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Deepening Topics

Deepening Topics. Mandatory Certifications of German Health Care Providers. Mandatory QM and QM-certifications. Stationary rehabilitation facilities till July 2013 Social Code IX, § 21 (3): only certified rehabilitation facilities will be paid by statutory health insurance

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Deepening Topics

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  1. Deepening Topics Mandatory Certifications of German Health Care Providers

  2. Mandatory QM and QM-certifications Stationary rehabilitation facilities till July 2013 • Social Code IX, § 21 (3): onlycertifiedrehabilitationfacilities will bepaidbystatutoryhealthinsurance Dentiststill 2011 • § 135a SGB V Requirement to implement and to further develop the internal QM • Have to prove since 2011 the fulfilment of the requirements of the Federal Joint Committee (G-BA) Medical laboratorieshavetocomplywith the Regulationsof Federal Chamberof Medical Association (BÄK) till 2010 • § 4a Medical Device Operating Regulation:QM-system hastobeimplemented and ensured in medicallaboratories. This isacceptedwhenstrictcomplianceof the BÄK togetherwithexternal QA. Manygoforaccreditation ISO 15189:2011

  3. Stationary rehabilitation facilities • Top associationsof the rehabilitationsupportersagreed in the frameworkof the Federal Associationfor Rehabilitation (BAR): • Basic requirementsto an internal Quality managementaccordingto the § 20 (2) Social Code IX • Uniform independentCertificationScheme • Rehabilitation-regulation of the Federal Joint Committee: • Substance and procedure of the medical rehabilitation • Qualificationof the reha-doctor • ICF orientation: International Classification of Functioning, Disability and Health

  4. ICF • Bio-psycho-social Model of the WHO • Disease and Health as dynamic occurrence Healthcondition (disorderordisease) Body Functions& Structure Participation Activity Personal Factors Environmental Factors

  5. ICF • Body Functions:physiological functions of body systems (including psychological functions). • Body Structures: anatomical parts of the body such as organs, limbs and their components. • Activity:execution of a task or action by an individual person • Participation:involvement in a life situation. • Environmental Factors: make up the physical, social and attitudinal environment in which people live and conduct their lives.

  6. 11 Quality elements of rehabilitation clinics I Core-requirementsfor the certification • Participationorientedmissionstatement • Conceptof the facility • Indication-specificrehabilitationconcept • Responsibilitiesfor QM in facility • Basic elementsof the internal QM-system • Relationshiptorehabilitants, relatives etc.

  7. 11 Quality elements of rehabilitation clinics II Core-requirementsfor the certification • Systematiccomplaintmanagementsystem • External Quality Assurance • ProcedureofOutcomemeasurement and analysis • Management ofFailures • Internal communication and personal development

  8. Dentist QM Dentists • § 135a SGB V requirements to implement and further develop the internal QM • Since 2011 the fulfilment of the basic requirements of the Federal Joint Committee regulation for QM for dentists must be proven. Audits by the Federal Dentist Association on random selection yearly at 2,0 % of the members at minimum required

  9. Dentist QM QM-regulation for Dentists of the Federal Joint Committee (G-BA) requires following basic elements: Evaluate and assess the current status Internal feed back about the efficacy of QM-measures Definition of targets Describe processes and responsibilites Basic elements Evaluate and assess again the new current status Education and training of employees Act on improvements

  10. Dentist QM QM Instruments of the dentists

  11. Dentist QM Further measures of the Quality Assurance of dentists: • Center for Dentist Quality • Joint Institution of the Federal Dentists Association and Federal Dentist Chamber • Develops guidelines for the mouth, teeth and orthodontics treatment e.g. fissures sealing, root submergence

  12. Medical laboratories • Internal and external quality assurance • Mandatory quality assurance of the Federal Medical Association‘s regulation for medical laboratories (Rili-BÄK) • Part A: Requirements for strucuture, resources and QM • Part B 1: special requirements for laboratories with special quantitative analyses: • Regular participation in ring testings on these tests based on agreed parameters

  13. Medical laboratories Requirementsfor the QM-System: • QM-manual must becompiled, updated and knownby all employees • Content: • Introduction and overallinformation • Targets and strategies • Top management • Personal • Resources and partners • Processes: e.g. SOPs, controlofdocuments, Proceduresfor Recording, internalaudits

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