Health promotion in hospitals: evidence and quality

1 Health promotion in hospitals: evidence and quality management Edited by: Oliver Groene & Mila Garcia-Barbero 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 Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Netherlands Norway 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 WHOLIS number.

2 E86220 World Health Organization Regional Office for Europe Scherfigsvej 8, DK-2100 Copenhagen , Denmark Tel.: +45 39 17 17 17. Fax: +45 39 17 18 18. E-mail: 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 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.

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5 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?

6 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. KeywordsHOSPITALS standards Health promotion standards quality OF Health CARE PROGRAM EVALUATION EUROPE CONTENTS Introduction (Mila Garcia-Barbero).

7 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 Hospitals ..9 evidence base and quality management ..12 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 hospitals ..21 Concepts used ..22 Policy of Health promotion in hospitals ..23 Health promotion for hospital staff ..24 evidence for general Health promotion ..25 Recommendations with regard to hospital tasks.

8 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) ..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).

9 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) ..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.

10 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 used ..120 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.