Revista de Calidad Asistencial最新文献

{"title":"Concordancia entre sistemas de estratificación e identificación de pacientes crónicos complejos en Atención Primaria","authors":"M. Sánchez Mollá ,&nbsp;I. Candela García ,&nbsp;F.J. Gómez-Romero ,&nbsp;D. Orozco Beltrán ,&nbsp;M. Ollero Baturone","doi":"10.1016/j.cali.2016.07.006","DOIUrl":"https://doi.org/10.1016/j.cali.2016.07.006","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the prevalence of patients with multiple chronic diseases in Primary Care using the multiple morbidity criteria and Clinical Risk Groups, and the agreement in identifying high-risk patients that require case management with both methods.</p></div><div><h3>Material and method</h3><p>A cross-sectional study was conducted on 240 patients, selected by random sampling of 16 care quotas from two Primary Health Care centres of a health area. Informed consent was obtained to access their electronic medical records for the study, and a record was made of age, sex, health status of Clinical Risk Groups, severity, multiple morbidity criteria, and Charlson index by physicians during clinical practice. Three patients were excluded due to incomplete data.</p></div><div><h3>Results</h3><p>The prevalence of patients with multiple chronic diseases following the criteria of the Ministry of Health among users was 4.11 (95% CI; 2.13-7.30). The frequency of patients with high risk Clinical Risk Groups (G3) in the chronicity strategy of Valencian Community was 7.59 (95% CI; 4.70-11.70), which includes patients with health status 6 and complexity level 5-6, and health status 7, 8, and 9. Agreement between the two classifications was low, with a kappa index 0.17 (95% CI; 0-0.5)</p></div><div><h3>Conclusions</h3><p>The prevalence did not differ significantly from that expected, and the agreement between the two stratifications was very weak, not selecting the same patients for highly complex case management.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 1","pages":"Pages 10-16"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.07.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91598061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fe de errores de «Estudio Regional de Incidentes Derivados de la Atención (ERIDA) en Urgencias»","authors":"J. Alcaraz-Martínez, J. Aranaz-Andrés, C. Martínez-Ros, S. Moreno-Reina, L. Escobar-Álvaro, J. V. Ortega-Liarte","doi":"10.1016/J.CALI.2016.09.001","DOIUrl":"https://doi.org/10.1016/J.CALI.2016.09.001","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"735 1","pages":"62-62"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76806295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concordancia entre sistemas de estratificación e identificación de pacientes crónicos complejos en Atención Primaria","authors":"M. S. Molla, I. C. García, F. J. Gómez-Romero, D. O. Beltrán, M. O. Baturone","doi":"10.1016/J.CALI.2016.07.006","DOIUrl":"https://doi.org/10.1016/J.CALI.2016.07.006","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 1","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85471523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desarrollo y evolución de un cuadro de mando integral en atención primaria: lecciones aprendidas","authors":"E. Bartolomé-Benito ,&nbsp;J. Jiménez-Carramiñana ,&nbsp;L. Sánchez-Perruca ,&nbsp;M.S. Bartolomé-Casado ,&nbsp;A.B. Dominguez-Mandueño ,&nbsp;M. Marti-Argandoña ,&nbsp;M. Hernández-Pascual ,&nbsp;A. Miquel-Gómez","doi":"10.1016/j.cali.2016.04.005","DOIUrl":"10.1016/j.cali.2016.04.005","url":null,"abstract":"<div><h3>Objectives</h3><p>To describe the design, implementation, and monitoring of eSOAP (Primary Health Care Balanced Scorecard) and its role in the deployment of strategic objectives and clinical management, as well as to show the lessons learned during six years of follow-up.</p></div><div><h3>Method</h3><p>Descriptive study areas: methodology (conceptual framework, strategic matrix, strategic map, and processes map), technology and standardisation.</p></div><div><h3>Results</h3><p>As of December 2014, 9,046 (78%) professionals are registered in eSOAP. A total of 381 indicators were measured from 16 data sources, of which 36% were of results (EFQM model), 39.1% of clinical management, and 20% were included in the Program Centre Contract. The Balanced Scorecard has enabled to deploy all strategic lines of Primary Health Care, and has enabled the healthcare professionals to evaluate the evolution of results over time, and at patient level (e.g. 16% increase in control of diabetic patients). A total of 295,779 reports were generated and 13,080 professionals were evaluated by goals.</p></div><div><h3>Conclusions</h3><p>There was an increased use of the eSOAP application by the professionals. The Balanced Scorecard was the key in deploying Primary Health Care strategies. It has helped clinical management and improved relevant indicators (health, patient experience, and costs), such as the management models that we used as references (EFQM Kaplan and Norton), and new emerging scenarios (Triple aim).