Ensuring medical quality
Quantifiably high medical quality is consistently the focus of medical care for our patients. We operate a comprehensive quality management system to ensure this objective is achieved.
How we have placed the delivery of high-quality medical care at the heart of our organization
Our quality management system is primarily controlled by our Central Service for Medicine together with other process owners. At corporate level, two Medical Consultants hold responsibility for all medical matters relating to inpatient care at Helios. They report directly to the Chief Executive Officer (CEO) of Helios, who is also the Chief Medical Officer (CMO). The full-time Medical Consultants advise the Helios management team and the regional leadership on all medical issues relating to alignment and control of the hospitals, coordinate the improvement of workflows and medical processes, and further the development of multidisciplinary care models. They also support hospital management teams in the appointment of Chief Physicians. Two other Medical Consultants are responsible for Helios Ambulant.
A Quality Management Steering Group coordinates central control processes for medical quality management and patient safety measures on a quarterly basis. The Steering Group is made up of the CEO/CMO and the two Medical Consultants, the Patient Safety Officer (PSO), the Central Service for Medicine, and the head of the nursing expert group. The hospitals’ medical management teams comprising the hospital manager, medical director and nursing manager also carry out a quarterly assessment of all reportable indicators together with the Medical Consultants. If hospitals report unusual values for quality indicators or notifications concerning patient safety cases, they are required to report to the Quality Management Steering Group. Measures are defined here for implementation within a one-year period. Such measures may include peer reviews at the hospital level or quality management measures at the corporate level.
Another important engine for quality is provided by the 30 Helios expert groups (German language only). Senior physicians in the various medical specialties meet here twice a year. They ensure that all the hospitals are up to date on research in their disciplines and that treatment processes are being used correctly. They discuss results from clinical studies and derive potential changes in treatment processes on this basis. They also discuss and decide on the introduction of standard processes, appropriate innovations, the selection of medical products, and communication or education campaigns targeted on employees or patients.
How we systematically improve the quality of medical care
In 2008, the Initiative Qualitätsmedizin (IQM; Initiative Quality Medicine) was established in conjunction with other hospital operators. The initiative is intended to improve and drive forward the treatment quality and comparability of hospitals by applying the principle of Measure – Publish – Improve. At its 25th anniversary in 2023, IQM was the largest voluntary quality initiative in the German healthcare sector. It has some 500 member hospitals run by municipal, non-profit church-owned, private and university operators.
The Helios quality management system is based on three stages:
Every step of a patient’s treatment in hospital is precisely documented for subsequent billing to health insurance companies. We use this routine data as a basis for measuring the quality of our medical treatments. The data show, for example, whether a patient’s recovery has taken longer than expected or whether complications or death have occurred. On this basis, we can assess whether treatment proceeded normally or whether potentially mistakes were made.
We also use our routine data to measure the German Inpatient Quality Indicators (G-IQI) as defined by the IQM. There are more than 380 of these indicators with information on over 60 important medical conditions and treatments. In addition, we collect data for more than 1,000 other quality indicators at Helios. We have selected 46 (2022: 47) key indicators from the G-IQI for the strategic management of our medical quality. Specific targets have been defined for these indicators and we review our achievement of them annually.
We publish our quality results (German language only) on our corporate website and on websites of our hospitals to foster continuous improvement and to avoid repeating mistakes. The data provide visibility concerning the performance of a given hospital by comparison with the national average, with other Helios hospitals, and with IQM member hospitals. In addition, each hospital and each department receives a monthly report on its medical treatment outcomes so that trends can be identified in their early stages and detailed analyses can be initiated as necessary. In the reporting year 2023, we achieved the target values of a total of 1,862 indicators (out of 2,099 achievable targets), corresponding to a proportion of 88.7% (2022: 87%).
If our hospitals fail to meet certain quality targets or if other irregularities become apparent, we carry out a detailed analysis of the relevant treatments and processes in order to identify any potential for improvement. The focus is on specific audit processes in the medical and nursing areas under a peer review process where cases are discussed by expert peers. A peer review involves specially trained doctors from our hospitals and from the IQM network who cooperate to investigate statistical anomalies. Findings are translated into concrete recommendations for action by the hospital with the goal of further improving treatment quality and patient safety. We performed a total of 22 peer reviews in 2023 (2022: 11).