Quality and responsibility

Good health and well-being

All members of our personnel are responsible for ensuring that our customers receive appropriate, high-quality and safe care. We aim to stand out by providing an outstanding experience in all customer encounters, regardless of the channel. We develop our work by listening to our customers and utilizing new technology.

Quality and impact are at the core of our operations

We are committed to the high quality and continuous development of our operations. We measure, monitor and manage our quality actively. Developing our service quality and operational efficiency even further allows us to ensure the best possible working conditions for our professionals and the optimal impact of our customers’ service experience, without compromising on the all-important aspects of human contact and empathy.

We divide our quality-related work into four areas:

  • Clinical quality
    Health care must be based on evidence and good care and operating practices, and it must be high quality, safe and appropriately implemented. At Terveystalo, we actively monitor, measure and manage clinical quality.
  • Operational efficiency
    Streamlined processes ensure the smart allocation of resources and the reliability of operations. All services provided by Terveystalo are based on our comprehensive and certified quality management system. Our customers can always trust the quality of our care, the smooth use of services, and the efficiency and safety of our services. In addition, we promote pleasant and efficient everyday life by developing our expertise and management. Our comprehensive network, digital tools and extensive service range constitute a platform for providing efficient, personal and local services for customers.
  • The customer’s experienced quality
    The customer’s experience is always personal and develops through every encounter. It is important to us that customers receive the care they need without delay and they are encouraged to make choices that promote their well-being. Our objective is to be the preferred provider of healthcare services for all customer groups.
  • The professional’s experienced quality
    We believe that satisfied employees provide a better customer experience in customer encounters, and so enhancing customer satisfaction. The realization of the strategy requires that we are able to attract qualified and motivated health care professionals to Terveystalo and retain them. This enables us to achieve clinical quality, superior service experienceand operational efficiency

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Quality management at all levels of the organization

The cornerstones of our quality system are patient safety and the national legislation governing the field. Our quality assurance system is a management system that provides a framework for managing quality and effectiveness at all levels of the organization. Our strategic priority areas, joint processes and measurability guide us towards consistently high-quality operations. Continuous improvement of our operations is an essential part of our quality efforts. The objectives of our quality-related efforts also include ensuring service availability, patient safety, an excellent customer experience, compliance with recommendations, data protection, information security and the development of the effectiveness of care. The Group’s quality steering group monitors the achievement of the quality objectives quarterly using quality indicators.

Patient safety is the foundation for quality in health care

Clinical quality is a key element of Terveystalo’s quality efforts that is continuously monitored and developed. Clinical quality refers to the patient receiving the right treatment at the right time and in the right manner, and that treatment has no avoidable adverse effects. We ensure service quality, safety, customer orientation and productivity through consistent operating methods, the continuous training of our experts as well as modern premises and technology. We manage patient safety by monitoring the number of procedure and clinic-specific post-surgery infections, hazardous events, official requests for clarifications, and the decisions of the Patient Insurance Centre, among other measures. We ensure the safety and effectiveness of the provided pharmacotherapy by medication plans, operating guidelines, and a basic range of drugs.

Each year, the themes, priorities and strategy of patient safety at Terveystalo are chosen by the Group’s patient safety team and confirmed by the quality steering group. This work is supported by internal and external audits. In 2022, the patient safety themes were: unacknowledged laboratory results, drug maintenance permits and drug treatment plan, faster identification and notification of hazardous incidents, and sharing information on the handling and actions related to hazardous incidents. The theme related to hazardous incidents emerged from the 2021 survey, where the patient safety culture, patient safety implementation and development needs were mapped. The clear structures and strategy of patient safety are aimed at effective cooperation to improve patient safety within clinics, throughout the organization, with the supervisory authorities and particularly in practical work with patients.

A good patient safety culture means having an open atmosphere in which employees are able to highlight any shortcomings or hazards (near misses/hazardous incidents) they observe in their work treating patients, without fear of sanctions or blame. Shortcomings and hazardous incidents are addressed openly and carefully to ensure that the issue does not reoccur. In 2022, we launched a new patient and customer safety online course. The course is mandatory for all employees working with patient care and persons in positions with responsibility for patient safety. The course is also recommended for private practitioners working in Terveystalo.

Self-assessment plan

We follow the Self-assessment plan drawn up according to Valvira's instructions, which is complemented by our operating manual and process maps with work instructions. We also follow occupational safety guidelines and guidelines on hygiene and infection control.