</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 1","pages":"Pages 40-49"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.04.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34616004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherencia al tratamiento tras trasplante renal como indicador de calidad de la información recibida: estudio longitudinal con un seguimiento de 2 años","authors":"G. Costa-Requena ,&nbsp;M.C. Cantarell ,&nbsp;F. Moreso ,&nbsp;G. Parramon ,&nbsp;D. Seron","doi":"10.1016/j.cali.2016.05.004","DOIUrl":"10.1016/j.cali.2016.05.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Transplantation is an optimal form of treatment for end-stage renal disease, but requires lifelong adherence to immunosuppressive therapy. The aim of this study was to longitudinally assess the adherence to treatment after kidney transplant, as well as to compare the amount of information about the treatment received at one month and 18 months post-transplantation, and its influence on adherence to treatment.</p></div><div><h3>Material and methods</h3><p>The <em>Self-Reported Measure of Medication Adherence</em> was administered at month (T1), 6 months (T2), 12 months (T3), 18 months (T4), and 24 months (T5) post-transplantation. <em>Survey about aspects of knowledge and attitudes about medication</em>, was administered at one month and 18 months post-transplant. Measures of central tendency and non-parametric tests were used to compare the data.</p></div><div><h3>Results</h3><p>The study included a total of 73 patients with a median age of 57 years. The percentage of patients non-adherent to medication was 9.6% (T1), 22.5% (T2), 29.2% (T3), 29.8% (T4), and 28.1% (T5). One month after transplantation “not consulting with the doctor on forgetting to take medication (<em>P</em>=.034) significantly influenced the non-adherence to treatment. At 18 months post- transplantation, none of the issues raised on medication knowledge had an influence on non-adherence to treatment.</p></div><div><h3>Conclusions</h3><p>Longer times since transplantation increased the non-adherence to treatment. Some issues regarding the information of treatment influenced the non-adherence in the immediate transplant period, but not in the follow-up.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 1","pages":"Pages 33-39"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34738952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efectividad de una intervención para mejorar la calidad de la cumplimentación del listado de verificación de seguridad quirúrgica en un servicio de cirugía general","authors":"I. Hernández-García, M. Giménez-Júlvez, M. Moreno","doi":"10.1016/J.CALI.2015.12.005","DOIUrl":"https://doi.org/10.1016/J.CALI.2015.12.005","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"17 1","pages":"58-61"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81414665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacteriemia relacionada con el catéter: evaluación de los resultados clínicos como plan de mejora de la calidad en el diagnóstico microbiológico","authors":"M.J. González-Abad,&nbsp;M. Alonso Sanz","doi":"10.1016/j.cali.2016.02.004","DOIUrl":"https://doi.org/10.1016/j.cali.2016.02.004","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 1","pages":"Pages 57-58"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.02.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90015262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La socialización de los profesionales sanitarios y el papel de la resiliencia en el desarrollo de conductas de bienestar en el trabajo","authors":"J. Cerezo ,&nbsp;M. Bernabé ,&nbsp;A. Lisbona ,&nbsp;F.J. Palací","doi":"10.1016/j.cali.2016.06.004","DOIUrl":"10.1016/j.cali.2016.06.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Socialization during the training of specialists is a key step in the subsequent adjustment and occupational well-being of health professionals in the hospital organisation.</p></div><div><h3>Objective</h3><p>To analyse the relationship of socialization and resilience with the engagement responses of specialists in training.</p></div><div><h3>Method</h3><p>Convenience sampling was used, with 110 professionals from six teaching units of different hospitals participating in the study. Descriptive and mediational analysis of the study variables were performed using SPSS 21 and Macro Preacher and Hayes (2004).</p></div><div><h3>Results</h3><p>The results show statistically significant relationships between socialization, resilience, and engagement. The mediating role of resilience is also shown (β<!--> <!-->=<!--> <!-->0.10; se<!--> <!-->=<!--> <!-->0.12; p&lt;0.05, 95% CI: [0.02-0.23]) to generate engagement in health professionals.</p></div><div><h3>Conclusions</h3><p>An interaction effect is observed between socialization, and specialty moderates resilience. Therefore it can be seen that positive socialization and resilience can promote good performance.