Transcript - European Partnership for Supervisory Organisations in

THE ORGANISATIONAL CHANGES OF THE
EXECUTIVE AGENCY FOR MEDICAL AUDIT
BULGARIA
Helsinki, 29-30.09.2015
Bulgaria
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Territory: 111 000 km2
Population: 7 202 198 (2014)
Ethnic distribution:
Bulgarians: 83.0%
Turks: 9.0%
Roma: 3.0%
Others: 6.0%
Republic of Bulgaria
In south-eastern
Europe - part of the
Balkan Peninsula
Bordered:
North
Romania
East
Black sea
West
Serbia and
The former
Yugoslav Republic
of Macedonia
South
Greece and Turkey
Bulgaria
Economic development
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GDP (BGN): 82.16 billion leva (2014)
GDP: 42 billion Euros (2014)
GDP per capita: 5 832 Euros (2014)
Health expenditures per capita: 283 Euros (2014)
Health expenditures as % of GDP: 3.98% (2014)
Health
Population: 7.2 million (2014)
Live births: 9.4 per 1,000 population (2014)
Crude death rate: 15.1 per 1,000 population (2014)
Life expectancy: 74.95 years
Males at birth (2013): 71.3 years
Females at birth (2013): 78.6 years
Executive Agency for
Medical Audit (EAMA)
• Established in January, 2010 with Decree of the
Council of Ministers as governmental institution
under the MoH’s power
The EAMA supervises:
• all types of healthcare establishments in the country
• the National Health Insurance Fund (NHIF) with its
28 regional offices
• the voluntary health insurance funds
EAMA – Mission
Continuous improvement of health care quality
and safety.
Constant control and monitoring of health care
providers’ activities and also of the activities of
compulsory and voluntary health insurance funds
and motivates them to continuous improvement of
their professionalism
EAMA – Vision
To stimulate changes in health care in order to
guarantee access of BG’s citizens to health care
services of good quality, safety, efficiency and
effectiveness
EAMA – Values
Our Values
I nnovations
A rrangement
M oral
O tgovornost (responsibility)
EAMA – Strategic Goals
• To develop a system for total quality management at a national
level;
• To initiate the legislation for quality management;
• To avoid the dissemination of corrupt health care practices;
• To develop data base in the field of health care quality;
• To develop medical errors’ reporting system;
• To motivate all health care partners to work for quality improvement
of health care services, etc.
EAMA – Staff
• The number of people working in the organisation – 68
• 4 Specialized and 1 Administrative Directorates
• No regional offices
EAMA
Executive Director
Deputy Director
Medical audit
of HC
establishments
Directorate
Insurance &
Patients Rights
Directorate
Medical audit
of hospitals
Insurance
Rights
Medical audit
of out-patient
care
Patients Rights
Chief Secretary
Quality
Assurance
Directorate
Administrative
Directorate
Financing & IT
Administration
& Legislation
EAMA – Three stages in the
development of the EAMA
Ist stage: 2010 – 2013
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Q & PS issue; Q Strategy 2010-15; Q analyses
Patients Rights
Register of medical errors based on people’s complaints
Training of staff
Collaboration w/ other HC partners
Open to the public
EAMA – Three stages in the
development of the EAMA
IInd stage: 2013 – 2015
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Administrative structure to the MoH
No Q & PS issue
No Q analyses
No collaboration w/ other HC partners
Limited staff training
Limited openness to the public
EAMA – Three stages in the
development of the EAMA
IIId stage: 2015 –
• Q & PS issue; up-date Q Strategy; Q analyses; Q
indicators
• Patients Rights
• Medical Errors Reporting System at national level w/
UBGPs
• Training of staff & HC professionals
• Collaboration w/ other HC partners
EAMA – Three stages in the
development of the EAMA
2010 – 2013
2013 – 2015
Q & PS issue; Q
Strategy 2010-15; Q
analyses
Patients Rights
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(Q indicators)
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Register of medical
errors based on
people’s complaints
Training of staff
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(Limited)
Collaboration w/ other
HC partners
Open to the public
2015 –
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(& HC professionals)
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(Limited)
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EAMA – Collaboration with HC
Partners
The EAMA works with the following institutions and partners:
• Ministry of Health;
• Regional Health Authorities – 28;
• NHIF / RHIFs;
• Executive Transplantation Agency;
• Scientific Societies of Medical Professionals;
• Union of BG Physicians / of BG Dentists;
• Prosecutor’s Office of Bulgaria;
• National Ombudsman;
• Ministry of Justice;
• National Social Security Institute;
• Patients’ Organizations.
EAMA – Q & PS
The Role of the EAMA for Q & PS monitoring
• Developed checklists and inspects the performance of
the health care establishments to assess the compliance
to the requirements of the medical standards and Health
Care Act;
• Periodically develops Q analyses related to a specific
issue (i.e. AG, children, etc.) with recommendations for
improvement;
• Works with the Scientific Societies of Medical
Professionals to implement improvement activities in
their domains.
EAMA – Q & PS
The Role of the EAMA for Q & PS monitoring
Future activities:
• To work on development of Medical Errors Reporting
System at national level together with the Union of the
BG Physicians;
• To work on development of List of Q & PS Indicators;
• To work on methodology for hospital ranking;
• To organize training and train HC professionals towards
Q & PS
EAMA – Organizational good
practices
Organisational good practices:
• Legislative initiatives for changes of the legislation
towards Q & PS;
• Very good collaboration with other HC partners;
• Q improvement initiatives together with the Scientific
Societies of Medical Professionals;
• Openness to the public and media;
• Questionnaire on the website for assessment of our
clients’ satisfaction
Cons:
• One centralized structure at national level w/o
regional offices
EAMA – Openness to the public and
media
• Publications of Q analyses and annual reports
on the website: www.eama.bg;
• Proactive to the media – flyers, explicative
campaigns, press conferences;
• Visiting hours to meet inspectors – every
Thursday from 1 pm to 4 pm;
• Questionnaire on the website for assessment
of our clients’ satisfaction
EAMA – Pros and Cons of the
organizational solutions
Pros
• Put the Q & PS issue at the
national level;
• Involves HC partners in Q & PS
initiatives;
• Increases the awareness of the
public and media towards Q &
PS;
• Legislative initiatives;
• Increased trust
Cons
• Increased number of complaints
• Increased workload of the
inspectors
• No increase of the human and
financial resources
EAMA – Conclusion
The most important result from the EAMA’s activities is
that fear and mistrust of the health care professionals
from that institution were replaced by gratitude and
appreciation because the aim of the EAMA is not
punishment but to guarantee access to health care of
good quality and safety, protection of patients’ rights and
dissemination of good practices.
THANK YOU FOR YOUR ATTENTION
www.eama.bg