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Fresenius Helios

The objective of the HELIOS quality management system is to continuously improve the results of medical treatments in all HELIOS hospitals. One main requirement is to make one’s own quality transparent on the basis of G-IQI quality indicators (German Inpatient Quality Indicators). These G-IQIs are not only used in the HELIOS hospitals but have been implemented in more than 500 hospitals in Germany. Variations of them are also used as indicators in Swiss and Austrian hospitals.

Clinically relevant indications and surgical procedures are documented with the help of now more than 1,500 key figures. Until now only some of these G-IQIs had access to reference values from nationwide statistics on diagnostics. For a large number of complex indicators, there were only reference values in scientific literature or estimates by groups of experts. Since 2012, there have also been benchmarks for more complex quality indicators, e. g. cardiac surgery, based on data from the Federal Statistics Office. This has further increased the transparency of treatment quality and improved the comparison of HELIOS’ hospitals with other hospitals.

HELIOS QUALITY PERFORMANCE INDICATORS (EXTRACT)


Indications/standardized mortality ratio (SMR1) 2012 SMR 2011 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 hospitals

More information can be found at: http://www.helios-kliniken.de/medizin/qualitaetsmanagement
Chronic obstructive pulmonary disease (COPD) 0.71 0.85
Acute myocardial infarction (AMI) 0.83 0.92
Heart failure 0.63 0.68
Ischemic stroke 0.83 0.92
Pneumonia 0.64 0.70
Hip fracture 0.97 1.00

Indications/standardized mortality ratio (SMR1) 2012 SMR 2011 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 hospitals

More information can be found at: http://www.helios-kliniken.de/medizin/qualitaetsmanagement
Chronic obstructive pulmonary disease (COPD) 0.71 0.85
Acute myocardial infarction (AMI) 0.83 0.92
Heart failure 0.63 0.68
Ischemic stroke 0.83 0.92
Pneumonia 0.64 0.70
Hip fracture 0.97 1.00

For 46 of these quality indicators, ambitious group-wide targets were defined, of which 42 were reached in 2012 on the corporate level, a success rate of 91% (2011: 85%). The aim is for the HELIOS hospitals to be better than the German average for these indicators. HELIOS achieved an SMR of 0.63 for heart failure (2011: 0.68). This indicates that the mortality in the HELIOS hospitals was 37% below the average of all German hospitals (2011: 32%). In the case of four indicators, we did not achieve the target value. HELIOS has analyzed the cases in the hospitals concerned in order to identify opportunities for improvement and to implement appropriate measures.

We measure our quality and present it in order to be able to evaluate the results of treatment and demonstrably improve them. The peer review process is an appropriate instrument for following up statistical abnormalities and looking systematically for ways to improve things.

We carried out an interdisciplinary and inter-segment peer review of so-called “low-risk” case scenarios for the first time in 2012. We looked more closely into the causes of death in surgeries with a low mortality rate (< 1%), including first implants of a total hip endoprosthesis, disc surgery, and small urological surgeries. We considered the individual preoperative risk assessment for the patients by their doctors and the risk management during treatment. These investigations took the form of interdisciplinary analyses and produced significant indications. In particular they found that the handling of anticoagulant drugs before scheduled surgeries could be improved. These anticoagulant drugs are increasingly used with patients who have vascular illnesses, such as cardiac infarctions or strokes, whether as a form of treatment or as a prophylactic. We applied this finding to specific recommendations on the handling of these drugs for surgical procedures. This will further improve patient safety.

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

The HELIOS Group regulation on hygiene, which is based on the recommendations of the Robert Koch Institute, is binding on all employees and all hospitals. HELIOS regularly trains employees on this regulation. Each HELIOS hospital is obliged to keep a record for all wards regarding the 17 most common infectious agents, particularly the multi- and pan-resistant ones. These include bacteria that have become resistant to methicillin and other antibiotics (MRSA – methicillin-resistant staphylococcus aureus). Every day a specialist hygiene nurse as well as the hospital hygienist will check all the laboratory figures from a ward for agents that have been brought in or acquired in the hospital (nosocomial pathogens). As of December 2012, HELIOS publishes on its Hygiene Portal www.helios-kliniken.de/hygiene (German only) how often the 17 most important infectious agents have been found in HELIOS acute care hospitals. The data is updated every six months. This initiative by HELIOS is an appeal for the issue of hospital hygiene to be dealt with transparently and openly. The aim is to improve quality management in hospitals and thus raise patient safety.

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