JOAN MARIA FERRER JOAN ORRIT ANNA RIERA ROSER

JOAN MARIA FERRER, JOAN ORRIT, ANNA RIERA, ROSER FERNÁNDEZ Council of the Mental Health Sector. Unió Catalana d’Hospitals. Barcelona (Spain) Unió Catalana d’Hospitals is a health and social services employers’ association that joins 107 public and private health provider institutions in Catalonia. This conglomerate totals 45, 000 health workers, of which 11, 000 nurses, 8, 000 medical doctors and 850 health managers. October, 2010 LA UNIÓ CATALANA D’HOSPITALS BENCHMARKING PROJECT: LEARNING FROM SHARING MENTAL HEALTH INDICATORS Aims & Objectives Methods To consolidate a benchmarking forum of mental health managers and medical directors who are sharing managerial and clinical indicators, monitoring and analysing their results, as a learning experience for promoting quality improvement for the mental health sector in Catalonia. A logic pathway In 2006, the Mental Health Council of La Unió Catalana d’Hospitals initiate a benchmarking project, committing an initial group of 10 mental health managers. This group, with the assistance of methodological external support, selected 25 mental health indicators and began to share their results. Those indicators explore multiple mental health quality dimensions, including access, timely service, human resources and productivity, resource allocation and quality. Moreover, the indicators were grouped by type of service: acute and sub-acute hospitalization, day hospital, rehabilitation day centers, and children & adult primary mental health care support centers as well. Participation in the project required the payment of general expenses in relation with the number of mental health centers an institution included. The participating organization in the benchmark signed an ethics code that committed confidenciality, and the provision of validated data on time. Data management for the project has guaranteed confidenciality identifiying each institution by a number code, which is only known by each provider institution CEO. Results Adherence rate to ambulatory follow-up visits (CSMA setting, year 2009) Fifteen mental health care providers, all of them operating for the public national health system, are today sharing managerial indicators in the benchmarking forum with a total of 125 mental health centers providing annual data from inpatient, ambulatory and community mental health care. This group represents aproximately 30% of the Catalonian mental health sector. Each institution has appointed a medical director for the discussion meeting and we join together for three benchmarking sessions along the year to discuss main results, to compare with the bench and review mental health standards established at the Mental Health Strategic Plan defined by the Department of Health. Open discussions are being the best opportunity to identify the top-succesful institutions in managing access and waiting lists, hospital lenght of stay, patient satisfaction, but also managerial topics like which one rockets productivity, or is the best one in patient's adherence to ambulatory visits, as one prominent quality indicator. Moreover, each year we are publishing a benchmarking report with all the results, and another provider detailed results report, comparing their centers with all the group. Today, the experience is moving to deepen analysis, and we have just initiated two new discussion groups to review two care processes in-depth: major depression and the severe mental health illness program. This time, discussions are led by mental health care professionals. Adult Primary Mental Health 2009 Variation 114 256 #7 Visits/inhabitant 9 18 #5 First Visit/1000 inhabitants 11 First Visit Waiting List 56 #5 #7 7 18 #7 Follow-up/First Visit Ratio 0, 5 5, 5 Hospital Admission referral rate 13. 997 Inhabitants/psychiatrist #7 30. 973 #5 Conclusions 1. La Unió Catalana d'Hospitals leading project is serving the mission of facilitating all adhered organisations the opportunity of sharing managerial results and learning from others, valuing the translation of best practices identified to the managerial and clinical arena. 2. The project has achieved the objective to transparently share results and has pioneered other benchmarking initiatives in the association, enriching the managerial debate, and serving institutions to focus their efforts in quality and performance. 3. Moreover, in analyzing results for learning purposes, managers can rapidly direct quality improvement and focus on specific areas. 4. Finally, the initiative has reinforced the association’s role, improving transparency in the mental health sector, and stimulating the interest in the creation of other benchmarking groups, getting professionals more involved in analysing results and improvement initiatives. www. uch. cat Bruc 72, 1º -08009 Barcelona (Spain) - T. +34 932 093 699 – www. uch. cat