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“Improving the process of recognising non-national education”
Federal Minstry of Health, Family and Youth, Department I/B/6
Austria

The Problem

Health professions (Physiotherapists, Biomedical laboratory technicians, Radiotherapists, Dieticians, Occupational Therapists, Speech and Language Therapists, Orthoptists, Nurses, Second level Nurses, Surgical Assistants, Disinfectors, Occupational Therapist Assistants, Laboratory Assistants, Doctor´s Surgery Assistants, Assistant Prosectors, Physiotherapy Assistants, Massage Therapists, Paramedic/Ambulance Nurses) are highly regulated in Austria. Europeans who have completed their education in other countries require permission from the Austrian government in order to practice in Austria.

The competent authority for obtaining permission is the Ministry of Health, Family and Youth.

As a result of the EU enlargement by May 1st, 2004, the treaty with Switzerland, and the increased migration inside of the European Union, applications for permission to practice in Austria swell explosively (63%). Applicants had to wait more than three months – in some cases even up to a year – before the Health Ministry completed the process of verification of the qualifications and delivered the needed permission.

The ministry was over burdened with these applications. As a result the staff of the concerned department, despite their strong commitment, became burnt out. Needless to mention about the frustrated applicants, who were waiting without being able to practice their profession.

Solution and Key Benefits

 What is the initiative about? (the solution)
The aim was to streamline the procedure and thereby reduce the time required to grant permission considerably. In addition, high quality should be maintained and the process should encourage and retain present staff in the department. Engagement of additional staff was not possible, except in a highly limited manner.

Further, planned EU enlargement called for innovative solutions to accommodate future developments. A strong influx from new member countries (Bulgaria and Romania) was expected. This would bring additional burden in evaluating the certificates because of the different kind of educational system prevailing there.

As a result of intensive and dedicated group work in the concerned department, a competitive “One-Stop” procedure was developed and implement on 1st February 2006. The whole process was streamlined. In selected cases, this resulted in granting the required permission within half an hour. There was a tremendous improvement to the previous average waiting time of 3 months.

The implementation of “One-Stop” procedure was informed to all hospitals in Austria, renewed man power agencies in Austria and abroad, and to the unions of health professionals. Further, complete details with frequently asked questions and a checklist was hosted on the ministry home page http://www.bmgfj.gv.at.

In the foyer of the concerned department in the Health Ministry, printed information material was placed. This would guide the applicants through the complete process, which was streamlined as one go. The registration, admission, payment of fees, and permission handing over was placed side by side.

Till now (December 2007) 1 300 permissions were handed out by using the possibility of “One-Stop”. The general average of all proceedings is now by eighteen days (45% within ten days). Direct customer contact increased satisfaction for customers as well as for the staff. Cost savings for applicants (costs for notarization, postage, possibility to earn money immediately) and the agency (postage, effective work, no need of accountancies), reputation for the Ministry of Health, Family and Youth are as important to list as the optimisation of human capitals and brainpower inside the authority and the positive effects for recruiting employers in Austria.

Actors and Stakeholders

 Who proposed the solution, who implemented it and who were the stakeholders?
The idea for “One-Stop” and the innovative solution were developed by the concerned department in a dedicated team work.

It is to be noted that the entire development and implementation of the solution was done internally. There was no involvement of consulting companies or external help; the only cost incurred for the ministry was some overtime payment for the staff involved.

Under the supervision of the head of the department, Mrs. Meinhild Hausreither, Mr. Stephan Kanhäuser and the team created the process of “One-Stop”. The solution was implemented by the whole team executing health-profession-permission proceedings led by Mr. Stephan Kanhäuser. Team members were:
Ms. Jasmin Gründling
Mr. Karl Hörmann
Ms. Anita Schinko
Ms. Ursula Szabo and
Mr. Gerald Tatzer-Schmid.
The secretaries, namely Mrs. Sylvia Fischer, Mrs. Claudia Grohmann, Mrs. Sylvia Matejka, Ms. Nicole Müllner, Ms. Sabrina Sorg, played an important role, assisting in all secretarial matters.

