Kvalitetsarbete I Landstinget i Kalmar län. 24 oktober 2007 Eva Arvidsson

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1 Kvalitetsarbete I Landstinget i Kalmar län 24 oktober 2007 Eva Arvidsson

2 Bakgrund Sammanhållen primärvård 2005 Nytt ekonomiskt system Olika tradition och förutsättningar Olika pågående projekt

3 Get the doctors on board Q: Our doctors are already busy and overwhelmed. How can we convince them to do this new work? What's the best way to motivate doctors? A: Most doctors want to give great care to their patients. Many of them also think that they are already giving great care and are working as hard as they can. Start by collecting data on how well their diabetic patients are doing in terms of standard measures of clinical quality. How many of Dr. Smith s patients have had a retinal examination in the past year? How many have a hemoglobin A1c under 7.0%, and so on? Give Dr. Smith feedback on his own patients compared to other providers, and national benchmarks. It is likely that he is doing much worse than he thought. If you then point out that most of his diabetic patients are coming in to see him (or someone else on his staff) six or more times a year you can try to convince him that he does not need to work harder to get improved care, he needs to have his system of care improved so that more of his patients get the correct advice and interventions offered. Make is easier for him (and his staff) to do the right thing. Obviously, it would help if financial incentives rewarded him for providing integrated and coordinated planned care for his diabetic patients. The Institute for Healthcare Improvement (IHI)

4 Get the doctors on board Q: Our doctors are already busy and overwhelmed. How can we convince them to do this new work? What's the best way to motivate doctors? A: Most doctors want to give great care to their patients. Many of them also think that they are already giving great care and are working as hard as they can. Start by collecting data on how well their diabetic patients are doing in terms of standard measures of clinical quality. How many of Dr. Smith s patients have had a retinal examination in the past year? How many have a hemoglobin A1c under 7.0%, and so on? Give Dr. Smith feedback on his own patients compared to other providers, and national benchmarks. It is likely that he is doing much worse than he thought. If you then point out that most of his diabetic patients are coming in to see him (or someone else on his staff) six or more times a year you can try to convince him that he does not need to work harder to get improved care, he needs to have his system of care improved so that more of his patients get the correct advice and interventions offered. Make is easier for him (and his staff) to do the right thing. Obviously, it would help if financial incentives rewarded him for providing integrated and coordinated planned care for his diabetic patients. The Institute for Healthcare Improvement (IHI)

5 Metod Fem indikatorer från Mål & Mått, i PVkvalitet.se Krav alla vårdcentraler cheferna ska prioritera kvalitetsarbetet cheferna kan ställa krav på förvaltningsledning Varje vårdcentral själv datainsamling dataanalys

6 Mål Aktivt arbete på alla VC kring åtminstone några av kvalitetsindikatorerna

7 Metod Inför 2007 Kontaktperson på varje VC Ansvar: indela datainsamling och -dialog Instruktioner Datarapportmallar

8 Datainsamling våren 2007 Utbildningsdagar Pvkvalitet.se Möte med kvalitetsansvariga Kontakter med enskilda VC

9 Resultat Efter sommaren 19 av 25 vårdcentraler hela eller delar av datainsamlingen 13 gått igenom resultat, diskuterat förbättringar nya gemensamma riktlinjer förnyad mätning, följa upp eventuella förbättringar. Uppföljning från primärvårdsledningen: verksamhetsdialoger - vad behövs för att hjälpa? personalbrist redan har pågående utvecklingsarbete inom andra områden för mycket: Datajournaler, hemsjukvård

10 Slutsats Över hälften är på gång med praktiskt förbättringsarbete!

11 Kinoloner

12 Kinoloner