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Plenary 1: Health-orientation of health services by management systems – what and why?
Plenary 2: Health-orientation of health care services by management systems – how? – Models and standards of good practices
Introductory keynote: Why should governance models be health oriented and balance health outcomes, ethical and economic aspects? – A health systems perspective from the OECD
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Head of the Health Care Quality and Outcomes Program, OECD Paris
Niek Klazinga, M.D., Ph.D. is since 2006 the strategic lead of the Health Care Quality and Outcomes program at the OECD in Paris. He combines this work with a professorship in Social Medicine at the Academic Medical Centre at the University of Amsterdam. Dr. Klazinga has been involved over the past 30 years in numerous health services research projects and policy debates on quality of care and published widely on the subject. Present commitments include a visiting professorship at the Corvinus University in Budapest and the University of Toronto, advisor to WHO/Euro, advisor to the Canadian Institute for Health Informatics and member of the Quality Council of the Dutch Health Care Institute (ZiN). Since 2018 his research group in Amsterdam is coordinating a large EU funded program with 14 PhD fellows on performance intelligence. Dr. Klazinga has (co)authored around 250 articles in peer-reviewed journals and to date completed the supervision of 38 PhD trajectories.
The Organization for Economic Cooperation and Development supports its 38 member states in the development of their economies. Health Care is considered as a part of the broader economy and does both contribute to the welfare of populations as consume a considerable amount of available resources. To justify investments through health care, the added value from a societal perspective is assessed. Since 2002 the OECD reports on the Quality and Outcomes of Health Care systems and since 2017 these reports include data on patient reported outcomes.The performance of specific health care services, such as hospitals, is reflected upon from the perspective of their contribution to the overall system goals: the health of the population. Hence system incentives should help align the hospital goals with the population-based health system goals. This is increasingly asking for health care delivery systems that take the integrated care trajectory pathways as the basis of governance and organization of care. Health care services should support people in realizing their potential health and they can do this through evidence- and person-based interventions. In this way the services add value for individuals as well as populations which is both ethical and economically sound.
Introductory keynote: Health Orientation of Health Services – What do we mean and why should governance models be health oriented?
Member and past Chair of the HPH Governance Board, Senior Advisor of the HPH Network Sweden
Margareta Kristenson is a specialist in Family Medicine and in Social Medicine and Public Health. She is a professor emerita in Social Medicine and Public Health at Linköping University, and Chief Physician in Region Östergötland, Sweden. Margareta is the Head of the Life Conditions, Stress and Health research programme, which explores psychosocial factors and psychobiological mechanisms as determinants for inequities in health. She was the National Coordinator for the Swedish HPH Network for many years and is presently a Senior Advisor for the Swedish HPH Network. Dr. Kristenson served as the Chair of the Governance Board of the International HPH Network from 2017-2020.
The International Network of Health Promoting Hospitals and Health Services (HPH) was founded to support a reorientation of health services, with the aim to become more responsive to health needs in societies served and contribute to the pursuit of health, as described in WHO Ottawa charter for Health Promotion 1986. The HPH vision aimed at meeting the rising challenges identified for health services especially of changing demographics with more elderly, new disease panoramas with more chronic diseases and multimorbidity, new treatment possibilities and new demands expressed by patients, all of this with an increasing gap between needs and resources. These challenges are even more prominent today. Moreover, evidence has now accumulated on effects of prevention and health promotion interventions, knowledge on how these interventions optimize medical interventions and on their cost-effectiveness. The HPH vision of using health orientation as a means for a more holistic, proactive and effective health services is therefore even more relevant today.Orienting health services towards best possible health gain is an obvious aim for patients, relatives and professionals and, also, for most purchasers and politicians. However, ambitious efforts to develop more cost effective health systems using New Public Health Management have in many cases lead to health services where economic gain is the “bottom line” and economy has become the aim, not the means, for best possible health gain. Also, the main part of quality systems are disease-oriented with main focus on medical treatment and outcomes for specific diseases and less focus on holism, promotion, prevention and patient’s perceptions of their health outcome. The new HPH definition (2020) expresses that "HPH shall orient their government models, structures and cultures to optimize heath gains of patients, staff and populations served and to support sustainable societies."To achieve this, management, leadership and organization need to develop explicit objectives for health orientation, health promotion and prevention, but also perform routine outcome assessment on health gain. These need to include, beyond important medical and professional outcome measures, also measures on patient reported outcome (PROM) in terms of health related quality of life (e.g. SF 36) and patient reported experience (PREM). Both of these can be routinely assessed, and monitored, as is done at many places in quality registers and quality improvement. If used for feed-back and learning not only to stakeholders/purchasers but also for professionals and "users" i.e patients and relatives, this can become an essential tool for a dialogue for needs assessment, in clinical settings and in health service management. This can also lead to a health promoting workplace, where ethical stress at workplaces can be changed towards a learning organisation and professional pride. Health gain measurements as a tool for health service management and health policy can in this way optimize health gain of patients, staff and populations served and create more sustainable health systems.
Chair of the HPH Governance Board, Medical University of Warsaw, Poland
Bożena Waleska-Zielecka is a medical doctor and Professor in Public Health at the Medical University of Warsaw, Faculty of Health Science. Since 2011, Dr. Waleska-Zielecka has acted as the Coordinator of the National HPH network in Poland and has served as a Public Health Committee member of the Polish Academy of Sciences since 2020. In addition to her terms as the former HPH Governance Board Chair (2016-2018) and Board member (2014-2016), Dr. Waleska-Zielecka has gained valuable competencies in healthcare management and quality assurance. She is a graduate of the Medical Faculty, Medical University of Warsaw and is a practicing heptologist and travel medicine doctor with special interests in health promotion, immunology of diseases of hepatotropic viruses, aetiology, infectious diseases, and epidemiology.
