2024-02-16 10:52:22
According to an initial assessment presented by the High Authority for Health (HAS), the 2023 quality indicators are generally satisfactory but progress remains to be made, particularly in mental health.
On the occasion of the annual publication of the results of the quality and safety of care indicators (IQSS) collected in 2023, and at a time when 50% of certification decisions have been made as part of the current certification process, the High Authority for Health (HAS) takes stock of the lessons learned from these measures on the quality of care within health establishments. According to its President, L. Collet, “the benefit of quality assessment is threefold. First of all, for professionals, it is an opportunity to take stock of their successes, their difficulties, their needs and to be supported in their primary intrinsic vocation: “to provide good care”. An essential height gain, including when teams are faced with an activity under tension (…). For public authorities, these systems make it possible to regulate through quality. Finally, these evaluation elements are particularly useful for hospitalized patients and their entourage, the community professionals who direct them to these establishments and more broadly all those who are interested in the quality of hospitals and clinics. »
Some results
In 2023, 34 indicators were measured on specific points of clinical care, coordination between professionals and prevention of healthcare-associated infections to enable each establishment to carry out the necessary improvement actions. They concern 4 sectors: medicine-surgery-obstetrics (MCO), medical and rehabilitation care (SMR), home hospitalization (HAD) and psychiatry. Overall, the HAS notes that a certain number of indicators have progressed satisfactorily, particularly in the assessment and management of pain in hospitalized patients and in the management of pressure sores in HAD. On the other hand, progress remains to be made, in particular on the liaison letter upon discharge from hospitalization, anti-flu vaccination for hospital staff and mental health.
Some data in psychiatry
• The transmission and quality of the liaison letter upon discharge from hospitalization still need to be improved overall. In this register, in full-time hospitalization in psychiatry, the margin for progression is significant, with a national score of 52/100 and only 26% of establishments achieving a satisfactory level on this indicator.
• Furthermore, new indicators were measured for the first time in a medical-psychological center (CMP): monitoring the cardiovascular and metabolic state of adult patients and identifying and helping to stop addictions. The first reports from the field suggest poor results. HAS emphasizes that establishments need time to structure their files and will publish more detailed reports in the coming months in order to complete this inventory. She emphasizes “It is not a question of pointing the finger at an entire sector which faces significant problems in the organization of care, but of allowing professionals working there to position themselves in order to improve their practices. »
Perspectives and projects
In terms of general perspectives, the HAS is beginning discussions with a view to a new version of the reinforced framework in 2025, in particular on the evaluation of the link between quality and resources, external activities, psychiatry, the management of medicines and medical devices, the prevention of infectious risks or even mastering environmental sustainability.
Note also that since 2022, a new Qualiscope online service has been opened. It displays for each health establishment its certification results and indicators of quality and safety of care. This platform thus provides access to rigorously constructed, reliable quality information and comparable between health establishments. Beyond the managers of public and private health establishments, in the interest of transparency, HAS has chosen to have this data accessible to all.
Care quality and safety indicators and certification: HAS takes stock of the level of quality of care in health establishments, press kit, February 2024, www.has-sante.fr
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