The German health care systemis one of the most advanced in the world. Germany ensures its doctors, nurses and other medical staff are well-trained and professional. Most doctors speak English proficiently, so communication is not a problem. Needless to say, medical institutions in Germany are state-of-the-art facilities as well. There is virtually nothing that could happen to you during your stay in Germany for which there is not a highly specialized medical professional in the country. Pharmacies can be found in almost any street in any German town, and there is always one nearby that is open at night and even on holidays.
All in all, there are more than 2,000 hospitals in Germany. About half are public, with about 30 of them being university clinics. There is also an increasing number of private non-profit and for-profit clinics.
Medical facilities are usually modern and have very high-quality standards. Staff and doctors are experienced and well-trained, and hospitals in Germany employ a great number of specialists.
In 1999, an independent, voluntary accreditation program for hospitals, the Kooperation für Transparenz und Qualität im Krankenhaus, or KTQ, was established with the collaboration of the federal medical chamber, insurers, and the board of the German Hospital Federation. Because the program expanded to include primary care, it changed its name in 2004 from Krankenhaus to Gesundheitswesen The Kooperation für Transparenz und Qualität im Gesundheitswesen, or KTQ-GmbH, is totally independent from the government and is an organization with limited liability, in conjunction with the appointment of a full-time chief executive.
This certification procedure, which is an active program without legislation, concerns:
- doctors’ surgeries
- dental surgeries
- psychotherapy centers
- rehabilitation centers
- inpatient (including partly inpatient) health care facilities
- ambulatory care services
- alternative residential arrangements
This procedure provides hospitals with the impetus for implementing new elements in quality management based on analysis and further development of existing structures and working processes (increased motivation).
The KTQ certification procedure is based on proven international standards, the most important of which:
- the Australian Council on Health Care Standards,
- the Joint Commission on Accreditation of Health Care Organizations, and
- the Canadian Council on Health Services Accreditation.
The KTQ catalogue, currently in its fifth version, comprises six main categories of standards:
- Patient orientation
- Staff orientation
- Management of information
- Quality management
Self-assessment is the first step; this is carried out by the hospital or the institution that seeks KTQ certification. Immediately after self-assessment, it can decide to take any measures needed to improve certain methods or processes, or it can directly seek KTQ certification.
External assessment is conducted via on-site inspection, on-spot employee interviews, and a study of documents. KTQ visits are carried out by renowned experts with proven knowledge, and assessment takes several days to complete. KTQ certification is the ultimate goal, proving that the hospital or clinic has satisfactorily fulfilled the quality control tests. KTQ certification is valid for a certain period, and hospitals’ names and quality reports are published on its website. The quality reports contain all parameters used in decision making. KTQ certification is not compulsory – but it is seen as a good measure of infrastructure and performance.
To earn the certification, the hospital must:
- Attain at least 55 percent of the “adjusted” total point score per category,
- Demonstrate participation in external quality-assurance procedures required by law, and
- Ensure publication of the KTQ quality report.
Three different cases can occur:
- A certificate valid for three years is issued after a successful external evaluation.
- For hospitals whose score deviates by only a maximum of 5 percent from the required percentage, an option is given of a follow-up survey to achieve the necessary score and thus fulfill requirements for certification. The criteria that must be improved in order to be eligible for certification should receive a measurably higher score during the follow-up survey than at the time of the first on-site visitation. Surveyors select especially those criteria that received less than 55 percent of the maximum score during the first survey. The hospital is given a maximum of nine months to address the selected criteria and complete the KTQ external survey.
- If the hospital and surveyors are unable to reach agreement during the external assessment concerning the contents of the KTQ quality report, or if the certification decision is appealed, the KTQ arbitration procedure is available.