The quality index measures clinical and experienced quality

We continuously develop our services, the quality and effectiveness of provided care and the service experience of our customers. We measure clinical, experienced and process results based on international best practices.

Terveystalo uses a quality index that consists of four components:

  • high clinical quality
  • availability of care
  • preventive care
  • experienced quality from the professional’s perspective and the patient’s perspective

  • use of the WHO Surgical Safety Checklist in surgical operations
  • prescriptions for drugs affecting the central nervous system relative to the number of physician’s appointments
  • duration of sickness absence issued on the day of operation for repair of the rotator cuff and the anterior cruciate ligament
  • percentage of preventive work of occupational health appointments
  • availability of care as measured by T3 (the third available appointment)
  • Net Promoter Score (NPS) for appointments
  • employee Net Promoter Score (eNPS)

In 2022, we continued to develop quality and effectiveness reporting and also adopted new quality indicators. We published a set of 32 quality indicators on our website.

We perform surgeries in our network of 18 hospitals. We systematically apply the WHO Surgical Safety Checklist before the start of each procedure. It is a standard list of questions to check safety issues relevant for the operation in the OR. In 2022, the WHO Surgical Safety Checklist was used in 98.9 (99.8) percent of the operations we performed.

When used appropriately, drugs affecting the central nervous system are effective and necessary. However, because of their adverse effects, their use requires careful discretion by a physician. We have a special project aimed at promoting the safe use of drugs affecting the central nervous system according to clinical guidelines in patient care. To harmonize prescription practices, we have prepared detailed guidelines for prescribing drugs affecting the central nervous system based on legislation, Current Care Guidelines, Smart to Avoid Recommendations, guidelines issued by the National Supervisory Authority for Welfare and Health, and operating models proven in clinical work. In 2022, our clinics wrote prescriptions for drugs affecting the central nervous system for 4.0 (4.3) percent of visits to a physician.

Our surgical operations aim to provide swift high-quality care pursuant to care criteria to quickly restore the patient’s functional capacity and ability to work. We systematically develop the treatment chain for our surgery patients. Our aim is to enable faster recovery and return to work. Correctly prepared surgery implemented without delay as well as a plan for early rehabilitation and return to work play a key role in this. The average length of sickness absence issued on the day of operation for surgical repair of the rotator cuff and the anterior cruciate ligament was 30 (32) days in 2022.

Work not carried out is expensive for Finnish companies. Therefore, it pays to invest in work ability management through preventive measures. Effective work ability management requires that organizations know what kinds of risks to work ability they are managing. With targeted health examinations, we survey the organization’s health and work ability risks and obtain information to support the management efforts. Our occupational health examinations always include an electronic, scientifically validated health survey. The survey is a self-assessment for the employees. Based on the survey, we can identify possible risks related to health and work ability. With the survey, we can target measures particularly to those with significant risks. In 2022, preventive work accounted for 69.6 (70.2) percent of all of our occupational health appointments.

 

We continuously develop the availability of care by managing the balance between supply and demand as well as by developing our digital services and the work of our professionals. We measure the availability of care by the T3 indicator, which is the number of days until the third available non-urgent appointment at our clinics. The figure indicates how quickly a customer can have an appointment with a physician. The T3 indicator for appointments with a physician was  1.93 (1.61) in 2022. In addition to physical appointments, the availability of care is enhanced by digital general practitioner appointments available 24/7. In addition, digital mental well-being services also lower the threshold for seeking treatment.

We aim to stand out by providing an excellent experience in all customer encounters. We develop our work by listening to our customers and utilizing technology. NPS (Net Promoter Score) is our most important indicator of customer satisfaction. We collect feedback with SMS and browser-based surveys, and we are continuously adding NPS measurements at new customer encounter points. In 2022, the NPS for our appointments was 82.7 (83.0). The NPS for our hospital services remained at a high level of 95.1 (94.7).

We want to be the most attractive workplace for professionals. The professional survey is one of our most important tools for improving internal procedures and supervisor work. The survey is aimed at all of Terveystalo’s professionals, including private practitioners. In the employee survey, the employee Net Promoter Score (eNPS) is used as a key indicator of well-being and coping at work. The eNPS figure indicates the proportion of our employees and private practitioners who would recommend Terveystalo as a workplace to others. In the 2022 professional survey, the eNPS recommendation index was 29 (32). Among the strengths of Terveystalo are the activities of work communities and cooperation in teams, as well as the work of immediate supervisors. In the development of professional experience, the aim is to nurture these identified strengths. Our aim is to have an eNPS recommendation index of 31 by 2025.

