quality care for quality aging: european indicators for home health care pisa, september 30-31, 2010...
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QUALITY CARE FOR QUALITY AGING: EUROPEAN INDICATORS FOR HOME
HEALTH CARE
Pisa, September 30-31, 2010
Dario Zanon Azienda ULSS 10 “Veneto Orientale“ Veneto Region
The Future of Primary Health Care in Europe III
Quality Care for Quality Aging: European Indicators for Home Health Care
EU Consortium EU Consortium :12 partners 7 EU Countries
DurationDuration: 18 months from January 2009 to June 2010 no cost extension of 3 months for dissemination
CoordinatorCoordinator: Regione Veneto / ULSS n.10 Veneto Orientale
Co-funderCo-funder: EC DG Employement, Social affairs and Equal Opportunities
BudgetBudget :396.470 €
EU contributionEU contribution: 300.000 €
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DecentralizationOutsourcing
Variety of providers
Public Administration needs
better define the delegated services
define the quality expected from the services
Societal challenges and services quality
The Project target
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Home Care formal services :
Home Assistance
Home Health Care
provided by Public Org. or by Private Org. on the basis of protocols and contracts with the public sector
Targeted to non self sufficient individuals aged 65 and over
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Project- Operational Objectives
Improve the knowledge base and the exchange of information about the HHC Systems in each Country Partner
Disseminate and transfer across countries, the best practices of quality assessment in HHC
Develop a set of monitoring, assessment and performance indicators on quality delivered in HHC
Theoretical Framework set of indicators
Quality
Dimensions
Concepts
Access Process
…
Satisfaction
…
Efficiency…
Affordability
Information and communication
Needs assesmen
t… …
Indicator 1 Indicator 2 Indicator 3 Indicator …
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AccessEfficacy
SatisfactionInput
OutcomeOutputProcess
Macroareas/Concept
Dimensions40 dimensions
Access procedure
Access rate
Affordability
Assessment
Continuity of care
Coordination
Coverage
Data protection
Dimensions of quality in HCAccess
procedureCoverage Health services
Plan (individual care plan)
Suitability of support services
Access rate Data protectionHR (Human Resources)
Plan fulfilment Suitable HR
Affordability DischargeInformation
and communication
PreventionSupport services
AssessmentEconomic assistance
Integration RecoverySupporting
tools
Assessment of needs
Education (of staff)
Lifelong learning
Skilled HR Timeliness
Bureaucratic barriers for asking the
service
EmpowermentMaintaining at
homeSocial
assistanceTools (for case management)
Continuity of care
Equality Monitoring
Social capital, social network and trust in the
system
Turnover
CoordinationEvaluation of
resultsPertinence Social services Visits
Level of analysis
baseline assessment
in-depth measurement
The set of the indicators Not quality standards but quality
indicators (and measures) to be used at local, regional and national levels
Only a “road map” to quality, a source of useful elements for measuring and improving quality
Must be adapted to local contexts
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Home Care Indicators & Balanced Scorecard
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The Learning & Growth Perspective (home-care workers)
The Business Process Perspective (processes)
The Customer Perspective
The Financial Perspectiveframework for a full strategic planning and management system
Conclusion: other important issues
Irregular work of
care
Technologies
Structure Management
Main qualityMain
quality
Conclusion: results
Integrated social and health information systems are recommended to have quality indicators.
The person and the assessment of the situation of the person’s multiple needs of care are the starting points for the development of the HC system as an integrated organizational system able to face the need of the continuity of care and to pursue a good, individualized efficacy of care.
Job satisfaction, empowerment, multi-professional collaboration of the HC workers is crucial
Prevention is an issue becoming more and more important.
Quality and accessibility are strictly related.
