Quality work – the engine driving Capio
Measuring and assessing quality
As a patient, we always assume that we get the best possible treatment when we need healthcare, which we do, in the sense that every healthcare facility strives to do the best it can. The requirement for simple and open comparison of healthcare results already exists in Europe, to varying degrees, and will be expanded in the future. This positive development is in the interest of the patients and can in itself lead to better healthcare quality. Quality must be reported on a systematic basis in order to be worthwhile. For each treatment, the most relevant outcomes should be pinpointed, in order to assess the value of the treatment for the patient. Capio divides the outcomes into three main groups: the clinical reported outcome (CROM), the patient reported outcome (PROM), and the patient reported experience (PREM). See the figure below. Examples of clinical reported outcomes are the frequency of complications, the time to recover after the procedure and the measurable control of the disease, while improvements in function and quality of life after treatment are examples of patient reported outcomes. How care is experienced ultimately depends on the medical outcome and how much pain, discomfort and tiredness the treatment causes, but is also to a great extent affected by how we provide information and our kind treatment. The care environment also has an impact. It must be possible to measure each of the three main groups of outcomes. These measurements are called Quality Performance Indicators (QPI).
Continuous quality work leads to improvements
Our results do not improve automatically. Improvements require determined, systematic initiatives. Our continuous improvement work entails developing our care processes so as to improve results. By understanding the care process and its significance to the results, we can focus on the most urgent needs for improvement. It is also important to set up measurable goals, process targets, for the day-to-day work, in order to follow up on whether the care processes are developing in accordance with our targets. This is all summarised in a quality plan, or quality budget. A quality plan includes the concrete measures to improve working methods that we consider significant for the quality indicators we wish to influence. These measures must be measurable, with allocated resources, and for each measure there must be a person responsible for achieving the improvement within a stated time.
Quality based on four cornerstones
Quality has many aspects. Capio focuses on four areas that we believe are most important for the patients – Modern medicine, Good information, Kind treatment and a Nice environment and adequate equipment. We call these the four cornerstones of quality. They may seem to be obvious – everyone practices modern medicine, keeps patients well-informed, treats everyone kindly and has good premises and the right equipment. However, a closer study reveals many areas that can be improved. Capio is active in several countries with different medical traditions, cultures and regulations, yet they all share in common that there is scope for improvement within all four quality cornerstones, in all countries and activities. This applies regardless of how far the unit in question has progressed with its quality work. Quality is not a final destination, but a journey towards the goal of continuous improvement for the patients.
Systematic quality work increases effectiveness
Plans are necessary, but will not make a difference unless they are implemented. Regular follow-up on the quality plan is therefore part of the normal business follow-up routines. Once the plan is successfully implemented, we expect the quality indicators to show that our quality has also improved. This is measured by regular Quality Performance Indicators (QPI).
This method of working is thus a cyclical process that takes place on a continuous basis. Quality work is the engine that drives Capio, ensuring that our patients receive the right, safe care, make a speedy recovery after treatment and experience security and expertise whenever they are in contact with us. In turn, this ensures that our work is effective, and also ensures confidence in us as care providers.
As a rule, our undertakings to the authorities include quality targets, usually formulated as process targets, which are targets for patients’ treatment, time frames, and so on. This is naturally worthwhile, yet we now wish to move forward and perform quality work more systematically, with even better treatment outcomes for patients. We call this working instrumentally with quality. This implies systematic quality work that is focused on continuous improvement in results, in terms of fewer complications and faster recovery after treatment. Fewer complications and faster recovery naturally also ensure increased effectiveness. We measure our effectiveness by Key Performance Indicators (KPI). We have KPI for how much care we produce and the resources we require to provide care. The ratio between these, i.e. our productivity, or utilisation of resources, is fundamentally determined by the quality of care.
Quality as an element of our corporate culture
Systematic quality work, as described here, is becoming part of Capio’s corporate culture and is continuously integrated into our normal working processes. The entire line organisation must be engaged in and represent our quality culture. A common language and measurement methods merely provide the underlying structure. Filling out this structure with the right content and having the dedication to achieve change requires competent and motivated employees at all levels. These conditions are determined by the second half of the Capio model, which is how we organise and manage our units.