From accreditation to quality improvement—The Danish National Quality Programme

Abstract

The Danish government launched a new National Quality Programme (NQP) in healthcare in 2015. It has changed the focus from old public management in terms of accreditation, regulation, rules and standards to new public governance focusing on delivering high quality healthcare and outcomes of value for the patients, health professionals and the Danish healthcare system. The NQP aims to strengthen the focus on continuous quality improvement and the launch of the programme was accompanied by a decision to phase out accreditation of public hospitals. The NQP includes 1) eight specific national quality goals, 2) a national educational programme for quality management, and 3) establishment of quality improvement collaboratives. Since the establishment of the NQP the indicator results have improved in several important clinical areas. However, causal conclusions related to the effect of the NQP cannot yet be made. This perspective on quality paper aims to give a short introduction to the NQP and documented outcomes.

The Evolution of External Healthcare Regulation in England; From Performance Oversight to Supporting Improvement; Comment on "The Special Measures for Quality and Challenged Provider Regimes in the English NHS: A Rapid Evaluation of a National Improvement Initiative for Failing Healthcare Organisations"

“…Evidence of impact of the programme is promising, with performance indicators showing improvement in clinical outcomes in mental health, cancer and cardiovascular disease and in service outcomes with a fall in hospital length of stay. 16 Crucially, responsibility and accountability has been devolved to local organisations. This draws parallel with the long-term tacit intentions for ICS in England that advocate for the availability of more dynamic data at the local level, decentralising responsibility thereby reducing the need for external oversight.…”

Composite Measures of Quality of Healthcare

“…The national objectives for the Danish healthcare system were defined, which included improved patient pathways, better quality of care with a special focus for chronically ill and elderly patients, increased survival rates, healthy life years and patient safety, timely diagnosis and treatment, greater patient involvement and a more effective healthcare system. [21,27] Today, Denmark has a total of 85 well-developed clinical quality registries, managed by The Danish Clinical Quality Program-National Clinical Registries (RKKP). [28] These registries contain patient-level information used for evaluation and improvement of quality of care.…”