J & # 39; was in Sweden last week, at the Annual Institute for the Improvement of Health Care. International Conference C was a big gathering: more than 3,000 people from around the world , including 1,000 from Sweden! We heard from people who work in the field of health and social services, who spoke passionately and We are convinced that there have been many presentations on the health care system Swedish health and I was impressed by the data and processes of Sweden, and more particularly by its models of long-term health care, term, community services for the elderly.
So, what did I learn?
A lot! I've learned that patient-centered care is alive and well in Sweden. We made a trip to Jonkoping (pronounced "Jon-shipping"), a city in southern Sweden, to visit the health care center, which includes a hospital and outpatient clinics. There we heard about a model of elder care called Esther Project . We also visited a dialysis center where patients have their own dialysis and a neonatal intensive care center where parents can stay with their baby 24 hours a day. The concept of patient engagement from the health center of Jonkoping has moved to another level. The center allows patients to co-design their care, in fact, and has hired four former patients who serve as mentors, supporters and counselors to current patients.
I have been particularly interested in presentations on new models of care for the elderly, as NCQA is working in this area. We heard from providers who use a patient-centered concept called "What Matters to Me"; it's a simple diagram that includes patients' own words about who they are and what they want to do; for example, "I am a 9 year old grandfather", "I was a plumber"
"I want to take the bus to get to town."
About Registers …
I also went to a very interesting presentation on Swedish registers, where groundbreaking collaborations are organized to address health outcomes. In one example, we saw how a collaboration reduced hemoglobin A1c in Swedish diabetic children. I really like this model of collaborative quality improvement based on the registry – could it be applicable to NCQA's work?
Of course, not everything is perfect.
On the other hand, I saw that the divisions between health and social services create problems for patients. Sweden's privacy laws prevent providers from sharing necessary information. When compared to other countries of the Organization for Economic Co-operation and Development (OECD), Swedish citizens regard the coordination of care as fair or poor. Because the system is decentralized, counties and cities often fail to share their successes and learnings.
Thus, Sweden has opportunities for improvement; I was impressed that these issues were freely discussed, often with "we must do better on this."
A "NCQA sister?"
Meeting people from all over the world and talking to them reminded me that health care is a common language and that the problems people are trying to solve are universal. A good example hit home when I met the deputy director of the "NCQA" of New Zealand, the Health Quality and Safety Commission created by the government five years ago . It was interesting to hear someone who lives and works at nearly 9,000 miles from DC saying that it's hard to hold people accountable for what they can not control, but that people should be rewarded for doing the right thing and not necessarily for the result … added, tracking the result is important. Sounds familiar?
Final Thoughts …
I came back from this meeting feeling incredibly energetic and inspired by what I saw. I think a lot of concepts are useful in our own work for the care of people with complex health needs. And I look forward to learning more about how we could use more quality improvement based on the registry.
Margaret E. O. Kane is the founding and current President of NCQA. Modern Healthcare magazine named O & Kane one of the "100 Most Influential People in Health Care" nine times, the last time in 2014, and one of the "Top 25 Women" in health care "three times.