Welcome Welcome in the inauguration in the inauguration of our new centre, of our new centre, And And THANK YOU THANK YOU all, for beeing all, for beeing here here . . The NC-CSAHI The NC-CSAHI Team Team NATIONAL CENTRE OF QUALITY, SAFETY, AND ACCREDITATION OF HEALTH INSTITUTIONS
Welcome Welcome in the inauguration of our new centre, And And THANK YOU THANK YOU all, for beeing here. The NC-CSAHI Team The NC-CSAHI Team NATIONAL CENTRE.
Dec 17, 2015
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WelcomeWelcome in the inaugurationin the inaugurationof our new centre,of our new centre, And And
THANK YOUTHANK YOU all, for beeing hereall, for beeing here..
The NC-CSAHIThe NC-CSAHI TeamTeam
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Dissatisfaction -Complains …!Dissatisfaction -Complains …!
Dissatisfied patients / citizensDissatisfied patients / citizens Dissatisfied Health Care professionals Dissatisfied Health Care professionals Risks, errors. Lack of safety Risks, errors. Lack of safety Insufficient and old technology Insufficient and old technology Low efficient medical care Low efficient medical care Overuse , under-use or miss-use of diagnostic Overuse , under-use or miss-use of diagnostic
and medical procedures and medical procedures Unjustifiable differences , in results and Unjustifiable differences , in results and
servicesservices Unaffordable cost by individuals and societyUnaffordable cost by individuals and society Delay in achievement of integrated standards , Delay in achievement of integrated standards ,
regional and European regional and European
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““The enigmas” of the new centreThe enigmas” of the new centre Quality ?Quality ?
The health care The health care outcomes outcomes
Patients satisfaction ?Patients satisfaction ? Cost-effectivenessCost-effectiveness
Safety ?Safety ?
Risks for the patient/ personnel Risks for the patient/ personnel
Medical errorsMedical errors
Accreditation?Accreditation?
Standardized Evaluation of Standardized Evaluation of thethe
professional competence of the professional competence of the health institutionshealth institutions
Re-certification?Re-certification? the periodic evaluation of the periodic evaluation of
the medical professionals the medical professionals competence based on competence based on contemporaneous criteriacontemporaneous criteria
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The challenge of empowerment of the The challenge of empowerment of the patients role patients role
Are the legitimate patient right known Are the legitimate patient right known ??
Are these rights implemented into practice?Are these rights implemented into practice?
Are patients organized? Do they have their own Are patients organized? Do they have their own VOICE. Are they heard ?VOICE. Are they heard ?
Are patient informed from us and taken their Are patient informed from us and taken their consent on what we are doing with them?consent on what we are doing with them?
Are patient real partner in managment of their Are patient real partner in managment of their own desease?own desease?
To what extend they are abel to holding us To what extend they are abel to holding us accountabel ? .. accountabel ? ..
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‘‘please, do not harm me …!’please, do not harm me …!’
A great number of risks and medical errors are A great number of risks and medical errors are harming patients in the healthcare institutionsharming patients in the healthcare institutions
In the world: Transparency – Correction In the world: Transparency – Correction
In the USA 100.000 patients are victims of medical errors in In the USA 100.000 patients are victims of medical errors in hospitals every yearhospitals every year
10% of inpatient in Eu undergo hospital injury form evitable errors10% of inpatient in Eu undergo hospital injury form evitable errors 10% of inpatient in uk undergo hospital infectious desease10% of inpatient in uk undergo hospital infectious desease
what about us?what about us?
Do we know what is happeining regrading the risks and medical Do we know what is happeining regrading the risks and medical errors ?errors ?
Is there any reporting system of the unintentional medical errors?Is there any reporting system of the unintentional medical errors? Do we learn from our errors?Do we learn from our errors? What we do : to avoid , to manage and recompensing harmed What we do : to avoid , to manage and recompensing harmed
patients ? patients ?
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Self-portrait with Dr. ArrietaSelf-portrait with Dr. Arrieta
“ “ with gratitude, to with gratitude, to my friend Arietta: my friend Arietta: for his affection for his affection and care in saving and care in saving my life form my life form dangerous illness dangerous illness …” …”
Francisco Goya 1820Francisco Goya 1820
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A new centre: what’s news? (1)A new centre: what’s news? (1)
NowNow
Passive patient: Passive patient: ““doctor doctor dependent “dependent “
““To err is wrongTo err is wrong” : ” : risks and risks and medical errors are hidden medical errors are hidden (culture of fear and (culture of fear and punishmentpunishment))
improvement = fixing improvement = fixing problemsproblems
the clinical practice and the the clinical practice and the use of the health technology use of the health technology based on opinions , and based on opinions , and intuition intuition
Expected changesExpected changes
Patient as active partner : Patient as active partner : holding us accountable holding us accountable
To err is human. Culture of To err is human. Culture of transparence and learning transparence and learning from our mistakes. from our mistakes.
improvement = to promote improvement = to promote the best practicesthe best practices
The clinical practice and the The clinical practice and the use of the technology baseduse of the technology based on the CPG and the on the CPG and the findings of the scientific findings of the scientific evidencesevidences
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A new centre: what’s news? (2)A new centre: what’s news? (2)
NowNow
Quality and safety of the Quality and safety of the health care, is unknown, health care, is unknown, not measurement, not not measurement, not rewarded rewarded
The competency of The competency of healthcare professionals healthcare professionals and health institutions is and health institutions is not not assessedassessed
..
