Establishing an Integrated Quality Assurance and Patient's Safety Service in a Tertially, Academic Medical Center

Abstract

Background: Clalit Health Services (CHS) is a large health care provider for 4.6 million enrollees in Israel. This is the country's largest medical organization with an annual budget of approximately 17 billion New Israeli Shekel (NIS). Rabin Medical Center comprising Beilinson and HaSharon hospitals is the biggest medical center of CHS, an academic, tertially, referral center, with 1200 beds, including all services of a modern hospital. Aim: To describe the establishment process of integrated quality assurance and patient's safety service and to evaluate its success in 4 years of activity. Quality indicators (process and outcome) were developed and monitored. Improvement was assessed by comparing the results of 2013 and 2016 indicators. Methods: We believe in “No blame or shame” and “To err is human” strategy. The patient is always in the center, continuous learning is being conducted with conclusions and improvement plans, implementation and systematic approach, measuring and proactive activity to improve patient safety. We used Plan Do Check Act (PDCA) cycle in most of the processes. Results: We established 4 units: quality assurance, risk management, regulation committee for policy, strategic affairs and legal aid, and unit of quality indicators and quality working plans. Quality improvement plan was performed every year. We demonstrated a significant improvement in most of the quality indicators measured. Conclusion: Organizational changes focused on patient safety, based on clinical protocols, quality indicators and special committees, brought the hospital to new, high level, achievements. We believe that our patients enjoy high level quality of care in the hospital safe environment.