Biblioteca Virtual en Salud

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Background. The improvement of care quality dependson the education and skills of the professionalteam as well as on an adequate work method, whichuses the right instruments of clinical managementsuch as medical history, registers or protocols.Objectives. Defining standardized criteria related tothe oncology care quality and applying them to agroup of hospitals within the framework of continuousimprovement establishing comparisons amongthem.Material and methods. Information taken from 14Andalusian public hospitals, in 2003 and first semesterof 2004. A total of 35 variables were collectedfrom official sources, validated studies and surveysas a starting point, grouped in four main issues(medical history, protocols, central commission andtumour sub-commissions), delays (diagnostic, treatmentand early diagnostic), variability (cytostaticsand radiotherapy), research (clinical trials and financedprojects) and work loads.Outcomes. In 3 out of 14 centers medical historiesare unique for each patient. In average, 3 of the 6most frequent tumor locations have joint protocols.The delays for the diagnostic test vary from 1 to 23days and from 11 to 29 days for treatments. Theconsumption increase of 12 cytostatics was of 71.8%(average of 602,413 € per hospital). The averagerate of patients undergoing irradiation was of 34 %.109 clinical trials were approved (a centre performes26) and 20 projects were financed (HealthDepartment, Consejería de Salud). The attendancepressure was of 140 patients per specialist in MOand RO (maximum of 241 and 214 respectively andminimum of 85 and 69).Comments. The information gathered in this studyshows a diverse nature, and meets items not alwaystaken into consideration, in a global way, but witha clearly complementary nature. No doubt, they offera scenery that deepens into the complexity ofwhich today means the improvement of the qualityof the non-monographic hospital centres that attendpatients suffering from cancer. It finally offersinstruments for the improvement of the clinicalmanagement which we understand it is of certainusefulness