The quality Safety, HTA The quality Safety, HTA and EBM are not and EBM are not InstitutionalizedInstitutionalized..
Expected changesExpected changes
Measurements methods, Measurements methods, and and rewarding mechanismsrewarding mechanisms
Periodic re-licensing of Periodic re-licensing of medical Professionalsmedical Professionals
Accreditation of health Accreditation of health institutions based on the institutions based on the European standards European standards
The National Centre for The National Centre for QualityQualityy,Safetyy,Safety, HTA, EBM is , HTA, EBM is alalready establishedready established… …
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WWW.QKCSAISH.GOV.ALWWW.QKCSAISH.GOV.AL Email: Email: [email protected]@qkcsaish.gov.alN
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The sector of Patient Rights and Menagment of The sector of Patient Rights and Menagment of Risks and Medical Errors (1)Risks and Medical Errors (1)
Empowerment of patients, Empowerment of patients, Patient centrenness. Patient centrenness.
Assisst on recognition and the Assisst on recognition and the Implementation of the patients Implementation of the patients rights.rights.
Informing and encouraging Informing and encouraging patient organization in NGO.patient organization in NGO.
Promting Therapeutic Education Promting Therapeutic Education for Patients with chronich for Patients with chronich deseases ableing them in self deseases ableing them in self management of their own management of their own deseases deseases
Dr. MIRELA CELA
“Health System exists, first of all to serve Patients and Citizens ?”
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TheThe ssector of Patient Rights and Managment of risks ector of Patient Rights and Managment of risks and Medical errors (2)and Medical errors (2)
Menagment of risks and Menagment of risks and accidental errors for patients accidental errors for patients and medical personnel. and medical personnel.
The preventive and The preventive and minimzing mechanisms of minimzing mechanisms of risks and errors.risks and errors.
Transparency and learning Transparency and learning form errors, a new culture.form errors, a new culture.
(from hidden, to raport , (from hidden, to raport , form guiltiness-punishment, form guiltiness-punishment, to learn-improvement )to learn-improvement )
Parcipating in „World Parcipating in „World Alleance of Patient Safety“ , Alleance of Patient Safety“ , of WHO.of WHO.
Dr. MIRELA CELA
„it is not wrong to err , but is wrong not to learn from mistakes „
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The challenge of choosing the ‘best’ in The challenge of choosing the ‘best’ in Medical Practice and Health Technologies Medical Practice and Health Technologies
What What medimedication equipment cation equipment , , examinationexamination, pro, procedure,cedure, or or methods are the best one methods are the best one ……??
Is the longest, oldest , or the Is the longest, oldest , or the most ‘famous’ experience most ‘famous’ experience always, ‘the best’..? always, ‘the best’..?
Is theIs the new or High Tech new or High Tech ,the ,the best, in relation to outcomes best, in relation to outcomes and cost- effectiveness ..? and cost- effectiveness ..?
Is the clinical practiceIs the clinical practice based based onon scientific evidence scientific evidence,, oror,,solely solely in in oppinions or oppinions or clinical clinical intuiintuitionstions … …??
How much successfulHow much successful are the are the metmethhododss andand te techchnolognologiesies that that we are curentely using we are curentely using ……??
To what extend patients are To what extend patients are satisfied with these ..?satisfied with these ..?
How much cost-effectiveHow much cost-effective??
How to distinguish the true values How to distinguish the true values among the enormous advertising among the enormous advertising in free market?in free market?
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The sector of Health Technology Assessment, Evidence- The sector of Health Technology Assessment, Evidence- Based Medicine and Clinical Guidelines Based Medicine and Clinical Guidelines
To assist and choose the best To assist and choose the best technology (the existing and the new technology (the existing and the new one) based on performance and cost-one) based on performance and cost-efficiency .efficiency .
To establish a networking Centre of To establish a networking Centre of collecting the Scientific Medical collecting the Scientific Medical Evidences.Evidences.
To use this Evidence Centre in the To use this Evidence Centre in the service of medical professionals.service of medical professionals.
To develop the best practical clinical To develop the best practical clinical guideline .guideline .
To promote the culture of decision-To promote the culture of decision-making based on facts, evidences, making based on facts, evidences, not simply on opinions.not simply on opinions.
