The well-being of our patients is our top priority at Asklepios. We want to provide them with excellent medical care. Ideally, we support them until they are completely healthy again. We therefore continuously scrutinise and improve the quality and safety of our work. We see digitalisation as an opportunity, since it opens up new avenues for optimising our structures and processes and developing innovative services for our patients.
Group standards
The Group Quality division defines the requirements that apply as minimum standards for all hospitals. Our on-site quality and risk managers are responsible for their implementation.
Clinical risk management
A comprehensive concept with methods and instruments for systematically identifying, evaluating and mastering clinical risks based on legal requirements is established and is continuously developed.
Audits
In addition to the internal hospital audits, all hospitals are audited annually by the Group Quality division. For instance, the implementation of the Asklepios program for patient safety, which forms part of our clinical risk management, is examined as part of these audits. From the results of the audits, we derive specific measures for improvement.
Training
Each year, Asklepios offers comprehensive further education and training on all relevant topics in the area of quality and risk management to all professional groups.
Complaint management
Our patients can give us valuable advice on how we can improve the quality of our treatments. To this end, our patient-oriented complaint management system is permanently embedded in our quality management.
Holistic healthcare
Our healthcare facilities and services are integrated to a degree that enables us to provide our patients with comprehensive inpatient and outpatient care. In our Centres of Excellence, we specialise in the treatment of specific symptoms. To provide the best possible treatment, we increasingly integrate digital solutions such as the Asklepios Online Clinic.
From prevention to rehabilitation
As part of its commitment to holistic healthcare, Asklepios provides a comprehensive treatment infrastructure for patients that offers support throughout the treatment process – from prevention and outpatient treatment all the way to inpatient treatment and rehabilitation. We provide basic, standard, maximum and priority care and participate in prevention and educational projects aimed at promoting general health in line with the precautionary principle. Our patients can avail themselves of a range of services including outpatient support at our medical centres.
In our hospitals and specialist clinics, we use established specialities to cater for all care levels of inpatient treatment. We have defined a total of 39 departments as Centres of Excellence. They stand out thanks to special features such as the large numbers of patients with specific diseases as well as an infrastructure adapted to particular symptoms. Thanks to multi-professional treatment teams, targeted care delivery using remedies and aids as well as the comprehensive rehabilitation services for our patients as part of their medically prescribed treatments, we endeavour to achieve the best possible treatment outcomes at our Centres of Excellence.
Optimised processes and digital services
In deploying digital solutions, we cooperate with partners from the healthcare sector. Together with Minddistrict, for example, we developed the Asklepios Online Clinic. This offers digital therapy programmes for people with mental health problems, which are combined with video calls and personal contact.
To ensure that we can guarantee the best possible treatment to our patients in the future as well, the hospitals in Hamburg use the hospital information system M-KIS. The treatment process is documented and presented transparently in the digital patient record. Since 2022, all hospitals in Hamburg have been working with M-KIS, and in the future all Asklepios hospitals will document their key processes digitally.
In addition, we are making increasing use of digital communication formats for prevention. In the health podcast “Die digitale Sprechstunde” (The Digital Consultation) jointly issued by German daily newspaper “Hamburger Abendblatt” and Hamburg’s Asklepios hospitals, doctors explain one medical topic or symptom in each episode and provide tips on prevention.
Health offers for companies
With our “Corporate Health” business segment, we help companies to boost the productivity and health of their employees. In cooperation with our subsidiaries the Fürstenberg Institute, INSITE-Interventions and Pulso Europe, we offer counselling programmes such as the Employee Assistant Programme (EAP), various work-life services, health coaching and medical check-ups. Our own employees can also use these programmes.
Guaranteeing patient safety
Top medical quality and safety are essential prerequisites to enable us to provide the best possible care for our patients. We understand that guaranteeing both in the long term is an ongoing process. In so doing, we consider not only our employees, but also our patients as vital sources of feedback.
To ensure high-quality patient care at all Asklepios hospitals, we use comprehensive quality management. The core component is the established programme for patient safety, which includes methods, tools and standards that allow us to detect clinical risks early on and to analyse and avoid them. A clinical risk includes everything that may endanger the safety of patients during their treatment.
Based on risk analyses and in the recommendations of the World Health Organisation (WHO) and the German Coalition for Patient Safety, we have developed appropriate standards and derived recommended actions and prevention measures. These include an operation safety checklist in accordance with the WHO, counting checks during surgery as well as patient identification armbands in all hospitals. The “Stop-Inject: Check!” method helps us avoid medication errors during intravenous injections. In 2021, it was awarded second place in the “German Prize for Patient Safety”.
Quality management system developed further
All Asklepios hospitals have a structured quality management system in place, which is continuously developed and adapted to current legal requirements. This system conforms to the legally required QM tools in accordance with the QM guidelines set out by the Federal Joint Committee and to the standards the Group has outlined for improving patient safety.
