In post-acute care, care and project management, all processes are regularly checked for their suitability and adapted, if necessary.
In accordance with the BAR guidelines, Fresenius Vamed implements all relevant measures to increase patient safety at its post-acute care facilities – including patient surveys, complaint management, and regular internal audits of all segments. The company receives feedback on the quality of the structure, process, and outcomes from the insurers, e. g., as part of the quality assurance of the German pension insurance or the statutory health insurance providers. In all Fresenius Vamed healthcare facilities, patients receive relevant information material and patient training to ensure long-term treatment success. Reporting systems for complaints are also available in some healthcare facilities. In Fresenius Vamed’s project business, the lead companies establish guidelines for all subsidiaries, which are reviewed in annual audits.
21 fully inpatient facilities provide care for people in need of care in care grades 1 to 5. The range of care and support includes basic care and medical treatment care, social care, day-structuring measures, and additional care for people with a considerable need for general supervision and care (dementia patients), as well as specialized care for people with severe neurological illnesses, with psychiatric or geriatric psychiatric illnesses, and for people with addictive disorders. In addition to full inpatient long-term care, all nursing facilities also offer short-term and respite care.
The nursing facilities are closely connected with the Helios hospitals located nearby so that they can provide residents with the best medical care quickly.
In geriatrics and geriatric care for the elderly and in palliative medicine, Fresenius Vamed has adopted the renowned salutogenesis methodological concept: Leading a self-determined life with dignity. The approach is based on a clear understanding of individual processes to support and maintain the health and well-being of our residents. In nursing and care, we focus on quality of life and a feeling of security and belonging.
Organization and responsibilities
Within the Management Board of Fresenius Vamed, the Management Board division responsible for the service business is responsible for patient and product safety.
In order to raise awareness of quality requirements among employees, Fresenius Vamed employs staff for quality and risk management. These employees report directly to management. Quality assurance officers carry out training courses, thus integrating all employees in the quality management systems of their facilities. The quality assurance officers can thus ensure that employees comply with their obligation to exercise due care. Fresenius Vamed informs its employees about its understanding of quality early in the initial training and introductory events. Guidelines are communicated to and documented for the relevant areas and departments in writing (e. g., via work instructions from the respective management).
The VAMED International Medical Board (IMB) ensures the exchange of information between Fresenius Vamed physicians from Austria, Germany, the Czech Republic, Switzerland, and the United Arab Emirates. Within Fresenius Vamed, medical specialist groups and executive conferences coordinate on quality and safety.
Policies and regulations
Fresenius Vamed sets ethical standards through its mission statement as well as through its Code of Conduct, the Clinical Code of Conduct, and the Code of Conduct for Business Partners.
Fresenius Vamed’s internal guidelines are based on regulatory requirements established throughout Europe, e. g., for rehabilitation. In care, Fresenius Vamed follows the renowned methodological concept of salutogenesis. In addition to the statutory requirements and the requirements of the insurers, Fresenius Vamed also adheres to international standards such as ISO and EFQM, expert standards, and medical guidelines. All internal guidelines are regularly reviewed and updated as necessary. Employees can obtain information on the guidelines via the intranet.
Hygiene management in rehabilitation and nursing care
One of Fresenius Vamed’s tasks with regard to hygiene in rehabilitation clinics and nursing facilities is to ensure the highest possible protection for everyone – without restricting rehabilitative measures for the individual. Protecting patients from infectious diseases during their stay is a top priority. Newly established healthcare facilities follow systematic guidelines from day one to prevent infections breaking out or spreading. Clearly defined procedures are followed and compliance with hygiene regulations is strictly controlled.
Fresenius Vamed’s hygiene standards in Germany are based on the recommendations of the RKI’s Commission for Hospital Hygiene and Infection Prevention (KRINKO). These recommendations take into account all legal requirements for hygiene.
