Pay for Quality

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122 Pay for Quality KCE Reports 118 hospitals pay a periodic fee to support benchmarking operations. An initiative like the hospital benchmarking in the Vlaams Ziekenhuisnetwerk provides indirect positive financial incentives through other shared services like material purchasing. Results (if available) No results evaluation available, with the exception of periodic hospital feedback reports. Sources (most relevant ones) See KCE report vol. 41 259 PATH: http://www.euro.who.int/document/e89742.pdf IQED: http://www.iph.fgov.be/EPIDEMIO/epien/PROG33.HTM Navigator: http://www.navigator.czv.be Delta: http://www.czv.kuleuven.be Vlaams Ziekenhuisnetwerk: http://www.vznkul.be/root/index.html 360° and patient safety indicator project: internal documents provided by FOD-VVVL Total budget Unknown (not publicly available) Table 19: Quality and patient safety in hospitals XIII. QUALITY AND PATIENT SAFETY IN HOSPITALS Initiated by Federal government. Overall objective To support the systematic use of quality improvement strategies, with attention for multiple quality domains Date of implementation in Belgium Since July 2007, additional financing has been approved within the remuneration of hospitals and this for the co-ordination of the quality and patient safety in Belgian hospitals. Target audience Hospitals (general, psychiatric, rehabilitation) Content Contract year 2007-2008: Six parts The mission, vision, goals and strategy with regard to quality and patient safety The first part of the contract aimed at further stimulating the hospitals into formulating a mission, a vision, goals and strategic objectives that also integrate patient safety. Structures and functions with regard to quality and patient safety Within the framework of the second part of the contract, the hospitals were asked to give an overview of the existing structures with regard to quality and patient safety by means of an organisation chart. These are the committees or functions that are financed by the federal government and/or legally imposed. Hospital survey on patient safety culture The third part of the contract aimed at assessing the patient safety culture. The federal authorities have used the Hospital Survey on Patient Safety Culture of the AHRQ (Agency for Healthcare Research and Quality) to do so. Reporting and analysing (near) incidents The fourth part of the contract related to the reporting and analysing of incidents and near incidents. The description of three quality projects The fifth part of the contract related to the description of three new quality projects: one for the field of ‘economic
KCE Reports 118 Pay for Quality 123 Primary focus (structure, process outcome) performance’ / ‘capacity and innovation’, one for clinical performance and one for patient safety. Multidimensional feedback including further details on a selection of 12 indicators The sixth part of the contract only applied to acute hospitals. The hospitals were asked to select 12 indicators and to develop actions for improvement. They were asked to select three indicators per field and to develop them in detail: 3 indicators for the field of economic performance, 3 for capacity and innovation, 3 for clinical performance and 3 for patient safety. Contract 2008-2009: three parts As a first part to the contract hospitals were asked to develop a multi-year patient safety plan, and based on the results of the evaluation of the patient safety culture (as performed in the previous year) two actions needed to be developed for quality improvement in two separate domains. As a second part to the contract the hospitals were asked to analyse a process where they could freely choose between a process as suggested by the government, or a process related to intramural transfers or a process based on results from the multidimensional feedback. As a third part to the contract hospitals were asked to list all of their indicators that were used for the management of quality and safety within the hospital. Contract 2009-2010: three parts As a first part to the contract the hospitals will be asked to develop a reporting and learning system for incidents and nearly incidents. In addition the hospitals will be asked to describe five incidents including the method used for the analysis as well as the actions that were taken to achieve the necessary improvements. As a second part to the contract the hospitals will be asked to develop or to (re)analyse an existing or new process within a multidisciplinary context. They could freely choose between a process as suggested by the government, or a process related to intramural transfers or a process based on results from the multidimensional feedback. 3. As a third part to the contract the hospitals will be asked to develop a multidimensional and integrated set of indicators related to quality and patient safety. The yearly contracts will always be based on the Donabedian’s triad and consist of three pillars: the development of a safety management system (structure), the analysis of processes (process) and the development of a multidimensional set of indicators (result). By 2012 all hospitals should have an integrated safety management system, assess both intramural and transmural care processes and use an integrated and multidimensional set of indicators. Type of indicators used (if any) Structure, process and outcome indicators Purpose of indicators used The purpose is hospital specific. They are mostly used as an input, based on benchmarking, to prioritize quality targets and related quality improvement strategies in a cyclical manner. Type of incentives Yearly budget Results (if available) The mission, vision, goals and strategy with regard to quality and patient safety
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Wettelijk depot : D/2008/10.273/50
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Pay for Quality

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