 

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Customer feedback plays a key role in the development of work. Terveystalo's experts have wished for direct, personal customer feedback in addition to unit-specific feedback. The collection of expert-specific customer feedback was tested in selected units in the fall of 2022. Almost 15,000 feedback requests were sent to customers and around 4,000 responses were received. The feedback received in the pilot was in principle positive and the average satisfaction with the expert service was 4.5, on a scale of 1–5.

The indicator of personal customer feedback that was chosen for the pilot was the so-called PEI (Patient Enablement Instrument) that measures the customer's ability to deal with their illness after their appointment. The PEI is commonly used in Finnish primary health care. In the pilot, two out of three respondents reported that they were managing better or much better with their illness after their appointment. The PEI index provides valuable information on the effectiveness and success of the treatment in solving the patient's problem.

The pilot was carried out in close cooperation with professionals. Over the course of the pilot, the functionality of the feedback tool and various feedback questions was tested: what kind of information the professional receives from the feedback, how the feedback can be used in professional development and how the professionals experience the feedback. According to the professionals involved in the pilot, the opportunity to receive personal feedback is an excellent change. Appointments often provide the right diagnosis and treatment, but the customer's experience may remain unclear. Feedback is also an important tool for professional development. The open responses provided professionals with information on the strengths of their operations and on issues that they should pay more attention to. A larger-scale collection of personal feedback was started at the beginning of 2023. The opportunity to receive personal customer feedback is also offered to other professionals.

Science-based care guidance is developed at Terveystalo with the help of common care pathways. Care pathways are defined by Terveystalo as ways of treating the disease or condition for which the customer has sought treatment based on the Current Care Guidelines and other generally accepted treatment guidelines.

The aim is to support professionals and customers in designing and implementing more effective care by making the choices in accordance with the care pathway easy in everyday life. Care pathways support the customer's self-care and care progress.

For professionals, the treatment protocols propose suitable next steps on the customer’s care pathway. Together with the customer, the professional then decides which of the proposals to put into action, taking the customer’s individual situation and needs into consideration. The customer can also be given direct guidance, for example, in the case of providing reminders about the next steps in the treatment, a national recommendation on influenza vaccination or another simple care pathway.

For the patient, this means a clearer, smoother and more predictable course of treatment. For the professional, care pathways provide better tools and clearer and smoother work.

The first care pathways defined by Terveystalo were introduced in 2021. At the end of 2022, there were care pathways for the treatment of non-specific lower back pain, depression and anxiety, insomnia, reflux, vitreous detachment and children’s lower respiratory tract infection, and a total of 360,000 care pathways were activated in the Terveystalo app.

 

The aim of care pathways is to:

  • Facilitate and support the work of professionals
  • Improve patient referral
  • Ensure examination and treatment according to the Current Care Guidelines
  • Facilitate customer flow
  • Increase the patient's knowledge of the condition and its treatment as well as self-care‚Äč
  • Create a sense of caring, as well as a health partnership with the patient
  • Improve customer satisfaction
  • Improve clinical quality and effectiveness

With the COVID-19 pandemic, remote service solutions became a key way for Terveystalo to provide health care services to a wide range of customers, regardless of time and place. At Terveystalo, a physician, nurse or therapist can also be consulted remotely via video or chat. Digital services efficiently improve the availability of care and lower the threshold of seeking treatment. The Terveystalo app provides, among other things, access to the Doctor Chat in seconds on average, at all times on every day of the year. The low-threshold Mielen Chat is also available to Terveystalo Occupational Healthcare customers at all times. In the Terveystalo app, customers can renew prescriptions, get referrals for laboratory tests and communicate with the nurse or physician responsible for their care. Clearly visualized laboratory test and imaging results are always available in the app. The app provides the customer with a personalized health plan. In addition, the app sends customers personal health-related reminders.

