Primary Health Care Strategy

This strategy represents the first comprehensive national policy statement for primary health care in Australia. It provides a road map to guide current and future policy and practice in the Australian primary health care sector. The four priorities are: improving access and reducing inequity, better management of chronic conditions, increasing the focus on prevention, improving quality, safety, performance and accountability.

Canada – Quality Monitor. Ontario Health Quality Council. 2010 report on Ontario’s health System

The report shows that although there have been some modest improvements in quality across Ontario’s health system, there is room for more improvement. There are examples of higher performance that could be applied more broadly. The top-line findings underscore areas of concern that are of critical importance: wait times; the accuracy and completeness of medical information; chronic disease management; access to primary care; and patient safety.

Europe - New policy briefs published for the Belgian European Union Presidency Ministerial Conference on the European Health Workforce

Two joint Health Evidence Network - European Observatory on Health Systems and Policies policy briefs and two policy summaries were prepared for the Belgian EU Presidency Ministerial Conference on ‘Investing in Europe’s health workforce of tomorrow: scope for innovation and collaboration’ (La Hulpe, September 9–10 2010): How to create conditions for adapting physicians’ skills to new needs and lifelong learning, how to create an attractive and supportive working environment for health professionals, assessing future health workforce needs, and using audit and feedback to health professionals to improve the quality and safety of health care.

UK - Care Bill becomes Care Act 2014

Britain’s Parliament has passed the 2014 Care Act creating a single care and support framework built on user wellbeing, quality and safety reform, and service integration. The legislation imposes limits on care costs, introduces new rights for caregivers, and establishes an eligibility threshold for care.

USA - Small Ideas for Saving Big Health Care Dollars

In 2012, American healthcare spending was $2.8 trillion. Rather than focus on large, controversial ideas for reducing expenditures, this RAND Corporation paper explores a collection of 14 specific approaches that individually generate modest cost savings. Approaches include substituting lower-cost treatments and implementing cost-effective preventative patient safety measures.

UK - NHS safe staffing: not just a number

Despite the fact that the greatest recurring cost in Britain’s National Health Service (NHS) is its workforce, a system for planning, monitoring and recording NHS staff numbers does not currently exist. This study identifies the clinical, safety, and financial benefits of keeping more robust workforce data. It also describes barriers to the adoption of digital technology for staff rosters, payment, and quality assurance.

Canada - Where you live matters: Canadian views on health care quality Results from the 2013 Commonwealth Fund International Health Policy Survey of the General Public

This final bulletin in the Health Council of Canada's Canadian Health Care Matters series presents Canadians’ views on and experiences with health care, based on the 2013 Commonwealth Fund Survey. It focuses on differences between provinces, comparisons among the 11 OECD countries participating in the survey, and changes in Canada’s performance over the past decade. Large variations between provinces in patient experiences, not only around wait times and coordination of care, but also in other areas including out-of-pocket expenses, patient safety, and preventive care, were identified.

Australia - OECD health-care quality indicators for Australia 2011-12

This Australian government report summarizes information supplied to the Health Care Quality Indicators 2012–13 data collection of the OECD. The report compares Australian data with previous years and with other OECD countries. Indicators cover primary care, hospital acute care, mental health care, cancer survival, hospital patient safety and patient experience. Compared to OECD averages, Australia has a higher burden of asthma and chronic obstructive pulmonary disease, and higher readmission rates for schizophrenia and bipolar disorders, but also better survival rates for certain cancers and acute myocardial infarction.

Germany - Health Care Lessons from Germany

Published by Canada’s Fraser Institute, this study compares the German and Canadian healthcare systems. The study concludes that the German system performs at a level similar to Canada, with a stronger performance in patient safety. Germany’s health expenditures, as an age-adjusted share of GDP, were 22% lower than Canada’s. Germany also has higher ratios of physicians and hospital beds per population and shorter wait times for all types of care.

International - OECD launches interactive website on regional well-being

This is an interactive map covering the OECD's 34 member countries. It rates 362 sub-national regions with a relative score out of 10 in eight categories: income, health, safety, services, civic engagement, education, jobs and environment and reveals some large disparities.

Canada - Health Quality Council of Alberta releases two reports that address continuing care in Alberta

On June 5, 2014, the Health Quality Council of Alberta (HQCA) released findings and recommendations from two separate reviews that focused on the quality of continuing care in Alberta. The first report examined the quality and patient safety implications of Alberta Health Services’ (AHS) policy on continuing care wait lists. The second report looked at the structures and processes that support quality assurance of publicly funded continuing care services in Alberta, including home care, supportive living, and long-term care. A need to provide more fairness, some degree of choice and improve demand modeling are among the recommendations.

Canada - Improvements in patient and public safety highlighted in 2014 Quality Index on Ontario's Cancer System

The Cancer Quality Council of Ontario (CQCO) released its 10th annual Cancer System Quality Index on June 24, 2014. It shows that the Ontario cancer system is successful in ensuring Ontarians are receiving care based on the best available evidence. Notable improvements were made in automated drug ordering systems in hospitals. Areas for improvement include reducing unplanned hospital visits during chemotherapy and radiation.

