Indicadores para la gestión de los servicios de salud pública

Se pretende definir indicadores apropiados para la gestión de los distintos servicios de una organización que presta servicios integrales de salud pública a una población y territorio definidos. Métodos: Análisis de la actividad y discusión con los responsables de los diversos servicios para buscar indicadores de obtención viable que recojan de la mejor forma tres aspectos: su actividad, su cobertura, calidad o efectividad, y su coste.

Gestión de calidad en una organización de salud pública / Quality management in a public health agency

Se presenta la experiencia de introducción de acciones de mejora de la calidad en una organización de salud pública. Tras la acreditación ISO 17025 del laboratorio de control oficial obtenida por requisito legal, la dirección acordó en 2003 extender la política de calidad, poniendo en marcha un repertorio de acciones mediante el análisis de procesos y la formulación de acciones de mejora, la mayor formalización de procedimientos, el conocimiento de la opinión de los clientes, la creación de grupos de mejora, y la auditoría o certificación externa. La organización respondió de forma diversa a estas iniciativas. Someter los servicios a auditoría o certificación externa parece el motor más poderoso para el cambio. El estudio de costes de la actividad permite valorar que, en 2010, el 75% del gasto total se realiza en servicios de salud pública sujetos a auditoría/certificación externa (AU)

This article describes the introduction of quality improvement actions in a public health organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users’ opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on public health services subject to external audit or certification (AU)

[Quality management in a public health agency]. / Gestión de calidad en una organización de salud pública.

This article describes the introduction of quality improvement actions in a public health organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users' opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on public health services subject to external audit or certification.

Indicadores para la gestión de los servicios de salud pública / Indicators for the management of public health services

Objetivos Se pretende definir indicadores apropiados para la gestión de los distintos servicios de una organización que presta servicios integrales de salud pública a una población y territorio definidos.Métodos Análisis de la actividad y discusión con los responsables de los diversos servicios para buscar indicadores de obtención viable que recojan de la mejor forma tres aspectos: su actividad, su cobertura, calidad o efectividad, y su coste.Resultados Se obtienen indicadores cuantitativos para todos los servicios productivos de salud pública relacionados en el catálogo de servicios, pero en algunas líneas de trabajo no parece factible cubrir los tres ámbitos. Además, para las actividades de coordinación y enlace los indicadores son a menudo menos cuantitativos y poco sensibles a cambios. Se ha podido cuantificar el coste para las grandes líneas de trabajo productivo y los 47 servicios o productos, y los costes indirectos se han estimado en un 14%.Conclusiones Es factible desarrollar un sistema de información de gestión para los servicios de salud pública que permita comparaciones a lo largo del tiempo o entre territorios, con indicadores de actividad para todas las líneas de trabajo productivo. Los indicadores que reflejan la cobertura, calidad o impacto de los servicios plantean las mayores dificultades. Para algunas líneas de trabajo se pueden obtener indicadores de coste por unidad de producto con sentido, y para otras es más difícil. En todos los casos, el coste por habitante y año es un buen indicador sintético del coste de los servicios de salud pública (AU)

Objectives To define a set of indicators for the management of the various services of an agency responsible for comprehensive public health in a defined area and population. Methods We analyzed the agency’s activity and held discussions with those responsible for the distinct services to define indicators whose estimation is viable and which optimally describe three aspects: the services’ activity, coverage, quality or effectiveness, and cost. Results Quantitative indicators were defined for all the productive public health services inventoried in the agency’s services portfolio, but not all three aspects could be covered in all areas. In addition, for coordination and liaison services, the indicators were often less quantitative and less sensitive to change. Costs were estimated for the main areas of productive activity and for the 47 services or products, with indirect costs being estimated as 14% of expenditure.Conclusions We defined a system of indicators for management control, allowing comparisons over time and with other geographical areas, and with activity indicators covering all production areas. Defining indicators reflecting coverage, quality or impact for all services is more difficult. Cost can be estimated by unit of production for some services, but less successfully for others. The yearly cost by population is always a good synthetic indicator of the cost of public health services (AU)

[Indicators for the management of public health services]. / Indicadores para la gestión de los servicios de salud pública.

