Vive la Différence: A Comparison of CPD Quality Assurance Systems in France and The United States.

Offering relevant, evidence based continuing professional development (CPD) to ensure the continued competence of health professionals is a universal concern. This concern will become even more crucial in a world facing global health threats and in a context of internationalisation of learning environments. While accrediting systems (i.e. external quality assurance systems for CPD) share a common goal to promote high quality CPD, each system is shaped by national history and contexts. An international movement is working to enhance the convergence of accrediting principles and processes. One of the first steps is to know and understand each other. This article serves this goal by offering a descriptive comparison of two seemingly different CPD quality assurance systems - in France and in the USA of America. The descriptions were developed by members of the accrediting bodies in both countries. The main finding of this descriptive study is that, despite stark differences in historical contexts and governance schemes, both regulators share principles of quality and independence of CPD and have endorsed a leadership role in promoting effective strategies, including interprofessional continuing education and practices. The commonalities of goals and values revealed in the study support the efforts of the International Academy for CPD Accreditation related to the globalisation of both health issues and learning environments.

[Preventing violence during hospitalisations in psychiatry]. / Prévenir les moments de violence lors des hospitalisations en psychiatrie.

Over recent years, the psychiatric sector has endeavoured to develop community-based care. Paradoxically, the number of compulsory hospitalisations is increasing. At the same time, the legal framework is evolving and measures relating to the deprivation of liberty in the context of psychiatric care have given rise to extensive guidelines. The work of the French National Health Authority represents, in this context, a certain continuity, with regard to the legal, ethical and social discussions around restriction of liberty practices within psychiatric units. The main focus is on the prevention and management of violent outbursts.

[The latest best practice guidelines relating to seclusion and restraint]. / Les dernières recommandations de bonnes pratiques sur l'isolement et la contention.

Several measures relating to seclusion and restraint are included in the French public health code. The best practice guidelines of the French National Health Authority, published in 2017, define these two notions and advise on the behaviour to adopt with regard to their implementation and monitoring. Likewise, informing and supporting the patient when these measures are lifted are critical moments which the teams must also be able to manage correctly.

Monitoring mental healthcare on a system level: Country profiles and status from EU countries.

AIMS: Routinely collected data can be used to monitor the performance and improve the quality of mental healthcare systems. Data-based and system-level Quality Monitoring Programmes in Mental Health Care (QMP-MHC) are increasingly being implemented in EU countries. They are believed to be indispensable for the sustainable improvement of the quality of mental healthcare. However, there is a paucity of comparative research on national strategies in quality monitoring. This study explores the status of system-level Quality Monitoring Programmes in Mental Health Care (QMP-MHC) in EU countries. It aims to provide a descriptive overview, which is intended to be the first step for comparative research in this field. METHODS: Case studies of system-level QMP-MHCs were gathered from eight EU countries. Experts from each country were asked to describe their approach using a template. These experts were all members of a Europe-wide network of researchers and members of public institutions involved in quality assessment and performance monitoring of mental healthcare. RESULTS: Country profiles were gathered from England, Denmark, France, Germany, Italy, the Netherlands, Portugal, and Sweden. All these countries have - or are in the process of implementing - system-level QMP-MHCs. Implementation seems to be facilitated when a national performance monitoring programme for general healthcare is already in place, although in the Netherlands, a QMP-MHC was established without being attached to a general monitoring programme. All the monitoring programmes described use various quality and performance indicators; some systems enhance this methodology with the addition of qualitative assessment methods such as peer reviews linked to accreditation processes. CONCLUSIONS: Research is needed to better understand the historical, political and technical backgrounds of the different national cases and to explore the effectiveness of different improvement mechanisms on the actual quality of healthcare. Policy makers and those designing performance measurement programmes are recommended to look across the borders of their own healthcare systems as there are many ways to assess performance and many ways to feedback results to service providers. No evidence is available whether one of these methods is superior to the others in improving the quality of mental healthcare.