Aula de Tracey Cooper, Presidente da International Society for Quality in Health Care (ISQua) no II Seminário Internacional sobre Qualidade em Saúde e Segurança do Paciente - evento do Qualisus - que ocorreu dias 13 e 14 de Agosto de 2013, no Ministério da Saúde, em Brasília.

1. Healthcare Quality and
Patient Safety
Brasilia August 2013
www.isqua.org

2. ISQua Background
 Non-profit, independent organisation founded 1985,
international office moved Australia to Dublin in 2008
 Members from 70 Countries (Individual and
Institutional)
 Governed by Board of 10: North America, South
America, Europe, Asia / Pacific regions
 Honorary Advisors: patients, accreditation, education,
research, low and middle income countries
 Board Committees (Editorial Committee,
Accreditation Council: CBA, Brazil)

3. International Reach

4. ISQua Accreditation Activity in South America
4
 Health Accreditation Service, Columbia
 CBA, Brazil 2013/2014
 ONA, Brazil 2013

5. Strategic Alliances
5
 WHO – Official Relations
 Health Technology Assessment International (HTAi)
 URC/USAID
 International Hospitals Foundation
 Institute for Healthcare Improvement (IHI)

6. High Reliability
Healthcare

7. WHO Facts about patient safety
 In developed countries up to 10% of patients may be harmed
while receiving hospital care
 Risk of health care-associated infection in some developing
countries is up to 20 times higher than in developed countries
 In some countries, proportion of injections given with
syringes/needles reused without sterilization is up to 70%.
Unsafe injections cause 1.3 million deaths annually. 300,000
die in India from dirty syringes and 30% are reused
 > 50% of medical equipment in developing countries is
unusable, or only partly usable, and can result in serious
injury or death
 There is a 1:1,000,000 chance of a traveller being harmed in
an aircraft. There is a 1:300 chance of a patient being harmed
during health care

8. Key Ingredients
Safety
Quality
Reliability
Culture of Learning
Informed Decision-Making
It’s all about….

10. “Systems and processes are only
as good as the people who work
within them”

11. COMMUNICATIONS
RELATIONSHIPS
BEHAVIOURS
MULTI-DISCIPLINARY
TEAM WORKING
CULTURE
LEADERSHIP

12. Title Slide
• Bullet Point 1
• Bullet Point 2
• Bullet Point 3
• Bullet Point 4

13. Leadership – Country Level
 Understanding the population priorities for health and
‘social’ care
 Aligning policy, strategy and resources for maximum
overall population benefit
 Developing and planning the workforce – building
capacity and capability
 Engaging with managers, clinicians and patients to
mobilise for safety and quality improvement
 Liberating the patient to safeguard their care and
clarify expectations for safe services
 Effective regulatory framework - responsive,
pragmatic and proportionate

14. Global Context

15. Global Trends 1: Demographic
 Economic slowdown
 Globalization of diseases
 Urbanization
 Global mobility: professionals and patients
(Regional strategies, health tourism)
 Aging population: By 2050:
- people over 65 ~= children < 14
- >50’s population increase from 1.4 to 3.1 billion
 Social care and support: older people, children,
people with a disability

16. The Speed of Population Aging
Time required or expected for percentage of population aged 65
and over to rise from 7 percent to 14 percent
Source: Kinsella K, He W. An Aging World: 2008. Washington, DC:
National Institute on Aging and U.S. Census Bureau, 2009.

17. Global Trends 2: Quality and Safety
 Universal health coverage and integrated care
 Reducing inequalities
 Quality and safety frameworks: standards,
measurement and evaluation – accreditation, licensing
 Informed decision-making: Cost, clinical and
comparative effectiveness. Health Technology
Assessment:
We should treat where there is evidence of benefit and not
treat where there is evidence of no benefit (or harm)
 Measuring performance and outcomes
 Optimising technology solutions

18. Regulating for Improvement

19. Regulating for Improvement
 Core element to quality and safety agenda
 Clear coherent quality and safety framework:
legislation ~ standards ~ guidance
 Outcome-based standards and assessment
 Focus on the important…support…and persist
 Not there to manage the system’s comfort zone
 ‘Safety ripple-effect’ in everything we do: wider
system learning
 ‘Minding the safety gap’ between Regulators

20. Get it safe..
..keep it safe..
..and then we’ll build quality

21. “The future depends on what
we do in the present.”
Mahatma Gandhi