OBJECTIVES: To define a set of indicators for the management of the various services of an agency responsible for comprehensive public health in a defined area and population. METHODS: We analyzed the agency's activity and held discussions with those responsible for the distinct services to define indicators whose estimation is viable and which optimally describe three aspects: the services' activity, coverage, quality or effectiveness, and cost. RESULTS: Quantitative indicators were defined for all the productive public health services inventoried in the agency's services portfolio, but not all three aspects could be covered in all areas. In addition, for coordination and liaison services, the indicators were often less quantitative and less sensitive to change. Costs were estimated for the main areas of productive activity and for the 47 services or products, with indirect costs being estimated as 14% of expenditure. CONCLUSIONS: We defined a system of indicators for management control, allowing comparisons over time and with other geographical areas, and with activity indicators covering all production areas. Defining indicators reflecting coverage, quality or impact for all services is more difficult. Cost can be estimated by unit of production for some services, but less successfully for others. The yearly cost by population is always a good synthetic indicator of the cost of public health services.

Evaluación de la calidad en salud pública: aplicación a un centro de acogida de animales de compañía / Quality evaluation in public health: the case of an animal shelter

ObjetivoHay un creciente interés por incorporar criterios de calidad a la gestión de los servicios públicos. Este trabajo propone un esquema integral de evaluación de la calidad del servicio del Centro de Acogida de Animales de Compañía gestionado por los servicios de salud pública de Barcelona.MétodosSe realizó una evaluación con tres componentes: la información recogida por los indicadores de actividad del centro (2000–2006), la conformidad con las normas legales e internas de los resultados de una auditoría interna (2006), y la satisfacción de los usuarios/clientes mediante una encuesta de satisfacción basada en el modelo SERVPERF (2006).Resultados Durante este periodo los animales sacrificados se redujeron casi un 70% y aumentaron las adopciones. La auditoría detectó 10 disconformidades (3,2% de los items valorados), sin que ninguna estuviera relacionada con el servicio al cliente. Las dimensiones de calidad del modelo obtuvieron puntuaciones elevadas en la encuesta de satisfacción; la seguridad (94,2%) y la empatía del personal (81,8%) fueron las mejor valoradas. La aparición tras la adopción de problemas de comportamiento (p=0,039) o de salud del animal (p=0,068) se asocia con una menor percepción de calidad.ConclusionesUn esquema de evaluación integral de un servicio de este tipo se revela factible. Se demuestra el cumplimiento con los procedimientos de trabajo establecidos y con la normativa legal vigente. Los resultados de la encuesta muestran un elevado grado de satisfacción de los usuarios(AU)

ObjectiveThere is growing interest in integrating quality approaches to the management of public services. The aim of the present study was to develop a comprehensive evaluation of service quality in the animal shelter managed by the public health services of the city of Barcelona (Catalonia, Spain).ResultsThe number of animals put to sleep was reduced by almost 70% and the number of adoptions increased. The audit detected 10 non-conformities (3.2% of items), none of which was related to customer service. In the satisfaction survey, the quality dimensions with the highest scores were safety (94.2%) and empathy (81.8%). The emergence of behavioral problems (p=0.039) or health problems (p=0.068) in the adopted animals had a negative influence on quality perception among adopters.ConclusionsA comprehensive scheme for the evaluation of this service is feasible. There is compliance with established protocols and regulations. The results of the survey show a high degree of user satisfaction(AU)

[Quality evaluation in public health: the case of an animal shelter]. / Evaluación de la calidad en salud pública: aplicación a un centro de acogida de animales de compañía.

OBJECTIVE: There is growing interest in integrating quality approaches to the management of public services. The aim of the present study was to develop a comprehensive evaluation of service quality in the animal shelter managed by the public health services of the city of Barcelona (Catalonia, Spain). METHODS: An evaluation study with three components was performed. Trends in the shelter's activity indicators (2000-2006) were analyzed, compliance with current regulations and protocols was assessed with an internal audit (2006), and user-customer satisfaction was measured with a survey based on the SERVPERF model (2006). RESULTS: The number of animals put to sleep was reduced by almost 70% and the number of adoptions increased. The audit detected 10 non-conformities (3.2% of items), none of which was related to customer service. In the satisfaction survey, the quality dimensions with the highest scores were safety (94.2%) and empathy (81.8%). The emergence of behavioral problems (p=0.039) or health problems (p=0.068) in the adopted animals had a negative influence on quality perception among adopters. CONCLUSIONS: A comprehensive scheme for the evaluation of this service is feasible. There is compliance with established protocols and regulations. The results of the survey show a high degree of user satisfaction.