In the German facilities, the central Head of Hygiene coordinates the hygiene specialists and establishes overarching standards, together with the CMO. One of the most important hygiene measures is hand disinfection. Fresenius Vamed follows the guidelines of the WHO in this regard. Hygiene specialists, doctors, and nurses with special hygiene responsibilities implement hospital hygiene measures. In Austria, the Federal Hospitals Act forms the basis for the management of hygiene plans, hygiene inspections, the use of hygiene specialists, and doctors with special hygiene responsibilities. In the course of the COVID-19 pandemic, hygiene inspections in the facilities were intensified. Hand hygiene and the correct wearing of protective equipment were continuously addressed.
Personalized and individually tailored rehabilitation goals
Fresenius Vamed uses modern, resource-oriented approaches, such as the ICF concept (International Classification of Functioning, Disability and Health) since 2015 or the computer-based evaluation system CHES (Computer-Based Health Evaluation System) since 2020. This enables patients to achieve the best possible, evidence-based functional improvement to increase activity and participation in all areas of life, even after severe illness.
In addition, the findings on treatment quality are published, for example by Fresenius Vamed Germany on the website Qualitaetskliniken.de. This allows patients to find out about key quality parameters of the various clinics before they are admitted.
Measurement of patient satisfaction and grievance processes
Fresenius Vamed measures patient satisfaction in its healthcare facilities in a continuous and structured process. The evaluation is conducted on a weekly and a monthly basis. The company collects data, evaluates it internally, and implements appropriate measures, if necessary. Patient surveys are conducted while the patient is in the clinic, as well as after their rehabilitation; in some clinics both approaches are established. In this way, they receive comprehensive feedback with regard to patient satisfaction.
Fresenius Vamed uses reporting systems for critical events and near-misses in its healthcare facilities, e. g., the electronic CIRS. Critical incidents can be reported anonymously there. The reports are processed by a dedicated committee. In addition, Fresenius Vamed uses systems for suggestions for improvement, material vigilance (material safety), and pharmacovigilance (drug safety). Thanks to these systems, a timely and appropriate response to potential sources of danger or complaints can be made, aligned with the internal quality standards.
Audits and recertification
To ensure adherence to quality standards, Fresenius Vamed also performs regular internal audits as well as external recertifications. This is done in the certified healthcare companies as well as in the other facilities of Fresenius Vamed. Quality management audits are carried out there once a year in accordance with the ISO regulations. Internal audits are carried out systematically and cover all business segments, and at a minimum, those topics that are required by the certified standards – e. g., all quality management processes. Besides ISO certifications, audits are conducted by the external regulatory bodies, listed in the chapter Well-being of the patient, section Certifications and commitment.
Fresenius Vamed provides information to its patients in different ways – for example, in the patient information folder or in the treatment contract, and via information brochures, privacy statements, the house rules, and the mission statement. Welcome lectures and training sessions are also offered. The website is available as a source of information before arrival. The goal of therapy is usually discussed and evaluated with patients during admission and discharge discussions.
Since Fresenius Vamed is also active as an accredited inspection body (ISO 17020) and as a manufacturer of medical gas supply systems (Council Directive 93 / 42 / EEC), the business segment is subject to both a labeling obligation and an information obligation in accordance with (Council Directive 93 / 42 / EEC) and Medical Device Directive (MDD) and / or ISO 13485. The accreditation authority uses external audits, for example, to check whether appropriate provisions exist and whether regulatory or normative requirements are complied with.
Fresenius Vamed defines its quality goals annually with the aid of additional key performance indicators. The findings from complaint, case, and risk management are also incorporated. The goals are reviewed regularly.
Progress and measures in 2022
In the reporting year, the management approach and the governance structure of Fresenius Vamed remained as reported in 2021. Measures focused on compliance with hygiene and safety protocols adapted to the pandemic situation. Progress focused on further developments in the area of patient information and patient satisfaction measurement of all facilities by means of standardized content, as well as the expansion of outcome measurement to include additional medical indications. Adjustments were also made to meet regulatory requirements, e. g., with regard to group size for therapies or room occupancy.
In accordance with the process specifications from quality management, Fresenius Vamed regularly reviews the potential and existing health and safety impacts of all significant product, treatment, and service categories for improvement potential. If necessary, corrective and preventive measures including a possible process FMEA (Failure Mode and Effects Analysis) are initiated.