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Fresenius Helios

You can only initiate changes, if you are aware of your own strengths and weaknesses. The objective of the HELIOS quality management system is to continuously improve the results of medical treatments in all HELIOS clinics. One main requirement is to make one’s own quality transparent on the basis of G-IQI quality indicators (German Inpatient Quality Indicators). With the help of now more than 1,500 key figures (2010: more than 1,300), clinically relevant indications and surgical procedures are documented. The timely, efficient measurement of quality indicators from administrative data has become critical for our result-oriented quality management.

In 2011, the HELIOS clinics made comprehensive additions to the existing set of indicators. Continuous monitoring can now be guaranteed for far more indications and surgical procedures than before. Heart and thorax surgery, for example, is now included in the process. The individual specialist groups of HELIOS also monitor and analyze additional key figures on the details of the medical and nursing care in the various disciplines.

HELIOS QUALITY PERFORMANCE INDICATORS (EXTRACT)


Indications/standardized mortality ratio (SMR)1 2011 SMR 2010 SMR2
1 SMR 1 corresponds to the German average SMR < 1 = means that mortality is below the German average
2 Adjusted for the current reference value of the Federal Statistics Office and newly acquired clinics

More information can be found at: http://www.helios-kliniken.de/medizin/qualitaetsmanagement
Chronic obstructive pulmonary disease (COPD) 0.72 1.06
Acute myocardial infarction (AMI) 0.65 0.77
Heart failure 0.60 0.68
Ischemic stroke 0.88 0.88
Pneumonia 0.65 0.76
Hip fracture 0.89 0.93

Indications/standardized mortality ratio (SMR)1 2011 SMR 2010 SMR2
1 SMR 1 corresponds to the German average SMR < 1 = means that mortality is below the German average
2 Adjusted for the current reference value of the Federal Statistics Office and newly acquired clinics

More information can be found at: http://www.helios-kliniken.de/medizin/qualitaetsmanagement
Chronic obstructive pulmonary disease (COPD) 0.72 1.06
Acute myocardial infarction (AMI) 0.65 0.77
Heart failure 0.60 0.68
Ischemic stroke 0.88 0.88
Pneumonia 0.65 0.76
Hip fracture 0.89 0.93

For 46 of these quality indicators, ambitious group-wide targets were defined, of which 39 were reached in 2011 on the corporate level. The aim is for the HELIOS clinics to be at least as good as the German average for these indicators. From 2012 onwards, comparison data from the Federal Statistics Office will be available also for complex defined quality indicators. This will further increase the transparency of quality and improve the comparison of HELIOS’ clinics with other hospitals to continuously improve their quality of treatment. Previously, HELIOS clinics had been using other scientific sources to determine comparable quality targets. The reason for doing so was that reference values from the statistics of the German Federal Statistics Office had previously only been available for basic diagnoses (e. g. heart attacks), but not for complex cases.

HELIOS provides full transparency for all quality data: They are published to all HELIOS employees monthly on the intranet. The same applies for the transparency towards patients and the public. For each acute care clinic, the results for medical treatment quality are published on the website www.helios-kliniken.de.

In 2011, HELIOS achieved an SMR of 0.60 for heart failure (2010: 0.68). This indicates that the mortality in the HELIOS clinics was 40% below the average of all German clinics (2010: 32%). In 2011, a German average for certain diseases was available for the first time. HELIOS integrated the corresponding quality indicators, for example for the chronic obstructive pulmonary disease (COPD), accordingly. COPD leads to damaged airways in the lungs, causing them to become narrower and making it harder for air to get in and out of the lungs. Where the few targets were not achieved, the deviation from the German average was so small as to be statistically insignificant.

HELIOS is one of the founding members of the Initiative of Quality Medicine (IQM) in which hospitals, hospital operators, and university hospitals joined together. Its members commit to three basic principles: The first is to take quality measurements with routine data, the second to transparently publish the results, and the third to carry out peer review processes. In May 2011, the results from 2009 and 2010 were published on the respective websites of the member hospitals. This accommodates the growing demand for transparency that comes from patients, cost carriers, and referring physicians.

Measuring and showing quality helps assess treatment results and to demonstrably improve them for the benefit of the patients. The peer review is, in this context, an appropriate instrument to follow up on statistic abnormalities. Experienced, specially trained physicians visit other hospitals as a peer review team. That team analyses together with the responsible chief physicians how the treatment quality could be further improved.

In 2011, IQM carried out 42 peer review processes across different providers; 13 of them in HELIOS’ acute care clinics. The number of reviewers within the initiative is continuously growing and at the same time, the training of the participating physicians, the so-called peers, is strengthened. The German Medical Association supported the IQM peer review process from the start with its own experts, and after the 2011 evaluation, introduced the continuing education curriculum “Medical Peer Review”. To date, more than 150 chief physicians are active as peers for IQM, so next year more departments will be able to benefit from the helpful assistance provided by physicians for physicians. For more information, please refer to the initiative’s website: www.initiative-qualitaetsmedizin.de.

However, quality management at HELIOS goes beyond the medical results. Our perception of quality also includes the standard of nursing care, the aim being to provide patients with the best medical and nursing care. This is a precondition for successful medical treatment. Our nursing staff – the biggest professional group at the HELIOS clinics – is in continuous communication with the doctors and other professional groups, e. g. therapists. The aim is to activate the patient’s physical, mental, and social abilities, and to restore their natural functioning to the greatest possible extent through preventive, curative, and rehabilitative measures.

Medical devices and drugs have direct relevance for the standard of medical quality. The patient-specific preparation of pharmaceuticals in our hospital’s pharmacies is subject to high quality standards and must be prepared in a hygienically correct manner. HELIOS continuously invests in safety and quality standards to be able to reach these high quality standards. In 2011, three new hospital pharmacies were set up in Erfurt, Krefeld, and Plauen. The investment required for each amounted to approximately €10 million.

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