Acute care 2019
Patient satisfaction among adults and parents
After evaluating the 2018 survey, the status at the beginning of October 2019 was as follows. Acute and children’s hospitals once again achieved a high level of satisfaction. They have been registering excellence in this aspect of reviews over a period of years now. The duration of admissions received the highest approval among adults, and the ethical behaviour of the staff came first among parents.
Link to press release
Postoperative wound infection
As the results of the 2017-18 review period showed, wound infection rates in Swiss hospitals and clinics have continued to decline. In the past ten years, they have declined in 8 of the 12 surgical procedures monitored by Swissnoso. For the first time in November 2019, ANQ was able to provide transparent data on how many patients per hospital and clinic received antibiotic prophylaxis in good time. In the light of this, after consultation all ANQ partners authorised the adaptation of the publication concept.
Link to press release
In May 2019, some 170 participants were in attendance at the Swissnoso and ANQ symposium. Addressed were the detection and prevention of post-operative wound infections (SSI), in particular the result of the implementation of a set of relevant measures in pilot hospitals. In addition to an update on hand hygiene (CleanHands module), experts gave talks on the outbreak of vancomycin-resistant enterococci (VRE) infection and the associated measures taken.
Ten years after the launch of the review concept, ANQ (Acute Care QC and administrative office) and Swissnoso discussed how the reviewing method could be streamlined in the future. Talks will continue in 2020.
Adult falls and pressure ulcers in adults, paediatric pressure ulcers
In the year under review, procedures were streamlined further. As a result, it was possible to publish the 2018 results in a transparent manner as early as mid-September 2019. These showed that after eight survey rounds in adults and six in children, pressure ulcer rates (for all categories) fell to their lowest level. The adult fall rate decreased slightly compared to that of the previous year.
Compared to the first review in 2013, the rate of paediatric pressure ulcers in the children had halved in 2018. Since 2019, the child survey has no longer been a required part of the ANQ review plan (i.e. is no longer mandatory). However, hospitals and clinics remain free to continue to collect data on pressure ulcers among children.
Link to press release
Readmissions
In mid-November, ANQ communicated the results for the 2017 Federal Statistical Office (SFSO) data year. The number of hospitals and clinics with above average readmission rates fell by more than a third compared to the previous year. The time to transparent publication was accelerated somewhat in 2019.
For the first time, ANQ commissioned additional analyses, both at the national and hospital/clinic level. The rates were individually analysed for each of the following indicators; the ICD diagnostic criteria, with/without surgical procedures, in terms of length of admission and after unscheduled readmission to the same hospital (internal) or a different one (external).
Link to press release
SIRIS implant register|Hip & Knee
With the publication of the 2019 annual report at the end of November, the register made a quantum leap. For the first time, the performance quality of implants could be assessed on the basis of two-year revision rates. These were registered for each implant, including the product brand names and encrypted for each hospital/clinic. Since the prerequisites for a transparent publication are now in place, the two-year revision rates with hospital and clinic names will also be published from 2020 onwards.
Link to press release
Quality Committee (QC)
QC Acute Care
The QC met for discussions four times in 2019. It approved the updated evaluation and publication concepts, the 2017/18 National Comparison Report for post-operative wound infections and the SILIS Annual Hip & Knee Report for 2012-2018, also in its summarised form. Furthermore, it discussed how to streamline the review of wound infections with Swissnoso. Dr. Florian Rüter of Universitätsspital Basel was appointed a member of the committee.
QC Prevalence Review
In their three meetings in the year under review, the experts approved the 2018 National Comparison Reports for adults and children and provided input to the National Summary Report, which hospitals/clinics received in May. They also discussed the extensive reduction of the 2019 National Report and the pilot audits (concept and quality level), which show the quality of data collection. This generated some very valuable information. During the year, the QC welcomed new members Mélanie Verdon of HUG, Anna Ziegler of the Hirslanden-Gruppe and Aurélie Glerum of the Hôpital Riviera-Chablais.
QC SQLape
In 2019, the QC discussed the contents of the additional hospital/clinic-specific evaluations and discussed the potential for optimisation of the overall situation. It also discussed and approved the revised evaluation concept 4.0 and the National Comparison Report for readmissions. For this purpose, the committee convened three times. Dr. Fabio Agri of CHUV Lausanne replaced Dr. Estelle Lécureux. Dr. Thomas Beck of the Insel Gruppe Bern was another new addition.
Expert Groups (EG)
EG SIRIS implant register
The members of this EG met four times in the year under review. On the agenda was the approval of the Annual Report 2019 (2012-18 data), also in its summarised form, as well as the handling of outlier data registered in connection with implant systems. The EG also worked closely with the team of authors on the Annual Report. Christian Brand and Lilianna Bolliger took their seats on the board, both the new representatives come from SwissRDL.