In my time as an ISQua Emerging Leader, I have been learning through an approach based on knowledge transfer and skills exchange. It’s strange but great because I've become more aware of and have really experienced Brian Herbert’s quote: “The capacity to learn is a gift, the ability to learn is a skill and the willingness to learn is a choice.”
In June 2019, I had the chance to visit the “Haute Autorité de Santé”; the French National Authority for Health (HAS) which is an independent public scientific advisory body. It is tasked to drive improvement in the quality and safety of healthcare and to advance social care. The main missions of HAS are:
- Measuring and improving healthcare service delivery;
- Recommending best practices;
- Evaluating health products and technologies covering the concept of health technology assessment;
- Coordinating and ensuring the dissemination of appropriate information on the quality of care in health facilities for users.
The first mission is further broken down into four types of activities:
- Accreditation of health facilities, public and private, and evaluation of social care services and facilities;
- Development, measurement and analysis of quality and safety indicators of care;
- Physician and medical team accreditation for high-risk practices;
- Public information and quality of care management.
In order to fulfil its tasks effectively, HAS is organised into five operational departments:
- Department for Medical, Economic and Public Health Assessment
- Department for Quality and Safety Improvement in healthcare
- Department for Quality, social and medico-social support
- Department for Communication, Information and User Engagement
- General Secretariat
From such a huge scientific organisation, there is so much to learn and I had to define specific learning objectives. With the guidance of Mr Bruno Lucet, ISQua Board member and Senior Advisor for HAS, we tailored a personalised programme for my visit.
My visit was to the Department for Quality and Safety Improvement in Healthcare to learn about the work of its four units:
- The Care Relevance Evaluation, Practices and Pathways Improvement Unit;
- The Evaluation And Tools For Quality and The Safety Of Care Unit;
- The Professional Good Practices Unit;
- The Health Facility Certification/Accreditation Unit.
I had the honour to meet Dr Catherine Grenier, the Department Director. We had an amazing exchange. She shared with me her professional experience, advising me to go ahead, each time an opportunity of progress presents itself. She gave me an overview of the department activities especially concerning the unit of evaluation and tools for quality and the safety of care, launched by her some years earlier. This unit focuses on analysing collected data from health facilities and on identifying quality indicators to monitor and to compare healthcare service delivery performance in a perspective based on patient-centeredness and health outcomes. It also provides health professionals with the necessary tools for integrating the culture of safety, managing risks and improving teamwork. The unit’s activity is increasingly reinforced because France has made a strategic choice to adopt a policy for a financial incentive to quality in healthcare.
During my visit, I had the opportunity to be hosted by the Health Facility Certification / Accreditation Unit. As I am working for the Tunisian Accreditation Authority (INEAS), it was important for me to deepen my knowledge and strengthen my skills in this field. The HAS team were generous in sharing with me their own techniques and experiences.
I met almost all the accreditation unit team and had constructive conversations and discussions with each one of them.
The French accreditation process was presented to me in the current French health system context. In fact, for 20 years, the health facility accreditation has been compulsory in France and currently, it concerns 2600 healthcare facilities. The process evolved through four different versions of accreditation standards, and the fifth version V2020 is being developed by the unit team. The V2020 survey process will give more importance to the patient pathway survey aiming to evaluate not only the healthcare service delivery process but also the relevance of the healthcare pathways via the evaluation of patients' tracer paths.
The team explained how they recruit their surveyors and the rigorous training programme that surveyors undertake which includes e-learning courses. I also learned about how the surveys are planned for each health facility. I met some client relationship managers, who explained to me their mission in supporting the health facility and in following it in its progression from an accreditation level to a higher one thanks to the programmes and the tools for quality healthcare improvement.
On top of these fruitful exchanges, I attended the meeting of the Healthcare Facility Certification / Accreditation Committee dedicated to deciding and pronouncing on the results of the surveys, chaired by Ms Anne-Marie Armanteras-de Saxcé. It was a great moment for me. In fact, at INEAS as we are launching the accreditation programme, we have not yet organised such a meeting; so, it was particularly interesting for me to attend.
I also learned about the integral role that the communications team play in the work of the Department for Quality and Safety Improvement in Healthcare. It was a pleasure to meet Ms Florence Pouvesle, who is responsible for managing the communication with both the healthcare facilities and the different stakeholders. She is also in charge of answering the users’ complaints, each year she receives about 1200. To inform the users and the healthcare professionals about the level of healthcare quality of all hospitals and clinics in France, HAS provided access to a platform: Scope Santé https://www.scopesante.fr/#/.
HAS organises regional meetings for the healthcare facilities to give them an opportunity to share their experiences of and to provide their feedback on the accreditation survey process. Other meetings are held with regional health agencies and the regional structures for health facility support, to harmonise the efforts of all agencies in improving the quality and safety of healthcare.
The last event, a conference entitled “Toward an accreditation/certification based on result culture for patients” was held on the 22nd of May 2019 during Paris Healthcare week. The objective of the conference was to promote the new Standards V2020.
I spent a wonderful study visit at HAS, in a warm and welcoming work environment. Unfortunately, I didn't have enough time to learn more about the other units belonging to the Department for Quality and Safety Improvement in Healthcare. The physician inside me is very curious to learn more about the activities undertaken by the Care Relevance Evaluation, Practices and Pathways Improvement Unit.
It would be perhaps for the next time because life is a continuous journey of learning. Finally, I would like to thank all the people I met within HAS and to express my deepest gratitude to Dr Catherine Grenier and Mr Brunot Lucet for facilitating this visit.