(a) Strategies

 Describe how and when the initiative was implemented by answering these questions
 a.      What were the strategies used to implement the initiative? In no more than 500 words, provide a summary of the main objectives and strategies of the initiative, how they were established and by whom.
To illustrate the objectives and strategies it is the best to show the achievements gained. A comparison of the previous and present processes is like this:

Before the introduction of “One-Stop”, the applicants had to submit their applications personally or by post. The papers submitted were checked for their completeness. Missing documents were formally asked for. If the education the applicants had absolved was not known, internal/external experts were consulted. This was sometimes time consuming and costly. The applicants had to pay partly the expenses incurred. The applicants were informed about the result of the check and invited to submit further documents, with which they could prove, that they have learned the missing subjects. If the applicants agreed to the result of the investigation, they got their permission. Before that they had to pay the fees, which were formally demanded. This procedure took regularly more than four months.

To change the system, first a catalogue of the 97 different proceedings was worked out. Based on the professional experience throughout the years, the education of the health-professions in the different countries was checked. Those cases, where there was no further verification of qualification necessary, were put on a list. Further it was established, which documents were needed by the ministry. The result was the “Information and Checklist for One-Stop”, hosted on the web-site.

This list was sent out to all Austrian hospitals, renewed job agencies, concerned health departments at home and abroad, and the unions of health professionals in January 2006.

It was technically arranged that registration of the application, submitting the documents, checking them, the payment of the fees, and submitting the permission could be done within half an hour.

So the main strategy and objective to implement the initiative was information. Use our experiences, streamline it and inform others about the result.

The next step was to train the team in the new program and their roles in the process. Finally “One-Stop” was implemented.

(b) Implementation

 b.      What were the key development and implementation steps and the chronology? No more than 500 words
The idea was born in January 2005.
May 2005: a new software was implemented, as the idea could not be realized with the existing one.
November 2005: restructuring of the plan
Analyses and solutions till January 2006
January 16th, 2006: authorization by the Minister of Health
January 17th - February 4th 2006: implementation of “One-Stop”
February 6th, 2006: the first “One-Stop” with 20 permissions
December 28th, 2007: 1300 “One-Stop”-permissions

(c) Overcoming Obstacles

 c.      What were the main obstacles encountered? How were they overcome? No more than 500 words
It was difficult to develop new ideas in a situation, in which the work load increased at the same time. The staff had to do the normal work load, handle the increasing number of complaints and be creative. Because of this work-load there was the enormous danger of discouragement and burn-out. In spite of all this pressure, the team was managed to create this new process.

(d) Use of Resources

 d.      What resources were used for the initiative and what were its key benefits? In no more than 500 words, specify what were the financial, technical and human resources’ costs associated with this initiative. Describe how resources were mobilized
Financial resources: About 60 hours of overtime

Technical resources: 2 PC´s and printers; development of new software.

Human resources: Engagement of additional staff was not possible, except in a highly limited manner. Internal training of the personnel to optimise their knowledge.

Sustainability and Transferability

  Is the initiative sustainable and transferable?
The team won already a price for “One-Stop” in Austria in December 2006 (“Verwaltungspreis 2006”). Especially because of this price, the project gained publicity. Several persons and institutions in Austria and from abroad asked for information and experiences in creating and implementing “One Stop”.

“One-Stop” helped to improve the reputation of the Ministry of Health, Family and Youth, and brought the optimisation of human capitals and brainpower inside the authority and positive effects for recruiting employers in Austria.

Lessons Learned

 What are the impact of your initiative and the lessons learned?
Finding a solution and implementing it was a tough work. The benefits of restructuring the work and the new spirit in the team achieved by doing it, paid off the hard work and efforts. The team was very proud for the results achieved. Within two years 1300 persons got their permissions via “One-Stop” – this means 1300 content persons and no more complaints.

Contact Information

Institution Name:   Federal Minstry of Health, Family and Youth, Department I/B/6
Institution Type:   Government Agency  
Contact Person:   Meinhild Hausreither
Title:   Head of department  
Telephone/ Fax:   +43/1/71100-4387
Institution's / Project's Website:   +43/1/71100-4165
E-mail:   meinhild.hausreither@bmgfj.gv.at  
Address:   Radetzkystr. 2
Postal Code:   1030
City:   Vienna
State/Province:  
Country:   Austria

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