1. NCQA; Polish Society for Quality Promotion in Health Care ACCREDITATION; CERTIFICATION; EXTERNAL ASSESSMENT IN POLAND ENQual 2ND WORKSHOP Barbara Kutryba, Halina Wasikowska Helsinki, 2nd April, 2004

2. Accreditation in Poland JCAHO accreditation type (hospital = functional entity) Specialty accreditation Accreditation of Laboratories

3. Recognized body (1994; NCQA) –Establishes and publishes standards (1998) –Conducts objective on-site evaluations (160 surveys conducted; 100 hospitals with Q certificate) –Publishes decision (Accreditation Council) Professional involvement –Consensus on standards –Surveyors = peers Focus on continuous improvement (cyclical surveys) Focus on the Patient (standards: weight; 77% relates to direct patient care)

4. Legislation for accreditation and certification  Decree of the Minister of Health, March 1993, establishing NCQA(agency of MoH);  Act on Healthcare Organizations, August 30, 1991 and  Amended Act on Healthcare Organizations, June 20, 1997, Art.18c (healthcare organization can apply for accreditation)  National Health Fund Act (NHF), April 2003: healthcare organization can apply for quality certificate (ISO or accreditation model)

5. Programme expenditure 1999, 2001 (log scale)

6. Program development Functional status Programme Active programme Hospitals (acute care) Psychiatric care In developmentPrimary Care Ambulatory Care Long-term care Spa resorts care Planned Assessment and certification of healthcare standards(ALPHA) 1998 2000 2004 2005

7. ISO certification in healthcare organizations Institute of Organization & Management in Industry ORGMASZ ISO 9001:2000 ISO 14 001 50 HO have ISO certificate (hospitals; ambulatory care centers; one day surgery centers; 1 social care center)

8. Accreditation ISO MORE FORMAL MORE SPECIFIC STAFF INVOLVEMENT LESS CREATIVE LESS FLEXIBLE LESS MARKETING VALUE PATIENT ORIENTED LESS FORMAL LESS SPECIFIC STAFF INVOLVEMENT MORE CREATIVE MORE FLEXIBLE MORE MARKETING VALUE CLIENT ORIENTED

9. Other mechanisms of external evaluation National/ regional clinical governance Statutory regulatory assessment ( Sanitary Inspectorate; Supreme Chamber of Control; National Labour Inspectorate) Licensing to be developed till end of 2005

10. European Accreditation Forum: since 1999; Forum hosted in Cracow in 2001 MARQuIS project ( Methods of Assessing Response to Quality Improvement Strategies) International