When newborn babies leave the premature clinic at the University Hospital Brno in the Czech Republic, the parents receive documentation that the hospital's quality management system complies with the requirements of the ISO 9001 standard.
Since 1999, the University Hospital Brno (UHB) has been in partnership with DNV. Step by step, the hospital's 60 clinics, with 4,500 employees, have been certified according to the Quality Management System standard ISO 9001.
Dr Zdenek Dolezel is head of the newborn intensive care unit. Today he is visiting Eve; a cute as can be baby girl with a proud mother by her side. Because she was born one month early, Eve has spent her first few days in the premature clinic. When taking her home, Eve's parents will receive a document describing her medication and treatment.
"If complications occur, we have easy access to accurate information. Mistakes can be located. The quality management system includes processes to locate and eliminate risk. Continuous improvement is systemised. We benchmark with other hospitals. Our patients are safer now," says Dr Dolezel.
He describes an incident at another hospital that recently mixed up babies. Two babies were sent home with the wrong parents. A document had been rewritten by mistake.
"We investigated if the same could happen at UHB. The conclusion was that it could not happen at our hospital due to the document handling system we designed to meet the requirements of the ISO 9001 standard."
Strategy and quality management
UHB is one of the biggest university hospitals in the Czech Republic. Its ambitions and challenges are mirrored in its Strategy Quality Plan. The focus is on patient safety, environmental issues, economy and transparency, health and safety for employees, and IT security. The management is discussing the implementation of additional ISO standards to fulfil the Strategy Quality Plan.
A pilot project on biological and normal waste will start up in 2008 within the framework of ISO 14001 (environmental management system standard). Other certification standards are being discussed as well.
"We use the ISO management system standard as a tool to strengthen our strategy. The government is introducing a new health reform in 2008. We believe the ISO 9001 certification processes have prepared us to meet future demands," says Jaroslav Peprla, the Assistant Director who has been instrumental in the ISO certification process at UHB since the start.
Stronger economy
The forthcoming health reform will provide upgraded guidelines for dealings between insurance companies and hospitals. In the Czech Republic, patient costs are governed by insurance companies.
"According to new Czech guidelines, certified hospitals are in a better position to negotiate terms with the insurance companies. This will benefit our economy and patients," says CEO Roman Kraus.
Dr Kraus is a medical doctor with an MBA. He started practising in a neighbouring hospital and then proceeded to hospital administration. He took over as the CEO of UHB a year ago. He is a driving force behind the change of mindset inside Czech hospitals.
"Before, patients were looked upon as medical problems. Today, our patients are first of all human beings and customers of our services."
A new work shift
On average, 40 operations per day are performed on children at UHB. At the end of every work shift vital information on patients is logged in computers. Before, most of this information was passed on verbally.
"The process towards certification involved a lot of work, but now we make fewer mistakes," says Dr Michal Klimovic, the head of the children's operation clinic. "Documentation is complete. A strict job description provides continuity. An emergency plan is in place. Statistics show that the safety management is working."
TEXT AND PHOTO: Håvard Solerød
Date: 11 February 2008