RESEARCH – January 2006

Health promotion and quality assurance in Estonian hospitals


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In the middle of the 1990s, the World Health Organization initiated the movement of Health Promoting Hospitals (HPH) to encourage hospitals to deal with disease prevention and health promotion. In Estonia the HPH movement was initiated in 1999, and by the end of 2005, 22 Estonian hospitals will be joined to the HPH network. Thepurpose of the study was to explain how hospitals have introduced health promoting activities and required quality standards, and to compare how these activities were implemented in HPH hospitals and in other hospitals which have not joined the HPH network (non-HPH).
Methods. At the beginning of 2005, a postal survey was conducted among the top managers of 54 Estonian hospitals. The questionnaire was based on the standards for HPH hospitals and on the regulation of the Minister of Social Affairs “Quality assurance requirements for health services”.
Results. The response rate was 80%. Regular patient satisfaction studies were conducted in 83% of HPH  hospitals and in 46% of non-HPH hospitals (p <0.03), 65% of HPH and 46% of non-HPH hospitals cooperated with various patient organizations (p <0.03). A system for reporting and an analysis of complications was implemented in 71% of HPH and 33% of non-HPH hospitals (p <0.03); also the implementation of various guidelines was more intensive in HPH hospitals. All HPH hospitals have carried out risk analysis on the workplace; staff’s job satisfaction studies were conducted in 89% of HPH and 41% of non-HPH hospitals (p <0.05).
Conclusion. The concepts of HPH and quality assurance are closely related. Making progress in health promotion is accompanied with quality assurance and vice versa. Implementation of health promoting activities in hospitals will promote the well-being and health of patients and hospital staff and will create a supportive environment for provision of safety and high-quality health services.