Internal audits improve patient care
The Group Quality division defines the specific requirements that apply as minimum standards for all hospitals. Internal quality and risk managers at the hospitals are responsible for their implementation. To ensure exceptional standards of medical, nursing and therapeutic patient care, all Asklepios hospitals are audited each year by the Group Quality division. In addition to this, the Asklepios audit program includes internal hospital audits and risk audits on priority issues.
The following examples are just some of the measures for improvement we derived from the audits:
- Development of a Group-wide standard for indication-specific pain management
- Provision of new printed media on complaint management at the hospitals, with the aim of informing patients about the existing options and channels for making complaints
- Continuation and further development of spot checks of patient records for compliance with the structural requirements from the Federal Joint Committee’s quality guidelines and documentation quality in the context of statutory quality assurance
- Ongoing optimisation of clinical processes
Patient safety as a key CR goal
Responsibility for our patients is the top priority for all Group divisions – including the Group ESG division. As part of the materiality analysis, we have defined patient safety as a key CR topic. The central goal of guaranteeing consistently excellent patient safety is now firmly anchored in our CR roadmap. To improve our ability to track progress, we have expanded our KPI set to include key figures for the Critical Incident Reporting System (CIRS) as well as the “Sicher Arbeiten Vertrauen Erhalten” (S.A.V.E.) prevention format.
CIRS reporting system: learning from mistakes
The Critical Incident Reporting System (CIRS) is a key component of our clinical risk management. With the help of CIRS, all employees can submit anonymous reports of mistakes and undesirable events in the clinical process. The system enables cross-departmental and inter-hospital learning from mistakes by passing on cases of general relevance along with specific prevention recommendations to all Asklepios hospitals.
Since 2010, more than 15,600 reports have been submitted, from which over 12,000 measures for improvement have been derived. These include measures to prevent medications that look similar from being mixed up, improvements to emergency equipment on wards as well as measures to prevent the misuse of equipment. In the 2022 financial year, our employees submitted 829 reports via CIRS and 393 measures were implemented. For the first time since this year, we have combined the CIRS key figures already developed in a process-oriented key figure. When interpreting this, it should be noted that generally one key figure alone – such as the number of reports – is not informative, but rather only an assessment of all relevant results for the process.
In the event of a medical claim, the Group Quality division conducts an intensive investigation. Systemic case analyses are conducted with the employees involved in order to identify errors and their contributory factors as well as to implement targeted measures to prevent recurrence.
S.A.V.E. prevention format
Obstetric emergencies are rare but highly dramatic events. Decisions have to be made extremely quickly and implemented under great stress and time pressure. In such emergency situations, it is crucial for the interdisciplinary team of gynaecologists, midwives, anaesthesiologists, neonatologists and nurses to work together hand in hand.
Since 2017, Asklepios has been implementing the medical law format “Sicher Arbeiten Vertrauen Erhalten” (Work Safely, Gain Trust – S.A.V.E.) with the aim of ensuring that all employees working in delivery rooms are optimally prepared for emergency situations during childbirth. The basic principle is to take a structured approach to the extensive informative on birth defects and their causes provided by liability cases by way of targeted emergency training combined with legal training.
This training is provided at the Institute for Emergency Medicine in Hamburg and on site in the Asklepios delivery rooms.
S.A.V.E. relies on networking, promotes dialogue between professional groups and locations, supports the optimisation of emergency structures and standards, raises teams’ awareness of legal issues and increases safety for patients and employees at the Asklepios hospitals. The S.A.V.E. format comes under the responsibility of the Group Medical Law, Insurance and Compliance division.
In 2020, this prevention format was rolled out to the company’s central emergency departments, leading to an increase in the number of employees trained in 2021 and 2022 overall.
Hours of training in delivery rooms and central emergency departments
Year | Employees trained | Hours of training |
2017 | 155 | 1,704 |
2018 | 268 | 2,724 |
2019 | 265 | 2,572 |
2020 | 244 | 2,540 |
2021 | 472 | 4,724 |
2022 | 525 | 5,508 |
Total | 1,929 | 19,772 |
We measure the success of the birth defect prevention format (S.A.V.E.) based on the number of birth defects with a medium or high liability risk in relation to the number of births (rolling three-year average). In the reporting year, this key figure was one in 2,988 births, based on the rolling three-year average for 2019 to 2021.
Strict hygiene regulations
Furthermore, hygiene is a key element of patient safety. For this reason, our hospitals are bound by strict hygiene regulations. These include internal Group training measures for specialist hygiene personnel, involvement in surveillance surveys and participation in the “Clean Your Hands campaign” of the World Health Organisation. The implementation of these standards is monitored in conjunction with quality management by means of internal and external audits.
Protecting patient data – analogue and digital
We also care for our patients in the digital domain. Our focus here is on protecting sensitive patient data. For this reason, digitalisation in our hospitals is closely monitored in terms of data protection. In this context, we create structures that allow data to be processed for the intended purpose in a secure environment, thereby increasing the level of data protection. We use a range of security standards to guarantee integrity, confidentiality and a high level of overall security:
- As part of a data protection management system, we monitor the implementation of data protection requirements. The management teams at the individual hospitals are responsible for implementing data protection. They are supported at operational level by the local data protection officers at the hospitals and Group companies and are assisted in some cases by local data protection coordinators. The Group Legal division acts as the central point of contact for advice regarding data protection.
