Baltic policy dialogue on improving quality of care and ensuring patient safety: strategies, regulation, monitoring and incentives


At a Baltic policy dialogue held on 15–16 November 2017 for senior-level delegates from the 3 Baltic countries (Estonia, Latvia and Lithuania), including the health ministers of Lithuania and Latvia, representatives from all 3 health ministries met in Vilnius to exchange experiences in improving quality of care and ensuring patient safety.

In addition to the challenge of guaranteeing access to health care that is provided in the right place and at the right time, ensuring that these services are of high quality is also critical. Focus on quality in health care goes back to the signing of the Declaration of Alma-Ata (incorporated in WHO European Health for All Target 31). Strategies to manage and improve quality are a frequently cited principle and justification for health policy reform, and yet these strategies are quite diverse and fragmented. This is partly because this process requires engaging so many different dimensions of the health system: not only regulating and organizing the inputs of the health system (providers, technologies and financial resources) but also managing people-centred health services delivery and monitoring the outcomes.

Although the understanding of the term quality varies not only between countries but also between stakeholders, at least 3 dimensions have been agreed on:

  • effectiveness,
  • patient safety and
  • people-centredness.

At the Baltic policy dialogue, delegates from the health ministries, insurers and health services presented their specific experience in regulating and certifiying health-care providers, using indicators to monitor and measure quality and promoting quality through incentives. Supported by international experts from Belgium, Denmark, WHO, OECD and the European Observatory on Health Systems and Policies, the policy dialogue also explored the potential for more collaboration within and between countries as well as international support that could help further build capacity for high-quality governance. All national stakeholders acknowledged the need to develop an integrated national approach to quality in health care that can integrate these efforts coherently. Creating a strong and shared culture of quality and safety among all stakeholders (patients, providers, payers and government) is considered a key to success.

The policy dialogue has been a valuable opportunity to share experiences and sharpen thinking within national teams in the Baltic countries. This was the 14th Baltic policy dialogue. The series started in 2004 and is held annually in one of the Baltic countries. This year the meeting was hosted by Lithuania’s Ministry of Health. Next year’s Baltic policy dialogue will be held in Riga, Latvia.