ABSTRACT
Objetivo. Identificar y describir un listado de eventos centinela (EC) en atención primaria (AP). Metodología. Consenso de expertos estructurado mediante 2 cuestionarios online. Los expertos fueron elegidos por su experiencia en AP y conocimientos en seguridad del paciente. El primer cuestionario valoró la adaptación de los EC hospitalarios del National Quality Forum 2006 al ámbito de AP a través de las respuestas: sí, no, sí con adaptación; en este último caso se permitió una nueva redacción de los mismos y además el cuestionario permitía la incorporación de nuevos EC. El segundo cuestionario incluyó los EC con respuesta positiva (sí, sí con adaptación>55%) para que los expertos eligieran entre redacción original y alternativa y los nuevos EC descritos. Resultados. De los 47 expertos convocados 44 respondieron a ambos cuestionarios. Se identificaron en total 17 EC para AP. Primer cuestionario: de 28 EC hospitalarios 12 se consideraron adaptables para AP; 11 de ellos con redacción alternativa. Treinta y ocho expertos propusieron algún EC nuevo referidos principalmente a: problemas con la medicación/vacunas, retrasos/ausencia en la atención, retraso diagnóstico y problemas con pruebas diagnósticas, resumidos en 5 EC. Segundo formulario: los expertos escogieron en más del 65% la redacción alternativa de los 11 EC adaptados a AP. Los 5 nuevos EC fueron considerados adecuados con respuesta positiva entre 70-85%. Conclusión. Se identificaron 17 EC para AP, lo que disponer de un listado de EC permitirá llevar a cabo una mejor gestión del riesgo sanitario (AU)
Objective. To identify and describe a list of sentinel events (SEs) for Primary Care (PC). Methododology. A structured experts' consensus was obtained by using two online questionnaires. The participants were selected because of their expertise in PC and patient safety. The first questionnaire assessed the suitability of the hospital SEs established in the National Quality Forum 2006 for use in PC via responses of "yes", "no", or "yes but with modification". In the latter case, a re-wording of the SE was requested. Additionally, inclusion of new SEs was also allowed. The second questionnaire included those SEs with positive responses ("yes", "yes with modification"), so that the experts could choose between the original and alternative drafts, and evaluate the newly described SEs. Results. The questionnaires were completed by 44 out of a total of the 47 experts asked to participate, and a total of 17 SEs were identified as suitable for PC. For the first questionnaire, 12 of the 28 hospital SEs were considered adaptable to PC, of which 11 were re-drafts. Thirty-seven experts proposed new SEs. These mainly concerned problems with medication and vaccines, delay, or lack of assistance, diagnostic delays, and problems with diagnostic tests, and were finally summarised in 5 SEs. In the second questionnaire, ≥65% of the experts chose the alternative wording against the original cases for the 11 SEs suitable for PC. The 5 newly included SEs were considered adequate with a positive response of 70-85%. Conclusion. Having a list of SEs available in PC will help to improve the management of health care risks (AU)
Subject(s)
Humans , Sentinel Surveillance , Primary Health Care , Consensus , Health Risk , Risk Management/organization & administration , Patient Safety/standards , Cause of Death , Surveys and Questionnaires , Health Services/standards , Health ServicesABSTRACT
OBJECTIVE: To identify and describe a list of sentinel events (SEs) for Primary Care (PC). METHODODOLOGY: A structured experts' consensus was obtained by using two online questionnaires. The participants were selected because of their expertise in PC and patient safety. The first questionnaire assessed the suitability of the hospital SEs established in the National Quality Forum 2006 for use in PC via responses of "yes", "no", or "yes but with modification". In the latter case, a re-wording of the SE was requested. Additionally, inclusion of new SEs was also allowed. The second questionnaire included those SEs with positive responses ("yes", "yes with modification"), so that the experts could choose between the original and alternative drafts, and evaluate the newly described SEs. RESULTS: The questionnaires were completed by 44 out of a total of the 47 experts asked to participate, and a total of 17 SEs were identified as suitable for PC. For the first questionnaire, 12 of the 28 hospital SEs were considered adaptable to PC, of which 11 were re-drafts. Thirty-seven experts proposed new SEs. These mainly concerned problems with medication and vaccines, delay, or lack of assistance, diagnostic delays, and problems with diagnostic tests, and were finally summarised in 5 SEs. In the second questionnaire, ≥65% of the experts chose the alternative wording against the original cases for the 11 SEs suitable for PC. The 5 newly included SEs were considered adequate with a positive response of 70-85%. CONCLUSION: Having a list of SEs available in PC will help to improve the management of health care risks.
Subject(s)
Primary Health Care , Risk Management/organization & administration , Sentinel Surveillance , Accidents, Home , Consensus , Delayed Diagnosis , Expert Testimony , Health Personnel/psychology , Home Care Services , Humans , Inpatients , Medical Errors , Outpatients , Patient Safety , Surveys and QuestionnairesABSTRACT
This paper describes the implementation of a patient safety strategy in primary care within the new organizational and functional structure that was created in October 2010 to cover the single primary health care area of the Community of Madrid. The results obtained in Patient Safety after the implementation of this new model over the first two years of its development are also presented.
Subject(s)
Patient Safety/standards , Primary Health Care , Humans , Organizational Objectives , Primary Health Care/organization & administration , SpainABSTRACT
En este trabajo se describe el despliegue de la estrategia de seguridad del paciente (SP) en atención primaria (AP) dentro de la nueva estructura organizativa y funcional que se crea en octubre de 2010, para dar cobertura al área única de salud de AP de la Comunidad de Madrid (CM). Así mismo, se detallan cuáles han sido los resultados obtenidos en SP tras la implantación de este nuevo modelo a lo largo de los 2 primeros años de su desarrollo (AU)
This paper describes the implementation of a patient safety strategy in primary care within the new organizational and functional structure that was created in October 2010 to cover the single primary health care area of the Community of Madrid. The results obtained in Patient Safety after the implementation of this new model over the first two years of its development are also presented (AU)