- A series of procedural instructions create binding instructions on the handling of data in the company. They specify, for instance, that patient data can be processed only with the patient’s consent if processing is necessary to comply with applicable laws and regulations or if another legal basis for this exists. We have agreed uniform standards throughout the company for evaluating risks during processing operations. If risks are identified, a binding catalogue of measures including specific time-lines for the implementation of improvement measures is defined. We inform our employees about the security standards that apply to data processing in mandatory training courses that we hold at regular intervals.
Preventing privacy breaches
Despite high security standards, isolated privacy breaches can still occur. In 2022, we documented 47 cases of breaches in the protection of personal data that were also reported to the relevant supervisory authority. All cases were recorded and analysed. From all incidents, we derived measures and documented these internally at the hospitals to prevent any future recurrence. The hospital in question informs the authorities of the implementation of these measures.
Own data centre in Hamburg
To provide the necessary IT infrastructure, Asklepios operates its own data centre with around 3,000 virtualised servers in Hamburg-Barmbek. The data centre is certified to the data protection and data security standard ISO 27001, and also performs independent internal and external audit-penetration tests. To prevent data loss in the event of hardware malfunctions or failures, all data is stored redundantly and monitored by virus scanners and other security systems. Asklepios also adheres to the principle of minimality, which means that every user is issued only with the rights that they actually need.
Improving patient satisfaction
A functioning, patient-centric complaint management system improves the care, safety and therefore the satisfaction of patients. A high level of patient satisfaction is of central importance to Asklepios. To identify and continuously improve weak points, we offer our patients a range of easily accessible ways to submit complaints on topics such as cleanliness, waiting times, the accessibility of channels for submitting complaints and the medical quality of complaint handling. We are making progress across a range of indicators such as the recommendation rate among our patients. We have expanded our KPI set accordingly during the reporting year.
Regular patient surveys
With the help of standardised questionnaires, we regularly ask our patients at the somatic care and rehabilitation hospitals whether they would recommend us to others. Patients can answer “yes” or “no” and can provide reasons if they wish. We strive to achieve values greater than 90%. The recommendation rate across all Asklepios hospitals was 91% in 2022. The surveys are currently conducted in writing and we have appointed a service provider to evaluate the results. In 2022, we also conducted the survey electronically at several hospitals in a pilot phase and identified potential for improvement. In all hospitals, complaints officers are responsible for optimising hospital processes and procedures based on the complaints submitted.
Patient-reported outcome measurement
As part of our stated objective to continuously improve our treatment quality, we use instruments such as patient-reported outcome measures (PROM). This method evaluates the success of a treatment from the patient’s perspective. In this context, patients are asked about their quality of life before the operation as well as six months, one year, three years, five years and ten years afterwards.
The purpose of these surveys is to gain a long-term view of the medical outcome and quality of life after the intervention. Recently, quality contracts for hip and knee endoprosthetics have been concluded at several hospitals with various health insurance funds. In this context, an assessment of the medical outcome will routinely be performed that also includes asking patients about their quality of life and measuring this as part of the patient-reported outcome measurement. These data will be sent in an anonymised form to the Institut für Qualität und Transparenz im Gesundheitswesen (Institute for Quality and Transparency in Healthcare, IQTIG).
We will use the information collected in this way to further optimise our therapies to guarantee patients the best possible treatment at our hospitals.
All complaint management systems at the Asklepios locations are based on the legal requirements and are reviewed during the annual audit by the Group Quality division.
Key figures for the area of patients
Parameter | Unit | 2022 | 2021 | 2020 | GRI |
---|---|---|---|---|---|
Critical Incident Reporting System (CIRS) | |||||
Processed CIRS reports | % | 80.3 | 78.0 | No data | 416-2 |
CIRS reports with derived measures 1 | % | 80.5 | 78.5 | No data | |
Implemented measures from CIRS 2 | % | 79.4 | 75.6 | No data | |
Hospital audits by the Group Quality division 4 (performance rate) | % | 95.8 | 92.8 | 88.0 | |
Recommendation rate in questionnaires | % | 91.8 | 91.4 | No data 3 | |
Breaches in the protection of personal data | Number of cases | 47 | 100 | 61 | 418-1 |
Servers with data protection and data security standard ISO 27001 | Number | approx. 3,000 | approx. 3,000 | approx. 3,000 | |
1 CIRS reports with derived measures in relation to the number of usable CIRS reports in percent | |||||
2 Implemented measures from CIRS in relation to the number of derived measures in percent | |||||
3 Key figures could be collected for the first time in the period from Q4 2020 to Q3 2021 (somatic care and rehabilitation hospitals not including psychiatry) | |||||
4 Including Klinik Oschatz and Klinik Melsungen |