1 / 23

Does a WHO HPH Recognition  Process Improve Health Service  Delivery and Outcome? 

Does a WHO HPH Recognition  Process Improve Health Service  Delivery and Outcome? . PHD Student Jeff Kirk Svane MA (DK) Professor Hanne Tønnesen MD PHD (DK/S) Supervisor Shu-Ti Chiou MD PHD MSc (TW) Advisor Oliver Groene MSc PHD (UK). Overview. Study aim and hypotheses Scope & Purpose

sileas
Download Presentation

Does a WHO HPH Recognition  Process Improve Health Service  Delivery and Outcome? 

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Does a WHO HPH Recognition Process Improve Health Service Delivery and Outcome?  PHD Student Jeff Kirk Svane MA (DK) Professor Hanne Tønnesen MD PHD (DK/S) Supervisor Shu-Ti Chiou MD PHD MSc (TW) Advisor Oliver Groene MSc PHD (UK)

  2. Overview • Study aim and hypotheses • Scope & Purpose • Background • Framework • WHO HPH Standards / Indicators • HPH DATA Model • HPH Doc Act Model • Other evaluated tools • Project Status

  3. Study aim The “WHO HPH Recognition Project” aims to: • Evaluate whether a WHO-HPH recognition / certification process for HP generates • more health promotion deliveries • better health gain for patients and staff

  4. Main hypotheses • Hospitals departments allocated to the Recognition Process will after 1 year: • Improve health gain for patients and staff • Deliver more HP services compared to the departments allocated to the control group continuing routine clinical practice

  5. Scope & Purpose Why a recognition project about HP? • Clinical HP is a patient-centred approach in health care services • HP Improves the effect of treatment results and contributes to improved patient safety => HP is a key dimension of quality in hospitals

  6. Scope & Purpose It is THE LEADING risk factors that can be influenced by HP • “(…) the three leading risk factors for global disease burden were high blood pressure (…), tobacco smoking including second-hand smoke (…), and alcohol use (…)” • Among leading risk factors are also overweight, malnutrition, physical inactivity Lim, Vos, Flaxman et al. Lancet. 2012

  7. Scope & Purpose Duly, HP integration is nowrecognized as a coreissue. E.g.: • Health 2020 (WHO, signed at WHA in Geneva, May 2012) • Strengthening Public Health Capacities and Services (WHO, signed at RC62 in Malta, September 2012) • Strategy for the Prevention and Control of Non-Communicable Diseases 2012–2016 (WHO at RC61 in Baku, September 2011)

  8. Scope & Purpose So HP is core, also for hospitals and health services But Implementation in real-life is still a challenge

  9. Scope & Purpose What about existing processes? • Hospitals and health services implement QM, accreditation, certification and recognition But: • HP is poorlyincluded • … and we dont knowif it really generates better health gain?

  10. Background • Sparse literature on accreditation and quality improvement • 1 Randomised Clinical Trials (RCT) evaluating impact of hospital accreditation on the quality of care at the national level in South Africa (Salmon JW, Heavens J, Lombard C, Tavrow P. Operations Research Results 2003;2:17)

  11. What can we conclude? • Better technical procedures and structure • No better clinical outcome or health gain • We need further studies with adequate power (sizeable sample)

  12. Management policy of HP • Patient Assessment • Patient Intervention and Info • Promoting a healthy workplace • Continuity and cooperation Framework (project elements) Hospitals: Useful recommendable (Groene O, Jorgensen SJ, Fugleholm AM, Garcia Barbero M. Int J Health Care Qual Assur Inc Leadersh Health Serv 2005;18:300-7.

  13. Doc. HP Activities (St. 3) HPH DATA Model (St. 2) HPH HPH Framework Clinicians: Understandable, applicable & sufficient for our patients (high reliability) (Tonnesen H et al, BMC Health Serv Res 2007 + Clin HP 2012)

  14. Other evaluative tools Short Form Health Survey (SF36): • Physical, mental and social conditions + 17 additional indicators • WHO HPH Standards not otherwise included (McHorney, Colleen A.; Ware, John E.; Raczek, Anastasia E. Med Care 1993; 31: 247-263)

  15. Design • An RCT with 2x44 hospital departments allocated to one of the two groups • Undergo the Recognition Process immediately = Intervention group • Continue their usual routine = Control group

  16. Evidence degree: Pyramid Meta-analysesSyst reviews RCT (intervention) CCT (intervention) Cohorts, Case-Control studies (Obs) Cases (Obs) Editorial papers and Consensus (’GOBSAT’) Animal Studies In Vitro studies (Eccles M BMJ 1998)

  17. Clin Dept n = 2x44 TAU Data collect R Data collect 1y 2y Site Visit & Data Val Data collect Data collect Site Visit & Data Val Trial Profile I I

  18. Inclusion criteria • All kinds of clinical hospital departments are eligible; from university as well as non-university clinical hospital departments

  19. Exclusion criteria • Palliative care departments, paediatric departments, nursing homes, non-hospital departments, and primary care facilities • WHO-HPH standards and tools are not validated for these clinical activities.

  20. mo I II III IV I II III IV I II III IV I Incl, Agree, Allocate 2 Baseline Package 1 Int Audit + Q Plan 2 Return Package 1 Implementation 12 Follow-up Package - Int Audit + Rev Quality Plan + Return package 3 Site Visit + certificate 2 Tailored timeline for each country Year 2 Year 3 Year 1

  21. Project status: Almost half way 40 out of 88 deptsincluded: • Taiwan: 21 • CzechRep: 8 • Thailand: 4 • Slovenia: 2 • Estonia: 2 • Canada: 1 • Indonesia: 1 • Malaysia: 1 • More arecoming up!(48 depts to go)

  22. Overview • Study aim and hypotheses • Scope & Purpose • Background • Framework • WHO HPH Standards / Indicators • HPH DATA Model • HPH Doc Act Model • Other evaluated tools • Project Status

  23. Welcome! • We look forward to the fruitful collaboration

More Related