1. Agency for quality and accreditation of the health care facilities Prof d-r Elizabeta Zisovska Republic of Macedonia Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

3. MISSION The Agency ensures quality and safety in health care through the process of accreditation and re-accreditation of the health care facilities. The Agency develops, revise and improves the standards of the health care in HC facilities, monitors the implementation of the standards and facilitates the preparedness of the HC facility for successful external assessment. Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

4. VISION The Agency for QAHCF is leading institution in the process of monitoring of the quality of the health care, and one of the key stakeholder within the HC system of the Republic of Macedonia contributing to the continuous improvement of the HC quality, in the favor of the patient safety and the wellbeing of all citizens of the country. Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

5. PRINCIPLES Dedication to the needs of the patients and health care system Accordance with the highest ethical standards of the transparency, respect, integrity, efficacy and efficiency Efforts towards continuous improvement of the quality and safety of the health care, patient- focused, his/her family and closest surrounding Continuous improvement of the knowledge and skills of the employees Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

6. QUALITY OF CARE The core components of the health care are: Clinical decision making Interpersonal skills Infection prevention (not make harm!) Record keeping Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

7. Developing the care plan Clinical Guidelines Clinical pathways Implementing the care plan Treatment (evidence-based) Clinical guidelines and protocols Evaluating the care plan Follow up of the outcome Improved or maintained the general health of the patients

8. Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

9. NATIONAL (COUNTRY) APPROACH -Health care improvement-top priority in any policy, program, law… -Continually assessing existing services in order to: Build on strengths Identify gaps Work on practical solutions to fil gaps Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

11. CURRENT SITUATION IN MACEDONIA Committees for monitoring and improvement of the health care within the hospitals -by the law (article 234, item 2, Law for Health Protection, “Official Gazette in Republic of Macedonia, number 43/12) Appointed teams for preparing the hospital for accreditation -internal decision Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

12. Monitoring and improvement of the health care Data registry Referring to the Health care Centers Analysis Reports Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

13. Overall indicators Internal diseases Surgery Gynecology and Obstetrics Pediatrics Indicators for quality of care in hospital facilities Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

14. Registering and referring Average age of the patients Number of discharged patients Number of died patients Number of autopsies of the died patients Number of deaths within the first 48 hours following admission in the hospital Number of cured patients following myocardial infarct Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

15. Number of died patients because of myocardial infarct Number of died patients because of myocardial infarct within the first 48 hours following the hospital admission Number of patients cured of cerebrovascular insult Number of patients died because of cerebrovascular insult Number of patients died because of cerebrovascular insult within the first 48 hours following hospital admission Number of surgically treated patients Number of patient treated non-surgically Number of died patients of those non-surgically treated Number of died patients surgically treated

16. Number of died pregnant and/or delivering women during hospitalization Number of live born newborns died until discharge from the maternity Number of deliveries Number of deliveries with caesarean section Number of injuries during the delivery to the mother and the newborn Length of stay for each patient (sorted by disease) Number of patients referred to other HC facility Number of nurses per department Number of beds within the facility

17. Number of surgical interventions in operation theatre Number of pre-operative days of treatment for all surgical interventions Number of operated patients in general, spinal and epidural anesthesia Number of doctors included in the operative program Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

18. Integration of the quality into everyday practice in hospitals AGENCY FOR QUALITY AND ACCREDITATION OF HEALTH CARE FACILITIES Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014

20. Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014 GENERAL ACHIEVEMENTS SINCE JULY 2014 Initial contacts with the hospital teams for monitoring the quality of care and/or accreditation (49/53) Development and second revision of the standards Promotion at the media and in the region Two workshops supported by TAIEX Coordinators for quality of care External surveyors Development of internal documents Models of AZUS and AKAZ Participation in external assessment in Belgrade

21. Dani kvaliteta u zdravstvu Sarajevo, 15-16 Decembar 2014 FUTURE STEPS Intensive preparation of the hospitals Development of self-evaluation tool Continuous working on internal documents New employments Strengthening capacities of the staff Team building Intensive collaboration with the regional Agencies Membership with ISQua Waiting for the first applications, approximately the end of 2015