Fresenius Helios

Treatment quality is a key strategic goal at HELIOS. The purpose of the quality management system is to contribute toward a continuous improvement in patient care. Now, over 1,300 indicators (2009: over 1,200 indicators) cover all the main diseases and surgical procedures, so that it is possible to record the number of performed services, (partially) the use of different surgical methods, and, where feasible, indicators for the quality of the outcomes. Conspicuous medical results at individual acute care clinics are reviewed critically and discussed in a peer review process. Internal experts analyze the treatment results that do not meet the HELIOS quality standards. Concrete improvements are then formulated together with the clinic involved. The aim of this analysis is to achieve improvements in the procedures and structures of the treatment process. The outcomes for the 30 main indications and surgical procedures are regularly published in the form of over 140 quality indicators both for the HELIOS Group and for each individual clinic on the Internet and in the respective hospital reports. We believe publishing the quality indicators for each clinic is valuable as it gives the doctor making the referral and the patient an idea of the standard of treatment quality at the clinics. As the records demonstrate, we have improved this continuously over the last ten years.

We have set ambitious targets for 33 of the 140 quality indicators. The aim is for the HELIOS clinics to be at least as good as the German average for these indicators. Where corresponding benchmarks are available, HELIOS expects its acute care clinics to meet best-in-class international standards in the area of surgical medicine. As the table shows, the Group achieved or exceeded the targets for 28 of these indicators (2009: 27).

Helios quality performance indicators (Extract)


Indications/standardized mortality ratio (SMR)1 2010 SMR 2009 SMR2

1 SMR 1 corresponds to the German average
SMR < 1 = means that mortality is below the German average

2 Adjusted for the current reference value of the Federal Statistics Office
More information can be found at: http://www.helios-kliniken.de/medizin/qualitaetsmanagement
Acute myocardial infarction (AMI) 0.77 0.81
Heart failure 0.65 0.73
Stroke 0.83 0.94
Ischemic stroke 0.84 0.92
Pneumonia 0.72 0.79
Hip fracture 0.93 0.88

Indications/standardized mortality ratio (SMR)1 2010 SMR 2009 SMR2

1 SMR 1 corresponds to the German average
SMR < 1 = means that mortality is below the German average

2 Adjusted for the current reference value of the Federal Statistics Office
More information can be found at: http://www.helios-kliniken.de/medizin/qualitaetsmanagement
Acute myocardial infarction (AMI) 0.77 0.81
Heart failure 0.65 0.73
Stroke 0.83 0.94
Ischemic stroke 0.84 0.92
Pneumonia 0.72 0.79
Hip fracture 0.93 0.88

In 2010, HELIOS achieved an SMR of 0.65 for heart failure. This indicates that the mortality in the HELIOS clinics was 35% below the average of all German clinics. Where the targets were not achieved, the deviation from the German average was so small as to be statistically insignificant. The medical teams at HELIOS are also pursuing goals relating to many details of care in their various specialist areas.

The HELIOS clinics are currently working together with the Technical University of Berlin on a comprehensive improvement and refinement of the quality indicators. The updated version of the system defines over 40 quality indicators (2010: 30) as corporate goals. It will be applied from 2011 onwards. This will allow continuous monitoring of the quality of the outcomes for a significantly larger number of indications and surgical procedures than before. Heart and thorax surgery will be included, for instance. With corresponding statistics available, the successful peer review process can be extended to other areas. This will enable still further quality improvements and strengthen HELIOS’ leading position in German medical care.

HELIOS launched the Initiative of Quality Medicine (IQM) in Germany in 2008 in collaboration with six other hospital operators. The aim of the initiative is to further improve internal hospital quality management on the basis of performance indicators. More hospitals joined IQM in 2010, also from Switzerland and Austria. The initiative now covers about 130 hospitals (founding year 2008: about 100), including a number of university hospitals. The marked increase in the number of hospitals participating in the scheme is testimony to the growing acceptance of the need for greater transparency in the health care sector. The members undertake to conduct standardized quality measurements of the treatment outcomes at their clinics, based on administrative data, and to publish the results. This voluntary commitment also includes a form of peer reviewing. In 2010, this was conducted for the first time within the framework of the initiative on a cross-operator basis. Consequently, external experts took part in peer reviews at HELIOS. Further information can be found on the initiative’s website at
www.initiative-qualitaetsmedizin.de.

However, quality management at HELIOS goes beyond the medical results. Our perception of quality also includes the standard of nursing care, the aim being to provide patients with the best medical and nursing care. This is a precondition for successful medical treatment. Our nursing staff – the biggest professional group at the HELIOS clinics – is in continuous communication with the doctors and other professional groups, e. g. therapists. The aim is to activate the patient’s physical, mental, and social abilities, and to restore their natural functioning to the greatest possible extent through preventive, curative, and rehabilitative measures.

HELIOS conducted a survey in 2009 in which more than 67,000 patients participated. The detailed results were published on the company’s website at www.helios-kliniken.de in the second quarter of 2010. An excellent response of 95% was achieved for overall satisfaction and whether patients would recommend HELIOS clinics to others. The analysis of the survey also confirmed the quality of HELIOS’ doctors (95% positive responses) and the nursing staff (94% positive responses).

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