Sweden – Health System Review

Brief analytical summaries or syntheses #43 Sweden – Health System Review Summary Published by the European Observatory on Health Systems and Policies, this report regards Sweden’s health system in detail. It describes the institutional framework, process, content, and implementation of Swedish health policies, highlighting challenges and areas that require further analysis. Background Sweden is a monarchy with a parliamentary form of government. The size of the population is about 9.4 million inhabitants and more than 80% of the population lives in urban areas. The GDP per capita, measured as purchasing power parity (PPP, current international US$), amounted to Swedish krona (SEK) 37 775 (€4200) in 2010. Life expectancy in Sweden is among the highest in the world. Diseases of the circulatory system are the leading cause of mortality, accounting for about 40% of all deaths in 2009. The second largest cause of death is cancer. There are three independent government…

Reducing waste in health care

Brief analytical summaries or syntheses #56 Reducing waste in health care Summary A key target in slowing healthcare spending in the US is the elimination of waste, which is thought to constitute over one third of all American health spending. This policy brief published in Health Affairs focuses on the types of waste in health care and ways to eliminate it. Background Health care spending in the United States is widely deemed to be growing at an unsustainable rate, and policy makers increasingly seek ways to slow that growth or reduce spending overall. A key target is eliminating waste — spending that could be eliminated without harming consumers or reducing the quality of care that people receive and that, according to some estimates, may constitute one-third to nearly one-half of all US health spending. Waste can include spending on services that lack evidence of producing better health outcomes compared to…

International - From efficacy to equity: Literature review of decision criteria for resource allocation and healthcare decision making

This systematic review published in July 2012 in Cost Effectiveness and Resource Allocation identifies criteria reported in the literature on healthcare decision-making. Among the most frequently mentioned criteria were equity, efficacy, safety, need, strength of evidence, and patient-reported outcomes.

Time for Transformative Change: A review of 2004 Health Accord

Brief analytical summaries or syntheses #40 Time for Transformative Change A review of 2004 Health Accord Summary Canada is no longer seen as a model of innovation in health care delivery and financing, says this report from the Standing Senate Committee on Social Affairs, Science and Technology. The committee’s review revealed that real systematic transformation of health care systems across the country had not yet occurred, despite more than a decade of government commitments and increasing investments. The committee made 46 recommendations it believes will truly transform the way health care professionals do business and will achieve lasting reform. Background On January 31, 2011, the Minister of Health requested that the Standing Senate Committee on Social Affairs, Science and Technology initiate the second parliamentary review of the 10-Year Plan to Strengthen Health Care (10-Year Plan), an agreement reached by First Ministers on September 16, 2004 that focuses on federal/provincial/territorial (F/P/T)…

Denmark - Good hospitals but primary health care must improve

The Danish central government and regions are leading international efforts to reform hospital systems, improving quality and safety by gathering specialists into major hospitals and closing smaller ones. The country should now focus on modernising its primary care sector to deal with the rising demands of chronic disease and a leaner hospital sector, according to the OECD’s Health Care Quality Review of Denmark.

Australia - A new way of measuring the performance of the health system

The CEO of Melbourne Medicare Local, Kristin Michaels said recently that a new survey method for measuring the effectiveness of the Australian health system had revealed interesting and challenging results. National research undertaken in June by Crosby/Textor for Eastern Melbourne Medicare Local used a core questionnaire based on the Australian Charter of Healthcare Rights. The Charter is intended to guarantee Australians that the health system delivers seven key health rights: access, safety, respect, communication, participation, privacy and comment.

UK - QualityWatch Annual Statement 2013

In this annual report, the UK organization QualityWatch assesses the quality of Britain’s health and social care services. The assessment draws on 150 indicators spanning primary care, community services, hospital stays, mental health services and social care. The indicators are evaluated in relation to six domains of care quality: access, safety, effectiveness, capacity, equity, and person-centred care.

UK - Jeremy Hunt announces technology fund for hospitals to help improve patient safety

Responding to the Francis report, which called on the National Health Service (NHS) to make better use of technology to improve safe, effective care, Health Secretary Jeremy Hunt announced a new £260 million fund for hospitals. A key target is technology to reduce prescription errors in hospitals.

Canada - Electronic Medical Records Deliver Efficiencies, Patient Safety, Improved Communication

Canada Health Infoway commissioned this study from PriceWaterhousCooper to calculate the benefits achieved since 2006 with a doubling in the adoption of electronic medical records (EMRs) in community-based practices. The study reveals that adoption of EMRs has brought efficiency and patient care benefits valued at $1.3 billion, most of which comes from administrative efficiencies.

Europe - A comparative analysis of health policy performance in 43 European countries

This article from European Public Health assesses national variations in health policy and investigates the influence of local political, economic and social determinants. The article reviews the policies of 43 European countries on nutrition, child health, infectious diseases, hypertension, cancer screening, road safety, air pollution, and tobacco and alcohol use.