|Implemented in this survey?|
The first Finnish patient safety strategy was published in January 2009. The strategy was developed by the Steering Group for the Promotion of Patient Safety set up by the Ministry of Social Affairs and Health in 2006. The main objective of the strategy is that patient safety will be embedded in the structures and methods of operation in health care.It focuses for example on improving patient involvement, proactive risk management and reporting of safety incidents.
The first Finnish patient safety strategy was published in January 2009. The main objective of the strategy is that patient safety will be embedded in the structures and methods of operation in health care. This will be pursued by
The responsibility for the implementation on the national level lies in the National Institute for Health and Welfare (THL).
The strategy outlines, for example, that every provider organization should have clear procedures for internal reporting, monitoring and handling of errors and patient safety incidents. Organizations should have comprehensive risk and quality management systems and agreed procedures for the aftercare of adverse events. They should have a patient safety plan and appointed persons coordinating the promotion of patient safety. Also organizations should use the national information on patient safety indicators for promoting patient safety and learn from each other to develop a patient safety culture. They should have the resources for making surveys of patient safety promotion and take part in research projects in the field.
At the national level, THL is to support the practical implementation of the strategy and its embedding in different healthcare units, develop equipment and methods of work, promote research on patient safety, monitor the development of patient safety by means of national indicators, further national cooperation between social and healthcare organisations and take part in international cooperation in the field.
The strategy also requires that patient safety will be integrated in primary education and continuous medical education.
The objective of the strategy is to increase patient safety by embedding supporting structures and methods into the healthcare system.
Increased quality of health services
providers, health care professionals, patients
|Degree of Innovation||traditional||innovative|
|Degree of Controversy||consensual||highly controversial|
|Structural or Systemic Impact||marginal||fundamental|
|Public Visibility||very low||very high|
The policy is rather innovative in the Finnish setting. Patient safety has really surfaced on the health policy agenda in last few years. However, from an international perspective this is not as novel. Although patients are in the centre of the policy, public visibility has been very low. One reason for that could be that the policy is rather consensual. Actors directly involved in the process strongly try to portray the patient safety issue from a positive perspective, while a negative framing of the issue could be more attractive to the media.
Patient safety has been raised on the health policy agenda in Finland during the last years, paralleling the activities on patient safety and quality at the EU level, OECD and in the Nordic collaboration. The Ministry for Social Affairs and Health (MSAH) has been the main actor in the developing of the new approach by following European developments in the field and launching the drafting of the strategy by nominating the steering group for the task.
MSAH activities really started in 2005 when a patient safety network was established. The network includes about 200 members representing healthcare professionals, healthcare providers, patients, non-governmental organizations and authorities. Before that, from the year 2003 onwards the Finnish Medical Association (FMA) has raised patient safety on its agenda. An important driver for this was that the issue had been discussed by other national medical associations in the EU. FMA held a seminar on patient safety and conducted a survey among healthcare units in 2003. Many other organizations had also been active in the first half of the 2000's: for example the Association of Finnish Local and Regional Authorities, the Finnish Patient Insurance Centre, the National Research and Development Centre for Welfare and Health (STAKES) and the Finnish Medical Society Duodecim. The first pilot projects for reporting patient safety incidents started in Finland in 2004. Before this decade, patient safety issues have been discussed only as a part of healthcare quality issues.
Important international background drivers were patient safety activities of the WHO (World Alliance for Patient Safety program, since 2004), activities of an expert group of the Council of Europe (2003 onwards), and activities within the European Union. Also the Nordic Council and OECD had been active in this matter before the steering group was set up.
|Implemented in this survey?|
The strategy was prepared by the steering group for the promotion of patient safety set up by the Ministry of Social Affairs and Health in 2006. This was first patient safety strategy in Finland. The group included a variety different stakeholders: the Ministry of Social Affairs and Health, the Association of Finnish Local and Regional Authorities, the Finnish Patient Insurance Centre, the National Research and Development Centre for Welfare and Health (STAKES), the National Public Health Institute, the Finnish Institute of Occupational Health, the National Agency of Medicines, the National Authority for Medicolegal Affairs, the Centre for Pharmacotherapy Development ROHTO, primary care providers, secondary care providers, private providers and patients.
The approach of the idea is described as:
The launch of the patient safety strategy was a major milestone in the process to put patient safety on the agenda of the healthcare system. It was the first national level policy paper explicitly focusing on this issue. A few key actors from different organizations have had an important role in pushing the process forward at the national level. The next step is to raise awareness for the topic at the provider level. Awareness for the issue of patient safety has increased slowly, but steadily. All stakeholder groups consider patient safety as an important theme, but part of the healthcare professionals, especially physicians, do not recognize the need to pay special attention to it.
|Ministry for Social Affairs and Health||very supportive||strongly opposed|
|National Research and Development Centre for Welfare and Health (STAKES)||very supportive||strongly opposed|
|Public providers||very supportive||strongly opposed|
|Private providers||very supportive||strongly opposed|
|Association of Finnish Local and Regional Authorities||very supportive||strongly opposed|
|Patients||very supportive||strongly opposed|
|Finnish Medical Association||very supportive||strongly opposed|
Patient safety is planned to be integrated in the new Health Care Act (see HPM 12/2008). It is planned that the act is going to permit the government to issue a separate lower level degree on patient safety. It is estimated that the bill is going to be passed by parliament in the course of this year.
|Ministry for Social Affairs and Health||very strong||none|
|National Research and Development Centre for Welfare and Health (STAKES)||very strong||none|
|Public providers||very strong||none|
|Private providers||very strong||none|
|Association of Finnish Local and Regional Authorities||very strong||none|
|Finnish Medical Association||very strong||none|
Responsibility of the implementation at the national level lies with the National Institute for Health and Welfare (THL). But service providers and healthcare professionals play an even more important role in the implementation.
Monitoring and evaluation is to be carried out by the National Institute for Health and Welfare (THL). However, the strategy does not explicitly define how it should be conducted.
So far, the process has successfully put the issue of patient safety on the health policy agenda at the national level. However, the key to successful implementation lies in the hands of service providers and healthcare professionals. The key question is how to increase understanding among providers and healthcare professionals that patient safety is something that really needs attention and that there is the possibility to increase the quality of services by implementing measures improving patient safety.
|Quality of Health Care Services||marginal||fundamental|
|Level of Equity||system less equitable||system more equitable|
|Cost Efficiency||very low||very high|
If successfully implemented, policy will have a positive impact on the quality of healthcare services.
Promoting patient safety together. Finnish Patient Safety Strategy 2009-2013. Ministry for Social Affairs and Health. Publications 2009:5. www.stm.fi/c/document_library/get_file?folderId=39503&name=DLFE-8037.pdf.