Spitex - Quality and indicators

Why is it so important to improve the quality of healthcare?

Health is one of the most valuable assets there is. It has a significant influence on a person's quality of life and lifespan. This makes it all the more important to maintain it for as long as possible and to restore it quickly in the event of illness.

However, this is not the only reason why the Swiss parliament decided to improve the quality of healthcare in 2022. Financial aspects also play an important role. Events such as infections, pandemics or medication errors not only cause suffering, but also high costs.

What guidelines must Swiss Spitex organizations adhere to?

Spitex organizations must meet special requirements at cantonal level. In some cases, further communal regulations apply - often as part of service agreements and operating licenses. Spitex organizations must also adhere to the quality requirements set out in the cantonal healthcare law.

The national quality standards take precedence over all these requirements. Since April 2021, the federal government has had to formulate both a quality strategy and development goals for the next four years. Spitex organizations receive support from the Federal Quality Commission in the form of programmes, studies and projects.

The law also provides for service provider associations to conclude a quality contract with the health insurer associations. This sets out binding quality measures.

A total of 19 such quality agreements should be concluded by spring 2022. However, negotiations have so far been unsuccessful and are still ongoing. There is still a lack of regulation and assurance of funding for the additional costs that the contracts entail. For example, the additional expense resulting from the annual reporting of the achievement of all quality requirements should be mentioned.

These and other additional expenses should be minimized. To this end, quality measures that Spitex organizations already implement in their daily work are to be included in the contracts. Among other things, this should prevent an increase in data collection.

Even if none of the quality contracts have been successfully concluded to date, the negotiations have already had a positive impact. For example, the umbrella organization Spitex Switzerland has set up a quality commission with representatives from all Spitex regions.

It discusses national quality issues centrally. In addition, a national Critical Incident Reporting System (CIRS for short) is to be created. This is a system that records all (potential) errors and enables them to be dealt with.

What does the Federal Quality Commission do?

The aim of the Federal Quality Commission, EQC for short, is to bring about sustainable change. To this end, a great deal of groundwork is to be done first. This includes, among other things:

• Collecting sound data
• Co-financing quality development projects
• Commissioning external parties to achieve the annual targets
  

What is the purpose of the Spitex quality indicators?

Unfortunately, there is a lack of standardized indicators in Switzerland that can be used to measure the quality of Spitex services. Sufficient indicators must first be evaluated and supplemented.

They should help to uniformly measure specific aspects that influence the high quality of Spitex services. This includes, for example, counting falls or documenting pain.

There is currently still a lack of standardized quality indicators that enjoy national recognition. These indicators were to be developed as early as 2022. However, this could not be completed as the basic work is still outstanding. A particular challenge lies in finding indicators that can only be influenced by Spitex and not by interprofessional teams.

What exactly are quality and indicators supposed to say?

The pure patient outcomes should not only express the quality of treatment. Rather, they should represent the quality of the processes behind the nursing services. To achieve this, it is necessary to consider more than just the patient's perspective. The viewpoint of professionals in the practical field is also required. Their involvement is central to quality assurance.

Digitalization does not stop at the healthcare sector and brings with it enormous potential. Employees in individual regions will soon be able to report errors digitally. They will use a computerized tool to report undesirable events.

This not only saves time. It will also make it much easier to analyze these incidents and track their processing.

Currently, falls, medication errors and other adverse events are reported using paper forms. They comprise five pages and are used to report both incidents and suggestions for improvement. This makes it difficult to classify the forms and therefore delays their processing. A means of increasing efficiency is therefore required.

This is why a computer-aided tool in the form of an app is currently being developed to simplify and speed up error management. Thanks to it, incidents should be reported in the shortest possible time and their processing simplified.

However, before it can be used extensively, employees need to be trained accordingly. By the end of October 2023, nine out of ten incidents should be reported via the app.

It is by no means the case that a lack of documentation is also an indication of inadequate care. As a rule, the opposite is the case. Countless Spitex organizations focus on quality even without meticulous documentation. This is particularly evident in the development of concepts relating to the training and further education of specialist staff.

In nursing homes, the documentation situation is often more unstructured than in Spitex organizations. It can happen that services appear in care plans that are not necessary or are not provided at all, but are nevertheless billed as services subject to compulsory health insurance. It is difficult to determine the reasons for this without complete documentation.

This makes it all the more important, especially in this area, to have comprehensive documentation that involves as little effort as possible.

Find the right Spitex with OPAN

At OPAN, we have made it our mission to find the ideal Spitex for every person in need of care. Of course, this also applies to your relative. To this end, we have launched an online platform for patient registration.

This enables medical practices and private individuals to reliably transfer applications to the desired Spitex. We guarantee a secure and fast information channel. In this way, we help to increase efficiency and save time.

More than 250,000 registrations have already been made via our platform. We would be happy to help you find the right Spitex for your relative. Please contact us if you have any questions. We will guide you through the use of our platform. We will also explain to you in detail the advantages it offers.