|Implemented in this survey?|
A policy program called ?Sneller Beter? (?faster treatments / sooner better?) is introduced to support innovation and quality management in November 2003. Aim of this program is to improve and stimulate efficiency and quality of medical care by bringing out best practice institutions ?Sneller Beter?.
A policy program called "Sneller Beter" ('faster treatments / sooner better') is introduced to support innovation and quality management in November 2003. Aim of this program is to improve and stimulate efficiency and quality of medical care by bringing out best practice institutions "Sneller Beter" (see survey 02/2003: "Quality Management more compulsory" reported by: Erasmus University Rotterdam, Institute of Health Policy & Management).
In the Dutch health care quality improvement is known. In the program Sneller Beter, quality management has to be linked to efficiency management and benchmarking.
Medical professionals and providers are key actors.
|Medienpräsenz||sehr gering||sehr hoch|
The new centre-right coalition (christian-democrats, liberals and social liberals) that came into office in 2003 aims at improving the efficiency and quality of health care services, not only by institutional measures (such as regulated competition) but also by setting up a system of benchmarking and best-practices in order stimulate local innovations.
|Implemented in this survey?|
The initiative came from the Ministry of Health and from the Dutch Association of Hospitals. The association of Medical Specialists are by-passed. Instead, the Ministry negotiated with individual hospitals and medical specialists in order to develop the program. By doing so, cumbersome negotiations with the Associations of Medical Specialists were avoided.
The main purpose of the idea is to improve the transparency, efficiency and quality of health care services by means of benchmarking and best practices.
To reach this goal, three main activities are introduced. First: a benchmark for hospitals and general practitioners, second: establish indicators for a safer and better care and last: start the program "quality, innovation, efficiency".
Three priority fields are mentioned: patient safety, patient logistics and patient influence and response.
Also a new referral system for general practitioners is developed. In the future patients will be referred to medical specialists in an acceptable time. Therefore a four step path is developed. Step one: tune the demand by using special refer forms. Step two: standardise patient groups. Step three: inform patients; and finally: define the urgency of treatment.
The interest of the media in all these issues (transparency, efficiency and quality) is overwhelming, but it is difficult to pinpoint down its exact influence on the policymaking.
Main stakeholders in this program are hospitals (with medical specialists) and general practitioners.
The first reaction of the hospitals and medical specialists was quite defensive. But now they feel and accept more and more the pressure to work transparent and efficient and serve quality and they see that technological innovation is developing in a way they cannot deny.
The programm will be successful for patients if it produces good results to patients, so that they get better insights in what is offered. Important is that the good examples not only are criticized by doctors but also by patients. Furthermore patients need transparency to be able to make a well considered decision about changing of insurer. Changing of insurer is a yearly right for patients.
This program also affects health care insurers. They are responsible for transparency efficiency and quality of care as well. Innovation will be used to reach these goals.
No formal legislation or adaptation of legislation is necessary.
There are many stakeholders who are, or can be expected to be, involved in the process towards implementation. First of all the hospitals and their professionals. Other stakeholders are: health care insurers (as purchaser of services they are not only responsible for access and cost but also quality of care), patient organisations, and the National Health Inspection.
Evaluation has taken place in providing best practices. These results are visible at the website of the program: www.snellerbeter.nl. The ministry of Health defined three priority themes distinguished in hospital and GP examples: patient safety, patient logistics and patient responsiveness. At this moment good examples of patient safety, logistics are already visible at the website.
At this moment we can say the program is successful, because of the presence of best practices.
Transparency, efficiency and a better quality of care, are all expected outcomes of the program.
|Qualität||kaum Einfluss||starker Einfluss|
|Gerechtigkeit||System weniger gerecht||System gerechter|
|Kosteneffizienz||sehr gering||sehr hoch|
Jan-Kees Helderman & Anniek Peelen