HealthManagement, Volume 12, Issue 4 /2010

Practical Examples and Experiences from Austria

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The focus of Dr. Heinisch's presentation was on how investments in quality can also lead to improvements in efficiency. During his presentation he used the example of the hospital partnership between the Hospital of the Sisters of Mercy and the Hospital of the Brothers of Mercy in Linz, through which quality and efficiency improved.

Heinisch believes that there are two aspects of quality in Austrian healthcare reform: quality of information that patients are given and quality of our decisions as healthcare providers. The Vinzenz Gruppe is an umbrella organisation for seven Order hospitals. Each hospital is of long-standing tradition. There is a public mandate and they work just like other hospitals.

Today in Austria the quality debate is cost-driven. This is not unexpected as healthcare expenses amount to 30 billion euro, 75 percent being public expenses; this amounts to 10 percent of GDP. Consequently, there is a huge pressure on public budgets. More and more people are discussing quality of care; better performances and services are increasingly important but so is economic performance and value creation. Heinisch stressed that hospitals are there to heal patients but also that economic benefits are a good sideline. Economic performance is there and it needs to be discussed.

There is no binding quality reporting in Austria, it is optional to inform on quality. Patients do not learn about quality or performance in hospitals, even though the hospitals have this data. While private health insurers produce national patient surveys, public insurers do not; there is a lack of comparable patient experience data. For these reasons Heinisch believes that we need to focus on the quality of our discussions and that improving quality is an investment not only to improve quality but to improve efficiency and also our values and humanness. All decisions must be made using these criteria.

Using the example of the newfound partnership of two hospitals in Linz, the Sisters of Mercy (<100 beds) and the Brothers of Mercy (<400 beds). Lots of departments are the same in both hospitals so in order to create a successful partnership the hospital needed to be restructured to become state-of-the-art. Departments had to be closed, staff were transferred to other institutions. This process took 10 years but eventually it was completed successfully. The saving potential is five million euro per annum and quality has also improved. Patient information is now shared and there is a new investment in humanness.

This investment in humanness is about improving the patient experience. Think about when a patient will be most afraid during their hospital stay. This is probably right before surgery, on their way to the OR. To counteract fear at this moment they have included a new grouppeople who push the bed to the OR. Before this was a man who has had no previous contact with the patient, now certified nurses, who know the patients and their families, do this job. This adds value for the patient. While medical results are questionable and costs are increased, a human touch is added, which you cannot pay for.


The focus of Dr. Heinisch's presentation was on how investments in quality can also lead to improvements in efficiency. During his presentation he used th

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