Primary Care Quality Sweden Supporting quality improvement in

Primary Care Quality Sweden Supporting quality improvement in primary care

Primary Care Quality Sweden A cooperation project

Primary Care Quality Sweden is a kind of quality registry, containing 82 quality indicators (measures) and the technical solutions for collecting data automatically and making it available both at the local and the national level.

Background • In Sweden there are over 100 quality registries • First national comprehensive quality system for primary care • Part of national Quality Management strategy – Easy access to best available knowledge – Ways of working that supports patients’ needs – Data available for follow up of results – Support to leadership

Primary Care Quality Sweden

At the health center • No extra documentation - data is collected from existing records • Automatic collection of data • No opting in or out is needed since no individual data is transferred • Individual patients can be identified and followed

Data can be used for • Seeing patients’ results • Finding the patients with the greatest needs • Identifying areas where we need to improve • Measures in local improvement work • Scientific projects (resident physicians, other professions) • Training, continuous professional development • Basis for local/regional dialogue

Some examples • How many of our patients with congestive heart disease has RAAS-blocker treatment? • How high is the continuity at our health center? • What proportion of patients with AOM are treated with PCV? • Which of our smoking patients with a chronic disease have not yet been offered help to quit?

Indicator areas Primary care specific Diagnosis specific Patient reported indicators Multiple chronic diseases Cardiovascular disease Continuity Diabetes Lifestyle habits Musculoskelettal disease Drug treatment Psychiatric disease Infections Asthma/COPD Osteoarthritis PREM PROM

Construction of an indicator Indikator: Behandling med betablockerare vid hjärtsvikt Mått: Diagnoskod I 110 I 132 I 500 I 501 I 509 Andel listade patienter med hja rtsvikt som fa r behandling med Tid betablockerare 18 mån Beskrivning och syfte: Ålder Betablockerare a alla r en viktig behandling som pa verkar mortalitet, morbiditet och symtom hosalla patienter med hja rtsvikt. Kön Hypertensiv hjärtsjukdom med hjärtsvikt Typ av Indikator: Kontakttyp Process alla Teknisk beskrivning: Antal listade patienter med diagnosen hjärtsvikt och behandling med Hypertensiv hjärt- och njursjukdom. Täljare: med hjärtsvikt Yrkeskategoribetablockad alla Hypertensiv hjärt- och. Uttagna njursjukdom med både hjärtsvikt och njursvikt läkemedel Nämnare: Antal listade patienter med diagnosen hjärtsvikt Hjärtinsufficiens Listad vc vid datauttag Datakälla: Journalsystem ja Kronisk hjärtinsufficiens ATC-koder Pat ID, diagnosen. C 07 Variabler: hjärtsvikt enl specifikation, ATC-koder enl specifikation Vänsterhjärtsvikt Felkällor: Hjärtinsufficiens, ospecificerad C 09 Förskrivning utanför journalsystemet C 07 AA 03 Pindolol Indikatorns ursprung: So. S indikator 6. 3: Andel patienter med hja rtsvikt som fa r behandling med betablockerare C 07 AA 05 Propranolol C 07 AA 07 Sotalol Indikatorn identisk eller förändrad: Identisk C 07 AB 02 Metoprolol C 07 AB 03 Atenolol C 07 AB 07 Bisoprolol

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Follow changes over time

Benchmarking

Data flow

How far along have we come? x Most county councils/regions are working on the connection Almost 200 out of Sweden’s 1200 health centers can see their data x x x x

Conclusions • A quality system developed by and adapted to Primary Care • Automatic collection of data • Real time data • Evidence based, multiprofessional indicators • Multimorbidity • Already available at almost 200 health centers

Thank you Primary Care Quality Sweden www. skl. se/primarvardskvalitet stina. garearvidsson@skl. se | ulrika. elmroth@skl. se

Quality Management strategy