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Quality of Health Care in Slovenia Results of Quality ass e sment in operative gynecology and perinatology .

Quality of Health Care in Slovenia Results of Quality ass e sment in operative gynecology and perinatology . prof.dr. Marjan PAJNTAR. Medical chamber of Slovenia.

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Quality of Health Care in Slovenia Results of Quality ass e sment in operative gynecology and perinatology .

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  1. Quality of Health Care in SloveniaResults of Quality assesment in operative gynecology and perinatology. prof.dr. Marjan PAJNTAR Medical chamber of Slovenia

  2. Providing quality of health servicein the Republic of Slovenia on thewhole is a basic component ofstability and perspective of theentire health service systemdevelopment and shall be adistinctive preferential strategic aim of this area.

  3. The first operative step is recognition of the problem or imperfection.This requires continuous or periodicalqualityassessment.

  4. Our assessment is based on Quality Indexes, which can becalculated from datagathered and processedfor this purpose.

  5. The quality indexes, as a system of control, provide distinctionamong individual institutions and individual doctors,issue guidelines to take measures.

  6. Project "Quality of health care in Slovenia" Medical Chamber of Slovenia Ministry of Health 1999 the begining, pilot study 2002 regular collection of the data.

  7. Scheme system

  8. Zagotavljanje kakovosti v zdravstvu, Okulistika:Operacija presenilnih in senilnih katarakt 01. Ime in priimek pacienta: 02. Številka popisa: 03. Ustanova in šifra ustanove: / 04. Datum rojstva: / / 05. Spol 1 moški 2 ženski Bolezni pacienta 06. Sladkorna bolezen 1 da 2 ne 07. Retinopatija diabetika neproliferativna 1 da 2 ne 08. Retinopatija diabetika proliferativna 1 da 2 ne 09. Krvni pritisk: / 10. Antikoagulantna terapija 1 da 2 ne 11. Ostrina vida pred operacijo: 12. Očesni pritisk – tonus aplanacijsko: Spremembe na očesnem ozadju 13. Oftalmoskopski pregled 1 da 2 ne 14. Degeneracija makule 1 da 2 ne 15. Krvavitev mrežnice 1 da 2 ne 16. Odstop mrežnice 1 da 2 ne Komplikacije operacije 17. Tip vstavljene intraokularne leče: 18. Poškodba zadnje lečne ovojnice: 1 da 2 ne 19. Padec lečnega jedra v steklovino: 1 da 2 ne 20. Fibroza zadnje lečne ovojnice: 1 da 2 ne 21. Vnetje očesa po operaciji: zunanje 1 da 2 ne notranje 1 da 2 ne 22. Sekundarni glavkom: 1 da 2 ne Rezultati operacije 23.Vidna ostrina po operacijibrez korekcije: s korekcijo: 24. Zdravnik: št. Sheet protocol

  9. Internet (WWW) protocol

  10. Data input and protection Each user has a username and a password for access to his own internet protocol. Data communication with the server is secure (SSL protocol). Data are collected in the central SQL database.

  11. From year 1999 we have collected more than200.000questionaries

  12. We begane in 1999 with pilot study in 47 medical branches. Regular collection is from 2002 in 35 medical branches, 20 are doing well. Except for perinatology the data are collected voluntarily in 34 medical branches.

  13. Collection of perinatal data in NPISS is running from 1986. We are collecting more than 300 items of genetic data, pregnancy, delivery and neonatal period in all maternity hospitals (14) in Slovenia and is obligatory by law.

  14. Processing of the data Each department get results in statistical and grafical way for their department and with comparision with average result of all other departments. Analysis of quality indicators are made also for results of individual doctors with comparision to other doctors results.

  15. We are collecting data in all departments in Slovenia for: Perinatology Gastrosurgery - Gall bladder Gynecologyc surgery (hysterectomy, adnexal lap.op.) ReproductionTorakal surgery (Ca Pullmonum) Infantile diabetes

  16. We are collecting data in many departments in Slovenia for: Internal intensiv care Operative intensive care Pneumonia – hospital aquired Nuclear medicine Oculistic-Operative cataracta Brest cancer surgery Pediatric nefrology Plastic surgery – carpal syndrom Psychiatry - sch Traumatology- hip op Urology, op benig. tumor prostatae Otolaringology- nasal polyp op Med. genetic

  17. In the last 5 years we have collected: More than 17.300 operative gynecological cases More than 76.000 perinatal cases

  18. q004 Gynecological operations Hysterectomy, laparoscopic adnexal operations

  19. q028 Perinatology

  20. Measures • Individual position,

  21. Study Results of comparission between all deliveries with deliveries of healthy primipara

  22. The best obstetricians

  23. Measures Compliments for good work! • For best departments • For best individual doctors

  24. On-line collection

  25. Problems • Motivation. • It is still great problem with motivation for partitipation. Many doctors are not aware that collected data serve themselves to asses their own results and to compare their results with other doctors with the other departments. Especially bad is in the departments where heads are not aware of importance of quality assesment. • Financial problems of the project.

  26. Vesoljski teleskop Spitzer NGC 7293, objavljeno 12.02.2007 Conclusion There is no one who would do things in such a way that they could not be done better, and there is nothing that could not be still perfected. https://kakovost.mf.uni-lj.si kakovost@zzs-mcs.si

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