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The last decades have proven by mounting evidence that quality strategies in health care can contribute to better health outcomes and more cost-efficiency of hospitals and other health care services. But quality is a rather open concept. It offers specific tools and strategies for professionals and decision makers - accreditation, performance assessment, guidelines, continuous quality improvement, managerial control mechanisms, accountability etc.. But what good quality is needs to be defined and gain the consent of key stakeholders of health care: patients, professionals and providers, financiers, health care and public health policy. For defining and implementing good quality, Health Promotion already has demonstrated that it can make a distinct and relevant contribution.

What specific synergies can be expected when linking quality and health promotion? From its beginning, HPH has aimed at contributing to hospital quality development by reorienting the hospital towards targeting and investing in increased and more sustainable health gain: for patients, but also for staff and the community population. Many hospitals in diverse health systems in Europe and overseas have taken up this approach, which is outlined in policy documents like the Budapest Declaration>> (WHO, 1991) and the Vienna Recommendations>> (WHO, 1997). With the 18 HPH core strategies>> and 5 Standards for Health Promotion in Hospitals>>, an explicit link of HPH to quality has been established: Hospitals can now rely on specific tools for strategic planning, performance assessment and continuous improvement of their health promotion activities.

What can participants expect to take home from this conference? There will be opportunities to learn from experiences of HPH with quality tools, to share concepts, evidence and experiences on achievements so far, and to open the discussion on future developments. The Scientific Committee has decided to highlight especially 4 topics that link HPH to quality:

Making the hospital a more effective agent for individual and public health by implementing the comprehensive vision of HPH

Hospital health gain depends on the quality of clinical services and on the kinds and quality of preventive and rehabilitative services offered beyond cure and care. But the health promoting or health damaging impact of the hospital setting is also of importance, i.e. the effect of material and social structures as well as organisational culture and hospitals' efforts to contribute to community development for better public health.

In order to release the full potential of HPH for the health gain of patients, staff and the community population, these aspects need to be combined into a comprehensive approach. This is in line with developments in clinical medicine, where the comprehensive management of complex diseases has proven to produce more effective outcomes. Also general management has recently seen a trend towards comprehensive approaches like corporate social responsibility. Such a comprehensive HPH approach needs explicit support within the organisation and beyond, especially from the health policy framework. The conference shall present and discuss concepts, strategies and examples of comprehensive HPH.

Transforming the hospital organisation - integrating wider HP strategic and quality criteria into hospital governance

How can the comprehensive overall HPH concept be implemented into the complex, dynamic, heterogeneous and fragmented context of a modern hospital? In order to fulfil its whole potential, HPH needs to be integrated into hospital governance and organisational development, and needs to be supported by a systematic and complex integration into hospital (quality) management structures.

The conference shall present and discuss specific strategies, experiences and recommendations to develop health promoting organisational structures and cultures, and to convince key stakeholders to participate in such an approach.

Empowering patients for healthy lives by enhancing the supportiveness of health care systems

If health care systems aim at increased and sustainable health gain for their patients and at avoiding unnecessary hospital re-admissions, the contribution of the hospital can be to accept more co-responsibility for the long-term illness and health behaviour of in- and outpatients. There are many ways to do so, from systematic patient empowerment to increased interface management and cooperation with other levels of care.

While lengths of stay are constantly decreasing, one and the same patient has often repeated hospital contacts (e.g. because of pre-check and diagnostics, intervention, follow up and consultation). What new opportunities do these developments offer for patient empowerment, and what requirements for interface management arise? The conference shall present and discuss knowledge and experiences on effective communication strategies and techniques for health promoting illness management and lifestyle development. Another focus will be on the necessary organisational frameworks to integrate patient empowerment into daily hospital routines and to safeguard sustainability after discharge.

Contributions of the hospital to developing health promoting communities

The hospital's core business is to provide services to acute or chronically ill patients. Why should hospitals in addition trespass the border to primary prevention and health promotion interventions in their community settings? Because many avoidable hospital admissions, which can also be troublesome to and influenced by hospital organisations, are not only due to unhealthy personal behaviour but also to unfavourable living and working conditions in the community setting. As experience shows, hospitals have opportunities to improve community conditions for health.

Partnerships and healthy alliances are core instruments for sustainable health promotion in communities, as documented e.g. in the Jakarta Declaration>> (1997) and the Bangkok Charter on Leading Health Promotion into the 21st Century>> (2005). There are many interesting examples from hospitals who have become initiators of or contributors to such alliances, and who have done a good job in reducing avoidable burdens of disease. Strategies and examples shall be presented and discussed at the conference.

Conference topics were presented and discussed in keynote lectures and panels, paper sessions, workshops, and poster sessions. In addition, a number of satellite events have been organised.

The conference provides a forum for exchange and further development of knowledge and experiences for the following target groups:

•••• Health care professionals from the medical, nursing and therapeutic fields;
•••• Hospital and health care managers;
•••• Representatives from patient organisations and other NGOs;
•••• Representatives from health policy and health administration;
•••• Public health actors and experts;
•••• Health and health promotion scientists and practitioners; and
•••• Health care consultants.

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World Health
Organisation,
Regional Office
for Europe
WHO Collaborating
Centre for Health
Promotion in Hospitals
and Health Care
University of Vienna Medical University
of Vienna
Federal Ministry for
Health and Women
Bereichsleitung für Sozial-
und Gesundheitsplanung
sowie Finanzmanagement
Österreichisches Netzwerk
Gesundheitsfördernder
Krankenhäuser
 
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