Improving the quality of care for people with chronic diseases: translating recommendations to practice.

INTRODUCTION: Aim of this paper is to present a guide for translating to practice an evidence-based set of Quality Criteria and Recommendations (QCR) to promote the implementation of policies and practices in the field of health promotion, disease prevention and care for people with chronic diseases. METHODS: The guide is based on real-world experiences of eight European pilot actions using QCR as a framework for practice design, development, implementation, monitoring and evaluation. All partners implemented their respective practices by following the same agreed process. RESULTS: The implementation method was summarized in seven steps where each of one outline a particular phase of the process. The guide provides a step-by-step tutorial for the implementation of QCR. CONCLUSIONS: Practical experiences from the pilot actions show the potential value of using the QCR in designing and implementing practices to improve the quality of care for people with chronic diseases.

A new understanding of health related empowerment in the context of an active and healthy ageing.

BACKGROUND: Recently, several initiatives have focused on how to create true person-centred health services. This calls for a new understanding of health-related empowerment in relation to people living with one or more chronic conditions. We report on a Delphi investigation among participants in the European Innovation Partnership on Active and Healthy Ageing that has led to a new understanding of health-related empowerment. METHODS: The Delphi process was conducted in three sequential rounds. In the first round, we presented a suggested first version for a definition of "health-related empowerment" divided into nine statements. One hundred and twenty-two experts were then asked if they agreed or not with each individual statement, and in the case they disagreed, to state the reasons for their disagreement. After revisions, the experts who had replied to the first version were asked again, if they agreed or not with each individual statement of the second version and to elaborate on disagreements. Finally, in the third round the experts were asked to provide comments to the final proposed definition in general and not by each statement. RESULTS: A total of 33 experts responded to the first version. The following revision included a merging of two statements, and the addition of health literacy as part of the understanding. The second version was sent out to the 33 experts and a total of 19 experts commented with moderate consensus. Changes included removal of "self-esteem" and change of "self-confidence" to confidence. Third version was sent out to all 122 experts with 16 respondents. Strong consensus was obtained for this third version, and is with one minor change presented as the final version. CONCLUSION: We propose a new understanding of the concept health-related empowerment, by focusing on the individual as a co-manager with freedom to choose and focus on their own well-being.

European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases: report of the European Union Parliament Summit (29 March 2017).

On March 29, 2017, a European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases (CRD) was organized by the European Forum for Research and Education in Allergy and Airway Diseases. The event took place in the European Parliament of Brussels and was hosted by MEP David Borrelli and MEP Sirpa Pietikainen. The aim of the Summit was to correspond to the needs of the European Commission and of patients suffering from CRD to join forces in Europe for the prevention and self-management. Delegates of the European Rhinologic Society, European Respiratory Society, European Academy of Allergy and Clinical Immunology, European Academy of Paediatrics, and European Patients Organization EFA all lectured on their vision and action plan to join forces in achieving adequate prevention and self-management of CRD in the context of Precision Medicine. Recent data highlight the preventive capacity of education on optimal care pathways for CRD. Self-management and patient empowerment can be achieved by novel educational on-line materials and by novel mobile health tools enabling patients and doctors to monitor and optimally treat CRDs based on the level of control. This report summarizes the contributions of the representatives of different European academic stakeholders in the field of CRD.

Selecting indicators for patient safety at the health system level in OECD countries.

BACKGROUND: Concerns about patient safety have arisen with growing documentation of the extent and nature of harm. Yet there are no robust and meaningful data that can be used internationally to assess the extent of the problem and considerable methodological difficulties. PURPOSE: This article describes a project undertaken as part of the Organization for Economic Cooperation and Development (OECD) Quality Indicator Project, which aimed at developing an initial set of patient safety indicators. METHODS: Patient safety indicators from OECD countries were identified and then rated against three principal criteria: importance to patient safety, scientific soundness, and potential feasibility. Although some countries are developing multi-source monitoring systems, these are not yet mature enough for international exchange. This project reviewed routine data collections as a starting point. RESULTS: Of an initial set of 59 candidate indicators identified, 21 were selected which cover known areas of harm to patients. CONCLUSIONS: This project is an important initial step towards defining a usable set of patient safety indicators that will allow comparisons to be made internationally and will support mutual learning and quality improvement in health care. Measures of harm should be complemented over time with measures of effective improvement factors.

Quality indicators for international benchmarking of mental health care.

OBJECTIVE: To identify quality measures for international benchmarking of mental health care that assess important processes and outcomes of care, are scientifically sound, and are feasible to construct from preexisting data. DESIGN: An international expert panel employed a consensus development process to select important, sound, and feasible measures based on a framework that balances these priorities with the additional goal of assessing the breadth of mental health care across key dimensions. PARTICIPANTS: Six countries and one international organization nominated seven panelists consisting of mental health administrators, clinicians, and services researchers with expertise in quality of care, epidemiology, public health, and public policy. Measures. Measures with a final median score of at least 7.0 for both importance and soundness, and data availability rated as 'possible' or better in at least half of participating countries, were included in the final set. Measures with median scores