it was decided that the price for services would
have been decreased for 0.3%. Hospitals were
allowed to choose the accreditation model by
themselves. Most of them decided for DNV-GL
accreditation, the other decided for JCI. Since 2016,
this obligation does not now exist. Some hospitals
still have their accreditation model established and
others have decided to use ISO 9001 and ISO EN
15224. Health institutions are still facing some
blame from media and the general public for the
adverse events reported.
In 2017 Ministry of Health initiated the
so-called Šilih project. The main purposes are to
identify and validate measures to reduce and
prevent warnings and adverse events during
medical treatments; to exercise the right to
adequate, high-quality, and an effective judicial
procedure when mistakes occur.
slovenia
Mr Simon Vrhunec
HOPE Governor, Association of Health Institutions
of Slovenia
Could you outline the strategy/approach
adopted in your country on quality and
patient safety or the two/three initiatives
in the hospital and healthcare sector in the
past ten years?
Approximately 15 years ago, the Ministry of Health
introduced the programme of quality improvement
in the health sector. For that purpose, the
Department for Quality was established. First, a
set of quality indicators was developed with the
cooperation of the Institute for Public Health of
the Republic of Slovenia and the hospitals
themselves. Hospitals were obliged to collect data
and to report indicators to the Ministry of Health.
In this period, the ‘non-blame culture’ was
developed in hospitals. Moreover, the quality
indicators were published and made available on
hospitals yearly reports. Finally, the Ministry
published each year a brochure with indicators for
all hospitals.
In 2012, the Ministry of Health and the Health
Insurance Institute of Slovenia agreed that
hospitals should have been accredited by an
international accreditation model by the end of
2014. For hospitals not accredited by that date,
Could you present us the two/three
expectations that your organisation/country
have today on improving the quality of
healthcare using the experiences and
competencies of patients?
In Slovenia there is a big gap between expectations
of the population regarding healthcare services and
the possibility of public financing to assure those
services. The results of this gap are very long
waiting lists and waiting times for specific services.
Emergency care is provided immediately. For all
elective services, regardless if they are needed with
urgency, the providers (hospitals) cannot assure
them in reasonable time. Spine surgery
represents one of this cases. Waiting time for
service differs among hospitals and varies from
six months to more than two years. It is
a reasonable expectation of patients and healthcare
providers that government should address its
resources (financial and human) to decrease
waiting times. Since public opinion is that
providers are responsible for waiting times
regardless of the fact that these are actually
caused by a lack of resources, hospitals also
expect that Government would accept the
responsibility. The other expectation of the
providers is to start to rebuild a ‘non-blame
culture’ because the trust between patients and
providers is at its lowest-ever level and
consequently it is very hard for healthcare
professionals to work in such circumstances.
In the past in the University Medical Centre
of Ljubljana, there was a board of patients
nominated to improve the management of
processes, taking into consideration their
experiences. This is a good example of patient
empowerment.
slovenia
Total health expenditure as % of Gross Domestic Product (GDP)
Percentage of current public expenditure on health as % of total current health expenditure
Hospital current health expenditure, as % of total current health expenditure
Out-of-pocket expenditure, % of current expenditure on health
All hospital beds per 100,000 inhabitants
Acute care hospital beds per 100,000 inhabitants
Acute care admissions/discharges per 100 inhabitants
Average length of stay for acute care hospitals (bed-days)
Practicing physicians per 100,000 inhabitants
Practicing nurses per 100,000 inhabitants
34
HHE 2018 | hospitalhealthcare.com
2000 2008 2015
7.8%
7.8%
8.5%
72.9%
73.6%
71.7%
n.a
40.9%
41.1%
12.5%
12.6%
12.5%
540.0
474.0
451.0
523.0
452.0
422.0
16.0
17.3
16.7
7.1
5.7
6.6
215.0
240.0
283.0
685.0
788.0
878.0