Adult psychiatry (AP)
The reviews record patients’ impairment due to physical and psychological symptoms (symptomatology) as well as the extent of freedom-restricting coercive measures (RMs).
Patients’ symptomatology when admitted to clinics was more severe in 2019 than in the comparison year 2017. The symptomatology was alleviated in all clinics during psychiatric treatment. The proportion of cases with at least one imposed RM increased slightly in comparison with 2017 as a result of the inclusion of data from three additional clinics; the overall number of cases continued to rise. All 96 clinics/clinic sites took part in the 2019 reviews.
In 2019, the results for Forensic Psychiatry were published for the first time. The group evaluated separately as the fourth type of AP clinic includes patients who are in the penal or correctional system. In this type of clinic, the proportion of cases subject to least one RM was 38.1%.
Link to press release
Child and adolescent psychiatry (CAP)
There was alleviation of the severity of symptomatology in all clinics during the psychiatric treatment. As in the case of AP, patients’ symptomatology on admission to CAP was also more severe than in the comparison year. There was a slight decline in the proportion of cases with at least one RM in CAP, despite the fact that there was a significantly higher number of cases. A total of 32 clinics/sites took part in the 2019 reviews.
Link to press release
Survey and evaluation methods
In January, the clinics were given access to the new dashboard – “moniQ – Dashboard for Data, Quality and Monitoring in Hospitals” – designed by the w hoch 2 evaluation institute. Institutions can use the dashboard to upload their data themselves and also to monitor data quality during the year.
Quality Committee (QC)
The QC met five times physically and online in the year under review. During the whole-day meeting, it discussed the 2019 National Comparison Reports and various further developments. Supplementary evaluations of data that has already been collected will prove additionally useful for clinics and ANQ partners over the coming years. The presentation of patients’ symptomatology will also be optimised.
On behalf of the ANQ Board, the QC started work on the pilot project relating to intermediate care in outpatient sites. The QC developed the concept for the pilot project in collaboration with the Swiss Society for Psychiatric and Psychotherapeutic Outpatient Clinics (SGPPT). The pilot project seeks to ensure that there are consistent quality reviews along the chain from inpatient treatment to outpatient treatment in institutes, with the aim of making recommendations for the introduction of national surveys for ANQ partners.
As a result of the COVID-19 pandemic, the QC decided to adapt the coding in the RM recording system and add “isolation for infectious/somatic reasons”. The adjustment will apply from 2021. As it was not possible to make the differentiation in 2020, it is likely that higher numbers of cases of people in isolation due to coronavirus will be registered.
Two long-term members of the QC resigned during the year under review: Prof. Yasser Khazaal of Lausanne University Hospital (CHUV) and Peter Hösly of Klinik Kilchberg. The ANQ Board appointed Dr. Christine Besse of CHUV as Prof. Khazaal’s successor. Lazaridis Panagiotis of UPD Bern has replaced Peter Hösly and will act as the representative for the chief administrators. Prof. Dr. med. Stefan Kaiser of Geneva University Hospitals (HUG) joined the QC in 2020 as a replacement for Prof. Achim Haug of Clienia Gruppe, who resigned in 2019.
Expert groups (EG)
EG Geriatric Psychiatry
The EG was reorganised in 2020 and now has the task of developing the specific essentials and criteria for geriatric psychiatry reviews. The aim is to align the quality reviews as far as possible with the needs of geriatric psychiatry. The EG will submit its recommendations to the QC Psychiatry, which will take these into account when reporting to the ANQ Board.
EG Patient Satisfaction – child and adolescent psychiatry (CAP)
The newly formed EG started its work in July. The EG discussed the process of conducting the survey and clarified outstanding issues during two video conferences. Two online information events took place in the autumn, which were planned and implemented by ANQ together with members of the EG and the review logistics centre w hoch 2.
EG Training in the Use of HoNOS, HoNOSCA, CMs in AP, CMs in CAP
Most training sessions had to be cancelled because of coronavirus. ANQ therefore decided to start developing a hybrid form of training that will enable both digital and physical participation in training sessions in future. The new concept for the CAP training sessions was created at the suggestion of the Swiss Society for Child and Adolescent Psychiatry and Psychotherapy (SGKJPP) and the Association of Chief Physicians in Child and Adolescent Psychiatry in Switzerland (VKJC).