Estonian clinicians learn from Danish experiences with hospital performance assessment

Through its National Indicator Project (NIP), Denmark has developed a model system for hospital performance assessment. Covering all hospitals in the country and involving clinicians in the indicator development process, NIP has become a frequently cited example for other countries. Data gathered over the past decade have shown improvements in patient care and have enabled comparison between different providers.

On 17 January 2013, Tartu University Hospital organized in cooperation with the Estonian Health Insurance Fund and WHO a seminar to introduce the Danish NIP and clinical registers to Estonian clinicians.

Estonian experience in using quality indicators

Estonian hospitals joined the WHO PATH (Performance Assessment Tool for Quality Improvement in Hospitals) project in 2005. Within this project, a group of six regional and central hospitals worked to adapt and implement PATH model indicators and to compare the results with participating hospitals in other countries. Development of clinical indicators was intended to draw hospital managers’ attention to quality management at hospital level and to increase their accountability with regard to quality enhancement.

Long-term learning and commitment

The reasoning and activities of the Danish system were introduced to participants to increase their knowledge on the use of indicators for quality improvement in hospital care. Invited speakers from Denmark, Professor Jan Mainz, founder of NIP, and Dr Paul Bartels, stressed the importance of clinicians’ initiative and leadership supported by hospital managers, as well as of the scientific approach and cooperation between different parts of the quality improvement cycle. Participants also discussed opportunities and threats involved in making the assessment results public.

Discussions between the Medical Faculty of Tartu University Hospital and the Estonian Health Insurance Fund focused on possibilities for long-term cooperation with the Danish NIP to enable Estonian clinicians to continue learning from Danish experiences.

Participants’ feedback on the seminar was good and the Estonian scientific medical magazine Eesti Arst will publish a long overview in its February 2013 issue.