Lo scenario futuro della rete HPH internazionale

1. Lo scenario futuro della rete HPH internazionale “Il valore degli ospedali per la promozione della salute in Toscana” Conferenza Regionale Della Rete HPH Toscana 10 Maggio 2006, Firenze Oliver Gröne Technical Officer, Quality of Health Systems and Services

2. Questions How do Health Promoting Hospitals (HPH) link to WHO Strategy? What are the directions of the HPH Network? How can HPH development be sustained in the future?

3. WHO Strategy: • - WHO Regional Office for Europe: 52 Member States, 850 million Citizens. • - Biannual Collaborative Agreements with 29 Member States. • Supporting Member States in developing their health systems.

4. WHO’s areas of work that relate to Health Promoting Hospitals

5. Hospitals for Europe working party: ‘Every 10th patient suffers from preventable harm’

6. How are hospitals doing … • Research in hospitals: • Harvard Medical Practice Study • Utah Colorado Study • Australia • Canada • Denmark • Japan • New Zealand • Singapore • UK Adverse events caused by negligence 2.9-3.7% Adverse events 7.5 – 16.6 % Preventability > 50%

7. Germany, UK, Australia, Canada, New Zeeland, US 7-10% of patients developed an infection while hospitalized (except for Germany) 19-26% of patients reported communication gaps >10% reported medical and medication error 60% errors estimated to occur outside the hospital Safety risks Poor care coordination Deficiency in care of chronic conditions Research on patient experiences C. Schoen, R. Osborn, P. Trang Huynh, M. Doty, K. Zapert, J. Peugh, K. Davis. ‘Taking the pulse of health care systems: Experiences of patients with health problems in six countries’, Health affairs, 2005

8. Resolution WHA55.18 URGES Member States: • to pay the closest possible attention to the problem of patient safety • to establish and strengthen science-based systems, necessary for improving patient safety and the quality of health care, including the monitoring of drugs, medical equipment and technology

9. The Health Promoting Hospitals strategy can be considered to complement existing quality and safety initiatives.

10. Functions and goals of Health Systems Sustaining Health Promoting Hospitals?

11. How can we establish a strategic link with these current challenges without loosing the vision and principles of the Health Promoting Hospitals Network?

12. Independent Secretariat • Project management at WHO Collaborating Centre for Evidence-based health promotion in Copenhagen, Denmark. • Responsibilities: • Administration of members • Internal and external communication strategy • Database update and development, and • Monitoring of membership fees.

13. Research at WHO CC Copenhagen • Introduction of HPH strategies and standards, • Identify evidence of successful health promoting activities, • Advice on teaching and training of staff in (E-B) health promotion, • Further development of standards and indicators for health promotion in hospitals.

14. Transparent Governance • HPH General Assembly to establish: • guidelines for the HPH Network, • criteria for membership, strategies, and objectives. • task forces. • Constituted of representatives of national, regional and thematic HPH Networks, Task Forces, and international coordinating institutions (WHO and WHO CCs).

15. Transparent Governance • Steering Committee to support strategic HPH Network development: • Strategic planning & actions on strategy, • Collaboration between network coordinators, Task Force Leaders, Working Groups, and external partners; • Input to scientific conferences; • Preparation of documents and General Assembly.

16. Transparent Governance

17. Internationalization • Development of International HPH Network mostly with the support of European hospitals. • But: Increasing interested from other continents. New networks and applicants: • Australia, Canada, South Africa, Taiwan, USA • In the future the HPH Network will remain international with stronger participation of hospitals from other continents.

18. Quality standards and indicators for HPHs • Systematic identification of priority areas and implementation of projects using the HPH Self-assessment tool. Application: • Possible annual self-assessment • Systematic derivation of three health promotion activities from periodic assessment • No public disclosure, but recognition of achievement and benchmarking.

19. Conclusion With the setting up of the new HPH secretariat, the network has become more independent from WHO. Main trends for the network are improved transparency, internationalization and systematic implementation of health promotion using quality standards and indicators. Health Promoting Hospitals are no longer a baby of WHO – they need to become a strong partner for WHO.

20. Conclusion WHO puts stronger emphasis on strengthening Member States’ health systems. HPH can collaborate through ministerial requests and contribute to piloting tools and shaping health systems. HPHs could also contribute through thematic foci, such as a year on patient safety from the perspective of Health Promoting Hospitals.

21. Thus, the relationship is changing from paternalism to partnership.