• 

Quality of IT service management – The benefits of ISO 9001 and ISO/IEC 20000 for a French hospital

by Francis Ebelé and Laurent Flesch

A hospital is not only a place for treatment. It is also a home and a place where patients live and receive a variety of services, and where quality management and information systems play an important part. A French hospital found support with ISO 9001 and ISO/IEC 20000 in its approach to patient care improvement.

The information systems management department (DSI) of Rouffach Hospital, a French mental health public institution in the Alsace region, obtained certification for its integrated system based on ISO 9001:2008 for quality management and on ISO/IEC 20000:2005 for information technology (IT) service management, at the beginning of 2009. This success is the crowning achievement of the efforts expended by DSI’s management and the 15 staff members who manage the information systems of several health care providers.

Rouffach Hospital specializes in three areas: psychiatry, psychiatric disability and elderly care. It is responsible for six adult psychiatry wards and one child and adolescent psychiatry ward. In addition to its primary health care mission, Rouffach Hospital runs a nursing training institute, a nursing auxiliary training institute and an infant day nursery in partnership with the community of municipalities of the Rouffach area. Its activity represents an active list of 12 100 patients examined at least once during the year.

By developing its health care activities and non-hospital settings (approximately 40) in accordance with the Regional Psychiatric Health Care Organization Scheme, the institution contributes to bringing health care closer to where patients live, encourages their social integration, limits long-stay hospitalizations and ensures continuity of care from hospital to home. Through its health and social care hub (specialist care home, home with a two-tier rating system, etc.) and specific cross-sectoral structures (for troubled teenagers, autistic children, elderly people, etc.), patient management can be better adjusted to their specific needs.

Integrated certification

Rouffach Hospital’s professionals combine their expertise to build the future and ensure a continual improvement of patient care through the implementation of a quality approach.

In addition to the V2 certification (on quality and security of care in health care institutions) which was issued to Rouffach Hospital by the French National Authority for Health (Haute Autorité de Santé) in 2005 and which was recently renewed for the V2010 version, the institution aims to implement a quality management system for its services. The hospital has been committed to quality improvement and certification for several years with the implementation of a number of activities leading to the certification of its laundry to ISO 9001 and of its catering services to ISO 22000 on food safety management.

In 2009, Rouffach Hospital’s DSI distinguished itself as one of the first hospital IT departments in France to obtain ISO 9001 and ISO/IEC 20000 integrated certification. The DSI is in charge of the hospital’s information systems and ensures that IT tools are designed to suit the institution’s strategy. It implements the IT systems development plan. Its responsibility is not limited to managing the hospital’s IT systems, it also manages the IT systems of many other hospitals in the Alsace region.

Controlling the quality management system

The management of Rouffach Hospital and the DSI have been cooperating with other hospitals in the Alsace area for a long time. The aim is to enhance this inter-hospital cooperation and to develop appropriate technologies in order to optimize the management of their IT equipment.

By placing customer satisfaction at the heart of its priorities, the DSI has opted for an efficient customer-contractor relationship between IT services and users, and taken into account their specific “core business” requirements. Certification to ISO 9001:2008 provides evidence of the performance of the methods used and the efficiency of processes. A sound quality management system is a source of efficiency improvements and a staff mobilization tool.

Best practices

ISO/IEC 20000 is based on the ITIL standard (Information Technology Infrastructure Library) which defines IT services management best practices, and on other benchmarks. It provides guidance on the implementation of processes and methods in order to improve performance and the quality of service delivery.

The DSI uses the “Pytheas” software package which enables it to meet functional requirements and offers flexible models for implementing its management system processes. Significant effort from the software publisher and DSI as well as substantial financial investment have made it possible to roll out within six months the software modules that were required to obtain certification.

The commitment of the 17 IT team members outside of their normal working hours has made it possible to achieve this objective within 18 months.

This effort provided many benefits such as enhanced knowledge of the IT service delivery processes which have all gained maturity and resulted in a consistent and upgradable management system using a continual improvement approach.

Offering more services

In order to maintain optimal services for its customers within a clearly defined legal framework, Rouffach Hospital, the 17 institutions in the Alsace region which are members of the inter-hospital IT cooperation, and the IT department have joined, since 1 January 2011, the Sym@ris Public Interest Group aiming to create synergy and to pool health informatics research initiatives. The group now comprises its traditional “software publishing” activity responsible for promoting and developing Cariatides, a patient health record management software, and the new “information systems management” platform.

In this context and based on its management system, the “information systems management” platform will be in a position to increase its service offerings and to better manage the quality of existing or future services.

ISO/CEI 20000:2005, consisting of two parts published under the general title, Information technology – Service management, enables service providers to understand how to enhance the quality of service delivered to their customers, both internal and external, to measure service levels and to assess performance. Part 1: Specification, defines the requirements for IT service management and is intended for the persons responsible for planning, implementing or upgrading such management within their organization. Part 2: Code of practice, represents an industry consensus on the guidance to be provided to auditors and the assistance to be given to service providers responsible for planning service improvements or audits against ISO/IEC 20000-1:2005.