Secretary for Public Health, Department of Health, Government of Catalonia, Spain
PhD in Medicine and Translational Research (University of Barcelona).Master's degree in Health Sciences Methodology from the Autonomous University of Barcelona.Specialist in Family and Community Medicine and Preventive Medicine and Public Health.Diploma in Health.Postgraduate Diploma in Quality Management (UAB-Avedis Donabedian Foundation).Member for more than 25 years of the working groups on Health Education of the Program of Preventive Activities and Health Promotion (PAPPS) of the Spanish Society of Family and Community Medicine (semFYC) and the working groups on Smoking Prevention and Control of the Spanish and Catalan Society of Family and Community Medicine (semFYC). Chair of these groups for a period of 5 years.Author of more than 100 scientific publications in journals and book chapters.More than 100 lectures invited to scientific conferences, especially in the fields of preventive medicine and health promotion.For 20 years she has developed teaching and research in these same areas.From 2006 to 2021 she has been the Deputy Director General for Health Promotion of the Public Health Agency of Catalonia of the Department of Health of the Generalitat de Catalunya.Since June 2021 she is the Secretary of Public Health of the Department of Health of the Generalitat de Catalunya.
Professor Tzu Chi University, Tzu Chi General Hospital, Taiwan
Dr Wang Ying Wei is the consultant in Hualien Tzu Chi Hospital and director of the Centre for Palliative Care. He is also Professor in the Department of Medical Humanities, Tzu Chi University. He received his MD degree from National Taiwan University and PhD from Tulane University in US. He completed his residency training in Family Medicine in Taiwan University Hospital. He was the former Director General in Health Promotion Administration MOHW, the former Secretary General in Taiwan Network of Health Promoting Hospitals and Health Services. His speciality included palliative care, medical education, and health promotion.
President NF Kinder / President NF Patients United / President EUPATI Austria
Claas Röhl studied communication science at the University of Vienna, after graduating from an engineering school. When his daughter was diagnosed with a rare disease called Neurofibromatosis he began to educate himself on this disease and did several educational programs on patient advocacy, patient involvement in research and fundraising. He set up the Austrian patient organization NF Kinder in Dec 2013 and in collaboration with Medical University of Vienna NF Kinder has set up Austrias first center of expertise for Neurofibromatosis in 2018. On a national level Claas Röhl is also chair of EUPATI Austria, co-chair of the umbrella organization for oncological patient organizations "Allianz der onkologischen PatientInnenorganisationen“, a member of the board of the Austrian umbrella organization for Rare Diseases "Pro Rare Austria", and he is a member of an expert advisory board for oncology at the Austrian health ministry. Claas Röhl is also involved in several international organizations, like the European umbrella organization for NF patient organizations "NF Patients United" that he chairs, the ERN GENTURIS where he serves as a member of the executive committee, or as a member of IHI’s pool of international patient experts.
Chair of the Scientific Committee of the International HPH Conference
Professor em. Jürgen M. Pelikan, Ph.D., is the Founder and Director of the WHO Collaborating Centre for Health Promotion in Hospitals and Health Care at Gesundheit Österreich GmbH (Austrian Public Health Institute). As principal investigator (PI) of the WHO model project "Health and Hospital" and the first European Pilot Hospital Project he has co-initiated the International Network of Health Promoting Hospitals and Health Services. Since its start, he is Chair of the Scientific Committee of the annual International HPH Conferences and advisor to the HPH Governance Board. Prof. Pelikan has an outstanding expertise in HPH-related projects including directing two EU-projects Health Promotion in Primary Health Care, General Practice and Community Pharmacy, and Migrant Friendly Hospitals. He was also involved as work package leader and PI in the first European Health Literacy Survey, the Diabetes Literacy Project and Health Literate Health Care Organizations. He is research co-chair of the WHO Action Network Measuring Population and Organizational Health Literacy (M-POHL) and is international PI of its European Health Literacy Survey 2019 (HLS19). Prof. Pelikan, a sociologist, has authored numerous publications on the theory of health and health promotion including salutogenesis, the settings approach, evaluation in health promotion, quality in health care, health literacy, and health literate health care organizations. Concerning HPH, he (co)authored the Budapest Declaration, the Vienna Recommendations, the 18 HPH core strategies and the New Haven Recommendations. He was a former President of the European Society of the Sociology of Health and Medicine and an elected member of the board of trustees of the International Union of Health Promotion and Education, a consultant to WHO/Euro, WHO-HQ and the European Commission. He was a member of the editorial board of the journal Health Promotion International and is a co-editor of Clinical Health Promotion – Research and Best Practice for patients, staff and community.
Director, Prevention and Health Promotion Unit at Public Health France (Santé publique France)
Holder of the Ph.D. degree in sociology of health, statistician, François BECK is the Director of the Prevention and Health Promotion Unit at Public Health France (Santé publique France) comprising about 100 researchers, engineers and assistants. He is also a researcher at the CESP. From 2014 to 2017, he was the Director of the French Monitoring Centre on Drugs and Drug Addiction (OFDT). His research activities, leaning on an epistemological reflection on the quantification of sanitary and social questions, have focused on addictive behaviours, drug-related social factors, sleep, social inequalities, and mental health, with a special emphasis on methodological issues, gender, risk perception, and cross-cultural comparisons. Since 1997, he has developed and implemented several general population surveys on alcohol, tobacco, and illicit drug use in the adult and adolescent general population in France. He has been involved as principal investigator in several of them. He has also been a Member of several scientific committees and advisory boards.