Public reporting, expert standards and indicators –
12
Public reporting, expert standards and indicators – different routes to improve quality in German long-term care London, 21 May 2009 Dr. Andreas Büscher Institute of Nursing Science at the University of Bielefeld
description
Public reporting, expert standards and indicators – different routes to improve quality in German long-term care London, 21 May 2009 Dr. Andreas Büscher Institute of Nursing Science at the University of Bielefeld. Overview. Long-term care in Germany - PowerPoint PPT Presentation
Transcript of Public reporting, expert standards and indicators –
Public reporting, expert standards and indicators –
different routes to improve quality in German long-term care
London, 21 May 2009
Dr. Andreas BüscherInstitute of Nursing Science at the University of Bielefeld
Overview
• Long-term care in Germany
• Principles for quality development and assurance
• LTC reform in 2008
• Expert standards
• External quality control
• Public reporting
Social insurance and security in Germany
Sic
kn
ess In
su
ran
ce
Pen
sio
n In
su
ran
ce
Five Pillars of Social Security
Accid
en
tal In
su
ran
ce
Un
em
plo
ym
en
t Insu
ran
ce
Lon
g-te
rm c
are
Insu
ran
ce
Social Assistance
Obligatory Insurance Scheme
Principle: 50% employer/Employee
Appr. 20% of employee‘s salary
Universal insurance coverage
Key data on long term care system
Joint agreement on quality principles
• Negotiated and agreed by stakeholders (self-regulation)
• Basis for external quality control by Medical Boards
• Guidelines and recommendations for internal quality development
• Structure, process and outcome criteria
• Results of quality tests by Medical Boards reveal problems in direct care (pressure sore prevention, food and fluid intake, incontinence care and gerontopsychiatric care)
LTC reform in 2008
• Concerns about quality
• Three different measures on quality of services: – National expert standards– Expansion of external quality control– Introduction of public reporting system
• Implementation of an arbitration board
LTC reform in 2008
• Procedure developed by German Network for quality development in Nursing
• Existing National Expert Standards:– Pressure sore prevention– Discharge management– Pain management– Fall prevention– Promotion of urinary continence– Care for people with chronic wounds– Nutrition management for ensuring and
promoting oral nutrition in nursing
LTC reform in 2008
• External quality control on a yearly basis and without announcement
• Refinement of control guideline
• Development of public reporting system based on control guideline covering the areas of:
– Nursing and medical care, care of residents with dementia, social and everyday life support and housing, food and domestic aspects in nursing homes
– Nursing care, activities prescribed by a physician, quality of the organisation an grade of service
First results of public reporting (May 2010)
• More than 7.000 reports
• 4.700 reports published
• Appr. 1.000 reports under review
• Appr. 1.000 reports awaiting additions from providers
• Appr. 280 reports with blocked publication, awaiting court decision
Conclusions
• Development of indicators has been commissioned for institutional long-term care
• Development of indicators also needed with regard to home care
• Attention needs to be given to recipients of cash payments and quality of care in the lifeworld setting
• Improvements and refinement of public reporting system to be expected
• LTC quality meanwhile involves different stakeholders and the public debate is ongoing
Institute of Nursing ScienceInstitute of Nursing ScienceAt the University of BielefeldAt the University of BielefeldPost Box 10 01 31Post Box 10 01 31D - 33501 BielefeldD - 33501 BielefeldTel. +49 521 106 - 6880Tel. +49 521 106 - 6880Fax +49 521 106 - 6437Fax +49 521 106 - 6437
[email protected]@uni-bielefeld.de
http://www.uni-bielefeld.de/IPWhttp://www.uni-bielefeld.de/IPW
![]project-open[ Reporting & Indicators Options](https://static.fdocuments.net/doc/165x107/54b38ddd4a7959b8468b4655/project-open-reporting-indicators-options-5584a7dd18bb4.jpg)