Dr. KLEVIS THOMAI
” to promote and choose the best based in opinions, or based on facts and scientific evidence”
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The challenge of professional medical The challenge of professional medical competencecompetence
Are the Diploma and the Are the Diploma and the medical licences with the medical licences with the eternity valueeternity value ?? ??
are the medical and are the medical and professional competences professional competences for nurses and doctors for nurses and doctors certified ? As they certified ? As they pretended? pretended?
Are the existed health Are the existed health institutions accredited ?institutions accredited ?
From whom, When? From whom, When?
Is there any existing Is there any existing criteria and regulatory criteria and regulatory mechanism for periodic mechanism for periodic evaluation of the evaluation of the professional and medical professional and medical competence in individual competence in individual and institutional level ?and institutional level ?
““even the best well-known even the best well-known doctors, trust and apply in doctors, trust and apply in their practice the news of the their practice the news of the science although not so far science although not so far after 5 years mostly results after 5 years mostly results not accurate that must be not accurate that must be changechange ””
Marcel RoustMarcel Roust
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The sector of accreditationThe sector of accreditationof health institutions of health institutions (Public and Private)(Public and Private)
The set of healthcare standards.The set of healthcare standards. The set of quality indicatorsThe set of quality indicators The set of performance indicators.The set of performance indicators. The methods of measurements The methods of measurements
and evaluation and evaluation The Process of accreditation.The Process of accreditation. To train and to able the trainers.To train and to able the trainers. To Promote and Educate the To Promote and Educate the
concepts and the culture of concepts and the culture of qualityqualityy, for the patients and y, for the patients and healthcare personnel.healthcare personnel.
Dr. XHENSILA FRASHERI
“the best hotels have five stars, what about the best hospitals, how to distinguish them.?”
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Re-licensing of medical professionalsRe-licensing of medical professionals
To design a legal To design a legal framework for Re-licensing framework for Re-licensing process.process.
To define methods , To define methods , criteria and standardscriteria and standards
The procesThe proces of evaluationof evaluation of of the the individual, individual, professional compentenceprofessional compentence of doctors /nursesof doctors /nurses
Links with other Links with other institutions related with institutions related with licensing, order of licensing, order of physician physician and continuing medical and continuing medical education.education.
ROZARTA TURKUMD in public health
“the license and diploma, are not in eternity”
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PartnershipPartnership
Country partnersCountry partners
Ministry of HealthMinistry of Health The Group of Hospital The Group of Hospital
StandardsStandards The faculty of medicine/ The faculty of medicine/
Nursing Nursing PHI, HIIPHI, HII Order of Physican, Order of Physican,
Profesionnal organizationsProfesionnal organizations Patients organizationsPatients organizations The press/MediaThe press/Media Medical professionalsMedical professionals Pharmaceutical Industry Pharmaceutical Industry The community and NGO-sThe community and NGO-s
IInternational partnersnternational partners
WHOWHO World BancWorld Banc USAIDUSAID,,UNICEFUNICEF SorrosSorros foundation foundation SSwiss foundationwiss foundation ISQUAISQUA,,EFQMEFQM,ESQHC,ESQHC ISO, NICE, ANAESISO, NICE, ANAES Italian Centre of QualityItalian Centre of Quality WHO Global Alliance of WHO Global Alliance of
Patient SafetyPatient Safety Pro- Shendeti Pro- Shendeti American Academy of FDAmerican Academy of FD
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The challenge of harmonizing partnershipThe challenge of harmonizing partnershipN
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The partnership and coordinationThe partnership and coordination
Bulding up links and Bulding up links and coordination with inner coordination with inner partners.partners.
Networking international Networking international partners.partners.
Coordinate and promote Coordinate and promote common activities. common activities.
Publishing ,Relation to Publishing ,Relation to Media and Public.Media and Public.
ANISA LEKA
“only together we can be successful”
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The Standards can be implemented only by common efforts
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and…the Director of the Centre :and…the Director of the Centre :
Dr Kishoti Dr Kishoti The dilemmas:The dilemmas:
Are these ideas utopias ?Are these ideas utopias ? Isn’t too early ..?Isn’t too early ..? Does any body think Does any body think
seriously about it ?seriously about it ? Is anyone interested ?Is anyone interested ? Futurology …?!Futurology …?! Just Imposibel dreams…Just Imposibel dreams…
The challenge:The challenge: “ “All dreams become true All dreams become true
if we have courage to if we have courage to follow them …“follow them …“
Walt Disney Walt Disney
My lord: “The Good Will make 1000 opportunities , the lack of it : 1000 obstacles”
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““the possible within the possible within impossible …”impossible …”
Aleksander BllokAleksander Bllok
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……catching the future …catching the future …N
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THANK YOUTHANK YOU
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