Quality and Innovation in Denmark

The Pursuit of Perfection through Quality and Innovation:
A View into Denmark's Public Health, Health House and Patient Safety Initiaitves.

In October 2015, CFHI sponsored two leads from the Nova Scotia Health Authority (NSHA) that had participated in the Atlantic Healthcare Collaboration tto visit health systems in Sweden, Denmark and Finland. Lynn Edwards and Tara Sampalli’s reflections on this trip provide the opportunity to explore the elements that make for a strong primary healthcare system and share results from their own improvements in primary healthcare and chronic disease management at NSHA.

This is the second of a three part series. Read the first part (First Stop, Sweden).
Read the third part (Finland).

Nyhavn, the 17th century waterfront

Nyhavn, the 17th century waterfront

The Danish System

In October 2015, we traveled to Copenhagen, Denmark in search of quality and innovation in healthcare. We were eager to learn from experts in patient safety and public health working in a high-performing system.

The Danish system provides publicly funded healthcare for all 5.4 million citizens of Denmark. In 2007, the system was centralized with an amalgamation from 271 to 98 municipalities, creating five healthcare regions. The Danish Ministry of Health has a coordinating and supervisory role without operational responsibilities for health services. The onus is on Danish regions to provide optimum hospital and primary care. The primary healthcare sector closely resembles that of healthcare in Canada, with primary healthcare providers acting as key entry points and offering coordination support for patients. Hospitals provide more specialized medical treatments and intensive care. Main trends in the system include increasing challenges of managing aging population, burden of chronic diseases (top trends are diabetes, cardiovascular, pulmonary emphysema, psychological diseases and rheumatoid arthritis). With decreasing hospital beds comes increasing dependency on primary health care services similar to the Canadian system.

Through a discussion with Katrine Schjønning, Chief of Public Health for the municipality of Copenhagen, we were presented a high-level look at the Danish health system and priorities. Katrine discussed how citizens of Copenhagen describe The Good Life philosophy which says, “Fundamentally, having good health provides us with freedom and the power to make our own choices in life, whereas disease and poor health limits our possibilities”. Katrine emphasized Denmark’s push for innovative practices that expand beyond the healthcare system to foster collaborative models with other government departments. For example, the health, social and employment sectors are implementing strategies and interventions that target early retirement as well as collaborating on interventions for mental health.

The municipalities are responsible for health promotion and disease prevention and rehabilitation, including chronic disease management for all citizens and care for seniors. Within the health region of Copenhagen, there are five health houses. The health houses act as a health promotion and prevention centre where teams focus on wellness, mindfulness and stress management, chronic disease, physical activity, mental health services linked with social and legal programs. Some family practice offices may be collocated in a health house. The programs are determined by the needs of the region. A thank you to the team at Vanlose Health House for sharing!

Vanlose Health House

Vanlose Health House

Improving Healthcare through Patient Safety

The Danish Society for Patient Safety (DSPS) was established in 2001 in response to the discovery that 9 percent of Danish patients were admitted to hospital as a result of an adverse event. The organization operates independently, and works to improve healthcare through patient safety. It is funded both publicly and privately. Its Board of Directors includes a diverse membership from Danish regions, municipalities, professional groups, patient organizations and industry.

Our two-day learning exchange with the Danish leaders in Patient Safety provided a forum for sharing and learning focused on several key initiatives underway, including:

  • In Safe Hands, a municipal program targeting safe patient practices in hospitals by reducing pressure ulcers, medication errors, falls and infections;
  • Safe Mental Care, a 10-team collaborative aimed at improving adult mental healthcare through improved medication management, physical health and reduction in use of restraint
  • Flow Program, aimed at improving quality at the point of care; and,
  • Hello Healthcare!, an initiative to involve patients and their supporters in the creation of patient and family centeredness inside healthcare.

Beth Lilja, CEO of the DSPS, pointed out, “The strategies for building the understanding and commitment to [patient and caregivers] partnerships at all levels of the health care system in Demark can be applied [across] other organizations, states, provinces, and even larger countries.”

Our meetings involved sharing some of the local primary health care initiatives from NSHA, including our improvement successes brought forth through CFHI’s Atlantic Healthcare Collaboration, such as the NSHA community health teams, frailty portal, integrated chronic care service and integrated chronic disease prevention and management.

Learn more about our work from recent publications:

Other information:
Read Beth Lilja’s BMJ blog on the Danish Hello Healthcare! program and other initiatives

Lynn Edwards

Lynn Edwards
Senior Director, Primary Health Care and Chronic Disease Management




Tara Sampalli

Tara Sampalli
Assistant Director of Research, Primary Health Care




Coming soon!

Learn about Lynn and Tara’s exchanges with health leaders in Finland.