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 1","pages":"Pages 27-32"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34666943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Por qué se retrasa el tratamiento de reperfusión en pacientes con código ictus? Un análisis cualitativo","authors":"B. Palazón-Cabanes ,&nbsp;J.J. López-Picazo-Ferrer ,&nbsp;A. Morales-Ortiz ,&nbsp;N. Tomás-García","doi":"10.1016/j.cali.2016.01.006","DOIUrl":"10.1016/j.cali.2016.01.006","url":null,"abstract":"<div><h3>Background</h3><p>Efficacy and safety of reperfusion therapy in acute ischaemic stroke is time-dependent and has a limited therapeutic window, which is, in fact, the main exclusion criterion. Initiatives to evaluate the quality of care are essential to design future interventions and ensure the shortest management times and application of such treatments.</p></div><div><h3>Objective</h3><p>The aim of the study is to identify and classify potential causes of delay in the administration of reperfusion therapy in a tertiary hospital, a reference for the comprehensive treatment of acute ischaemic stroke.</p></div><div><h3>Material and methods</h3><p>The project was developed in Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. A total of 337 patients with acute ischaemic stroke treated with reperfusion therapies were evaluated. For qualitative analysis, 2 working groups were formed: an advocacy group that designed and directed the entire project, and a multidisciplinary one, which served as a source of information and a mechanism for active involvement of all professionals in the stroke-care chain. Information was collected in 3 meetings and then, both the flowcharts and the cause-effect diagram were prepared.</p></div><div><h3>Results</h3><p>Based on the above tools, potential causes of delay were identified and classified according to an operational criterion into unmodified structures, and modifiable ones with known evidence and hypothetical repercussions. Modifiable ones are noted for their importance in the design of future improvement interventions in stroke care. Some of them are: Variability in following established protocols, lack of procedures in some parts of the stroke-care chain, etc.</p></div><div><h3>Conclusion</h3><p>Knowledge of the current situation has just been the starting point, but it has been an essential requisite for the design and implementation of a quality improvement program to shorten in-hospital stroke code times.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 6","pages":"Pages 347-355"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.01.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34408407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percepción de los médicos de atención primaria sobre la receta electrónica en el Servicio Madrileño de Salud","authors":"A.I. Villímar Rodríguez ,&nbsp;A.B. Gangoso Fermoso ,&nbsp;C. Calvo Pita ,&nbsp;G. Ariza Cardiel","doi":"10.1016/j.cali.2016.01.008","DOIUrl":"10.1016/j.cali.2016.01.008","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the opinion of Primary Care physicians regarding electronic prescribing.</p></div><div><h3>Methods</h3><p>Descriptive study by means of a questionnaire sent to 527 primary care physicians. Period: June 2014. The questionnaire included closed questions about interest shown, satisfaction, benefits, weaknesses, and barriers, and one open question about difficulties, all of them referred to electronic prescribing. Satisfaction was measured using 1-10 scale, and benefits, weaknesses, and barriers were evaluated by a 5-ítems Likert scale. Interest was measured using both methods. The questionnaire was sent by e-mail for on line response through Google Drive® tool. A descriptive statistical analysis was performed.</p></div><div><h3>Results</h3><p>The response rate was 47% (248/527). Interest shown was 8.7 (95% CI; 8.5-8.9) and satisfaction was 7.9 (95% CI; 7.8-8). The great majority 87.9% (95% CI; 83.8-92%) of respondents used electronic prescribing where possible. Most reported benefits were: 73.4% (95% CI; 67.8-78.9%) of respondents considered that electronic prescribing facilitated medication review, and 59.3% (95% CI; 53.1-65.4) of them felt that it reduced bureaucratic burden. Among the observed weaknesses, they highlighted the following: 87.9% (95% CI; 83.8-92%) of respondents believed specialist care physicians should also be able to use electronic prescribing. Concerning to barriers: 30.2% (95% CI; 24.5-36%) of respondents think that entering a patient into the electronic prescribing system takes too much time, and 4% (95% CI; 1.6-6.5%) of them perceived the application as difficult to use.</p></div><div><h3>Conclusions</h3><p>Physicians showed a notable interest in using electronic prescribing and high satisfaction with the application performance.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 6","pages":"Pages 338-346"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.01.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34524098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}