In total, there were approximately 1.4 (1.0) million digital appointments in Terveystalo in 2022. A total of 2.9 (2.0) million appointments corresponding to 34 (25) percent of all appointments were conducted as remote appointments, digitally or by phone. The Terveystalo mobile application has more than 1.2 million active users and up to 2.5 million users  have registered for Terveystalo's digital services. The number of bookings made using the digital appointment booking service in the Terveystalo app and on the website has multiplied in the last few years. Terveystalo's digital appointment booking service was named the best user experience in the Grand One 2022 competition.

Terveystalo's solution to primary health care is concept called Smooth Health Centre. We want to offer well-being services counties our long-term experience as a public healthcare partner, our advanced digital services and our expertise in utilizing data.

Terveystalo has extensive experience in providing public social and healthcare services. Over the years, we have been responsible for 27 social welfare and health care units in more than 30 municipalities. Terveystalo's expertise includes all the service areas of public primary health care: health centre services, services for families with children and the elderly, oral health services, and services for adults and special interest groups. It is essential to manage the service and care pathways between the different entities in such a way that the services can be used as smoothly as possible by residents and that the service production is cost-efficient and effective. Different geographical areas have their own social and health challenges: the population has its own specific characteristics and municipalities have different areas of expertise. Each one needs to create its own functional and unique whole.

Terveystalo has introduced ways in which the availability and quality of care have been improved at health centres. Terveystalo regularly monitors the activity data of the health centres whose services it produces: e.g. the T3 time of access to care, the number of staff and the use of resources. Health centres have introduced a multidisciplinary way of working; nurses, physicians and other healthcare professionals work in a team that solves the customer's health concerns together. In this way, the patient's case can be solved more often than before already during the first call. A nurse alone is able to solve about 40 percent of the customers' care needs, and when a physician is involved, that rate rises to 60–70 percent. Another major change is digital and remote services. Health centres have a model where the customer's need for care can be solved remotely by phone or chat with the help of a nurse and physician already during the first contact.

We produced the health centre services of 16 municipal health centres in 2022. In 2022, the average T3 time (the third available appointment) describing the availability of non-urgent appointments to a physician in our health centres was 12.0 (6.5) days and the T3 time to a nurse was 2.0 (1.0) days. Our target is less than 7 days to see a physician and less than 1 day to see a nurse. The availability of care was excellent nationwide at our health centres throughout the year. Queues for oral health care have also remained at a good level in Terveystalo's 12 outsourced dental clinics. The average T3 time for non-urgent dentist appointments was 35 (35) days. NPS, which measures the customer satisfaction of health centres was 80 (80).

The central objective of the social welfare and healthcare reform is to enable equal social and health care everywhere in Finland. The care guarantee for primary health care will be gradually tightened between 2023 and 2024. The aim is that non-urgent care will be available within seven days starting from the end of 2024, instead of the current three months. Innovative and cost-effective solutions are needed in primary health care in order to achieve this goal.

Terveystalo has developed a digital platform for the public sector, which has been built to meet the needs and challenges of the well-being services counties.

In the future, well-being services counties will be able to concentrate all digital services related to health care on the platform developed by Terveystalo. The digital platform is ready for comprehensive integrations, such as patient information systems or national services such as Omaolo. The patient can manage their own appointments, have a remote appointment and continue self-care using the health coaching and information packages provided by the platform, all in one place. The appearance and content of the digital platform can be tailored according to the customer's wishes. The platform operating in the browser of a computer or phone requires strong authentication and thus customer and patient data can be processed securely.

The digital platform enables the customer to be treated smoothly during one session: a physician can join a nurse’s appointment or a chat appointment can be switched to a video appointment, if it is necessary to solve the problem. Remote appointments are an easy and modern way for the customer to seek help in health issues. In addition, they enable easy access to professionals in locations where it is otherwise challenging. By utilizing telemedicine and digital solutions, well-being services counties can direct to local clinics only those patients who would benefit from it, which helps dismantle the care queues. Learn more about Terveystalo's digital platform 

Biobanks make samples and data available to high-quality research and product development projects that aim to find the causes of diseases and promote general health. The goals of Terveystalo’s biobank are the promotion of the population’s health, the identification of factors involved in disease mechanisms, the prevention of diseases and the development of products or treatment practices that promote the population’s well-being or health or that are used in medical care. We investigate the causes of diseases and support the development of products and treatments used in health care. Our biobank also promotes scientific research related to COVID-19. Terveystalo’s biobank has been awarded ISO 9001:2015 quality management system certification.