Q-Day 2020 a focus on trending topics

Six practical modules relating to acute care, psychiatry and rehabilitation, two keynote presentations and one panel discussion: Q-Day 2020 offered an extensive program to 300 professionals, partners and guests.

On 16 January 2020, there was not a single empty seat in the auditorium at the Bern Expo Conference Centre when ANQ Director Dr. Petra Busch opened Q-Day 2020. The 300 professionals, partners and guests were looking forward to a diverse program including a panel discussion, keynote presentations and practical modules. The main emphasis was on the trending topics of transparency and agility with regard to quality measurement and its development, as well as the revised Article 58 of the Swiss Healthcare Insurance Act (KVG). This is already the fourth time that ANQ has hosted Q-Day, providing a platform for the transfer of knowledge and know-how, the exchange of insights and networking.

In her welcoming address, Dr. Petra Busch looked back at the beginnings of ANQ: «The foundation of ANQ was a pioneering achievement by the major partners in the healthcare sector, and it is now recognised at an international level.» In a constantly changing environment, it is vital that ANQ is able to make decisive, agile and client-focused responses to new requirements, technologies and conditions. The strategic status assessment performed by ANQ in June 2019, to which a number of professionals made valuable contributions, is of corresponding importance.

In 2020, ANQ will draw conclusions from this assessment, on which it will base respective future measures and actions. Among these will be the launch of two pilot projects on quality measurement in outpatient hospital acute care and intermediate hospital outpatient psychiatry. ANQ will also look at how routine data can be better utilised, remedial actions and measures for improvement documented and verified and how digitalisation can be harnessed more consistently.

«ANQ now has solid foundations. This gives us the freedom to respond in agile and client-focused ways to changing conditions.»

Dr. Petra Busch, ANQ Director

Transparency at any price? Keynote presentation on the downsides

In his keynote presentation, Prof. Karl-Heinz Wehkamp addressed the question of «Transparency at any price?» from an ethical and financial perspective. The former clinician, now a medical advisor, was not afraid to highlight the downsides of the competition between hospitals and clinics.

He criticised current quality definitions and concepts and the notion that quality can be definitively quantified. In his opinion, the core aspects that are important for everyone – love, value, recognition, solidarity, health and quality of life – cannot be measured. The ideology of quantification misses the point – and even causes damage, according to Professor Wehkamp. «Results concentrate on the factors of 'quality' and 'safety'. Consequently, aspects which are fundamental when it comes to humane, dignified medical care, nursing and treatment are completely ignored.» There is a major risk that management and politics will create virtual worlds «which are inconsistent with the perceptions of doctors and nursing staff and which tend to produce paradoxical effects as regards the sought-after quality.»

«To achieve true quality, management must have a feel for the soul of medicine and care.»

Prof. Dr. Dr. med. Karl-Heinz Wehkamp

The audience followed his presentation with great interest and shared his conclusion: «As important as data is, it is corporate culture that ultimately makes the decisions on quality. But without capable and dedicated personnel, good medicine and care would be impossible. And there would be no quality without good medicine or care.»

One key focus, many perspectives (from left to right): Kathrin Huber (Swiss Health Sector Directors Conference), Carlo Tschudi (Swiss Federal Office of Public Health), Erika Ziltener (President of the Swiss Federation of Patient Organisations), Mariann Spycher (Humane Change/Moderation), Heinz Brand (santésuisse Chairman, former member of the National Assembly), Prof. Dr. Bernhard Güntert (curafutura, ANQ Board) und Anne-Claude Griesser (CHUV Lausanne, ANQ Board, H+ Board).

Swiss Healthcare Insurance Act, Article 58: panel discussion on risks and opportunities

In 2019, after prolonged debate, the Swiss Federal Parliament approved revised Article 58 - «Improving Quality and Efficiency» - of the Swiss Healthcare Insurance Act. The amendments, which will enter into force from 2021/2022, are giving experts plenty to talk about. The audience was equally looking forward to the panel debate.

Chaired by Mariann Spycher, the top-level group of experts discussed the opportunities and challenges presented by the revised KVG article (see the podium discussion handout). The audience was also invited to take an active part in the discussion. For the first time ever on a Q-Day it was possible to ask questions using a smartphone, tablet or notebook and to participate in the debate in real time. As there were nearly 70 questions, it was of course by no means possible to discuss all of them. In the follow-up to Q-Day, ANQ thus made a corresponding list of questions and answers available online.

Selected questions from the audience:

«The imposition of penalties also poses risks. What do the panel guests think?»

«How is the Q-Committee composed and who is responsible for it?»

«Why is our main focus here on poor quality? Wouldn’t it be more efficient to focus on the transparency of outstanding quality?»

«Does comparing hospitals help to improve quality?»

Sharing of insights and discussion

In six practical modules, dedicated professionals from the fields of acute care, psychiatry and rehabilitation outlined (pilot) projects, research and examples of best practice being undertaken and originating from their organisations.

Staying on the ball

«To more than just agile you need to be mentally flexible»: In their keynote presentation, Dr. Markus Holtel und Dr. Stefan Pilz discussed how quality management in medical institutions is changing and how agile principles are important in connection with this.

In their portrayal of the tensions that exist between the formal and informal side of an organisation they cited vivid examples from clinical practice. One thing became apparent – collaboration between both sides is essential to ensure a suitable level of quality, performance, staff motivation and patient well-being. According to both speakers: «To achieve positive changes, quality management must have a good understanding of both sides.» Depending on the status quo, more rules and regulations may be needed, or these may need to be modified or removed to give more room for manoeuvre. Agile principles – not methods (!) – play a key role here: «These are capable of making quality management more effective.» It is particularly from successful, agile businesses that place an emphasis on customer-orientation that we can learn: «A greater focus on the patient perspective will alter the perception of what quality really means.»

Dr. Markus Holtel (left) and Dr. Stefan Pilz

Photos: © Tanja Lander / ANQ