1 The WHO Regional Office for Europe The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international Health matters and public Health . The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular Health conditions of the countries it serves. Member States Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Edited by: Oliver Groene &. Health promotion Israel Italy Kazakhstan Mila Garcia-Barbero in hospitals: Kyrgyzstan Latvia Lithuania Luxembourg Malta evidence and quality Monaco Netherlands Norway management Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia and Montenegro Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom Uzbekistan World Health Organization Regional Office for Europe Scherfigsvej 8, DK-2100 Copenhagen , Denmark WHOLIS number: Tel.
2 : +45 39 17 17 17. Fax: +45 39 17 18 18. E-mail: E86220. Web site: Health promotion in Hospitals: evidence and quality Management Country Systems, Policies and Services Division of Country Support WHO Regional Office for Europe May 2005. Edited by: Oliver Groene and Mila Garcia-Barbero ABSTRACT. More than a decade ago the WHO Health Promoting Hospitals project was initiated in order to support hospitals towards placing greater emphasis on Health promotion and disease prevention, rather than on diagnostic and curative services alone. Twenty hospitals in eleven European countries participated in the European pilot project from 1993. to 1997. Since then, the International Network of Health Promoting Hospitals has steadily expanded and now covers 25 Member States, 36. national or regional networks and more than 700 partner hospitals. But, what has been achieved with regard to the implementation of Health promotion services at both hospital and network level?
3 Is there an evidence base for Health promotion and has this facilitated the expansion of Health promotion services in hospitals? And how can we evaluate the quality of Health promotion activities in hospitals? This volume addresses some of these key issues in Health promotion evaluation and quality management and is intended to help Health professionals and managers to assess and implement Health promotion activities in hospitals. Keywords HOSPITALS standards Health promotion standards quality OF Health CARE. PROGRAM EVALUATION. EUROPE. World Health Organization 2005. All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
4 Where the designation country or area appears in the headings of tables, it covers countries, territories, cities, or areas. Dotted lines on maps represent approximate borderlines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The views expressed by authors or editors do not necessarily represent the decisions or the stated policy of the World Health Organization.
5 CONTENTS. Introduction (Mila Garcia-Barbero)..1. Health promotion in hospitals - From principles to implementation (Oliver Groene) ..3. Health promotion : definition and Why hospitals for Health promotion ? ..5. Evolution of the International Network of Health Promoting evidence base and quality The way forward ..16. evidence for Health promotion in hospitals (Hanne T nnesen, Anne Mette Fugleholm & Svend Juul J rgensen) ..21. evidence -based Health promotion in Concepts used ..22. Policy of Health promotion in Health promotion for hospital staff ..24. evidence for general Health promotion ..25. Recommendations with regard to hospital tasks ..30. Systematic intervention and patient education ..32. evidence for specific Conclusion ..42. Eighteen core strategies for Health Promoting Hospitals (J rgen M. Pelikan, Christina Dietscher, Karl Krajic, Peter Nowak).
6 46. Introduction ..46. Patient-oriented New Health promotion services for hospital Promoting Health of staff ..55. Promoting the Health of the population in the An overview of the 18 strategies for Health promoting hospitals ..58. Putting Health promoting policy into action ..60. Development of standards for disease prevention and Health promotion (Anne Mette Fugleholm, Svend Juul J rgensen, Lillian M ller & Oliver Groene)..64. Underlying principles for work on HPH ..64. Standards for Health promotion ..68. International principles for the development of Standards and evidence ..72. Existing standards in the area of disease prevention and Health Process for the development of standards ..76. Conclusion ..78. Implementing the Health Promoting Hospitals Strategy through a combined application of the EFQM Excellence Model and the Balanced Scorecard (Elimar Brandt, Werner Schmidt, Ralf Dziewas & Oliver Groene).
7 80. Introduction ..80. From Health promoting values to Health promotion strategy ..81. Implementing the HPH concept in the organizational structure and culture of the hospital ..83. The Addition Model ..83. The Integration Model ..85. The WHO HPH/EFQM/BSC Pilot Project in the Immanuel Diakonie Group ..86. Application of the EFQM Excellence Model ..87. HPH strategy implementation with the Balanced Scorecard ..92. Conclusion ..96. List of contributors ..100. Annex 1: Ottawa Charter for Health promotion First International Conference on Health promotion , Ottawa, Canada, 17-21 November 1986 ..102. Annex 2: The Vienna Recommendations on Health Promoting Hospitals ..107. Annex 3: Standards for Health promotion in Hospitals ..112. Annex 4: Acronyms and abbreviations EUR/05/5051709. page 1. Introduction (Mila Garcia-Barbero). More than a decade ago, the WHO Health Promoting Hospitals (HPH) project was initiated in order to support hospitals towards placing greater emphasis on Health promotion and disease prevention, rather than on diagnostic and curative services alone.
8 The Health Promoting Hospitals strategy focuses on meeting the physical, mental and social needs of a growing number of chronically ill patients and the elderly; on meeting the needs of hospital staff, who are exposed to physical and psychological stress; and on meeting the needs of the public and the environment. Twenty hospitals in eleven European countries participated in the European pilot project from 1993 to 1997. Since then, the International Network of Health Promoting Hospitals has steadily expanded and now covers 25 Member States, 36 national or regional networks and more than 700 partner hospitals. But, what has been achieved with regard to the implementation of Health promotion services at both hospital and network level? What is the scope of Health promotion activities in hospitals and how can the principles laid out in the Ottawa Charter for Health promotion be put into practice?
9 Is there an evidence base for Health promotion and has this facilitated the expansion of Health promotion services in hospitals? Is Health promotion a service anyway? How does Health promotion relate to quality management? And how can we evaluate the quality of Health promotion activities in hospitals? This volume provides a review of the background of the Health Promoting Hospitals project and addresses some of the key issues in Health promotion evaluation and quality management: Chapter 1 gives an overview on the principles and concepts of Health promotion in hospital , summarizes the rationale and development of the Health Promoting Hospitals movement and raises a range of issues on the evaluation and implementation of Health promotion activities in hospitals. Chapter 2 presents a summary of the evidence base for disease- specific and for general Health promotion activities in hospitals indicating the level of evidence for major Health promotion interventions.
10 EUR/05/5051709. page 2. Chapter 3 offers many conceptual innovations in thinking about the strategic importance of Health promotion in hospitals and describes 18 core strategies for Health promotion in hospitals. Chapter 4 describes the importance of using quality standards to assess Health promotion in hospitals and describes the properties of the five standards developed to support implementation of Health promotion activities. Chapter 5 finally offers valuable insights in the implementation of Health promotion activities in hospitals through a combined application of the European Foundation for quality Management (EFQM) excellence model with the Balanced Scorecard approach. This book is intended to help Health professionals and Health managers to assess and implement Health promotion activities in hospitals. We hope that the principles, evidence , strategies, tools and quality standards presented in this volume support practical application and thus help hospitals ensuring safe, high quality and effective Health care.