public reporting, expert standards and indicators –
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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 PresentationTRANSCRIPT
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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
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Overview
• Long-term care in Germany
• Principles for quality development and assurance
• LTC reform in 2008
• Expert standards
• External quality control
• Public reporting
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Social insurance and security in Germany
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Five Pillars of Social Security
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Social Assistance
Obligatory Insurance Scheme
Principle: 50% employer/Employee
Appr. 20% of employee‘s salary
Universal insurance coverage
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Key data on long term care system
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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)
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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
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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
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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
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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
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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
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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