Building a European network for change

A European Union project is raising the bar on quality and patient safety by encouraging EU member states to share good practice. We spoke to its coordinator, clinician Jean Bacou.

In these recessionary times, health services across Europe are facing a common challenge: the need to improve quality while reducing costs. One initiative designed to help them combine forces is the European Union Network for Patient Safety and Quality of Care (PaSQ) – a three-year project working to share good practice on quality and patient safety across all member states.

Jean Bacou explains: ‘All EU member states are facing the same problems, with scarce resources, but they usually try to solve them alone. We think it’s important that they share their experiences and exchange information in order to move forward.’ The ultimate goal is to help countries develop patient safety programmes, with support for those that are less advanced.

Funded by the European Union Public Health Programme, PaSQ is coordinated by the French national authority for health, Haute Autorité de Santé, with elements being run by health institutions in Croatia, Greece, Denmark, Germany, Spain and Slovakia.

Identifying interventions

The project focuses on two areas of work: first, identifying just a few evidence-based safety interventions to pilot in a limited number of healthcare organisations across the EU, and second, exchanging wider good practice through an EU-wide database.

To gather the good practice, the team is conducting a detailed literature review, supported by extensive input from professionals working on the ground. So far they have amassed more than 350 clinical examples to improve patient safety, and more than 120 organisational examples for quality improvement. The next step is to develop the database, from which each national body will select one or two practices to promote within its country, with funding and support from PaSQ.

In developing the database itself the team will try to avoid too much selection, says Jean. 'Instead, we will try to assess the level of transferability, to ensure that a practice is useful for another environment. We have criteria for doing that. But we want to include a large number of examples to allow each nation to choose and possibly adapt the good practice that is most relevant to them.’

A crucial part of the programme involves building an international network of around 60 institutions (which in the UK include the Department of Health, NHS England and the Health Foundation). They filter the messages down to healthcare bodies and, ultimately, health professionals. The project is supported at the European level, too, by Europe-wide representatives of stakeholders that include patients, healthcare professionals and healthcare organisations.

Emerging themes

One year into the project, some themes are emerging. ‘We have noticed everywhere that if you want to address quality of care, you have to do it with all the stakeholders involved, and teamworking is essential,’ says Jean. Activities being piloted for implementation include improved drug management through medication reconciliation; checklists to avoid wrong-side surgery; hand hygiene; and paediatric early warning scores. ‘We chose these as they were already proven to be efficient and there are existing implementation tools that we could promote,’ explains Jean.

Adaptation

Adaptation is key to the ethos of the project: a ‘one size fits all’ approach clearly will not work when there are wide differences across countries. Even within countries, culture can vary widely across regions, or between organisations, so transferability is always important.

But those differences can produce valuable learning too, explains Jean: ‘The culture in some countries has been more paternalistic than in others, making involvement and empowerment of patients more difficult to implement. But it’s just a matter of time. We can accelerate the use of good practice by sharing experiences of clinicians or patient representatives. It might help people to change their way of thinking.’

For now, the scheme is still a pilot. The challenge is to secure ongoing EC funding to ensure sustainability. Jean remains optimistic: 'Patient safety is high on the EC agenda. But we want to prove that we can progress by exchanging information, rather than yet more regulation: sharing our learning and adapting it to local need rather than harmonisation.’