Identificación de las prácticas seguras simples en un área de atención primaria / Identification of simple safe practices in a primary care area

Objetivos. Valorar las prácticas seguras (PS) elaboradas por la Unidad Funcional de Gestión de Riesgos Sanitarios (UFGRS), según su complejidad de implantación y el impacto en la seguridad del paciente (SP) e identificar PS simples (PSS). Material y métodos. Desde la UFGRS del Área 4 de Atención Primaria (AP) de Madrid, se han elaborado un número importante de PS, posteriormente se valoraron según su complejidad de implantación e impacto potencial en la SP, identificándose las PSS: contra eventos adversos (EA), de baja complejidad de implantación y de alto impacto en la SP. Por último, se identificaron las barreras para su implantación efectiva y se diseñaron acciones para superar dichas barreras. Resultados. Se han elaborado 50 PS, de ellas 42 se han generalizado a todo el área. Se han identificado como PSS: 7 de nivel 1, que cumplen las condiciones ideales. Las principales barreras tienen que ver con la falta de formación, cultura, liderazgo de los equipos directivos y profesionales de los centros y escasa difusión de las PS. Conclusiones. Desde la UFGRS se ha elaborado un número importante de PS, identificándose PSS para AP. La mayoría de estas tienen que ver con el uso seguro de medicamentos y con las vacunas(AU)

Objectives. To assess the safe practices (SP) prepared by the Health Risk Management Functional Unit (UFGRS), according to their complexity of introduction and the impact on patient safety, and to identify simple SP. Material and methods. A number of important SP have been prepared by the UFGRS of Madrid Health Area 4 Primary Care (PC). They were subsequently assessed according to their complexity of introduction and their potential impact on patient safety, simple SP (SSP) for the prevention of adverse events, low complexity of introduction and impact on patient safety. Lastly, the barriers to their effective introduction were identified, and actions were designed to overcome these barriers. Results. Of the 50 PS prepared, 42 have been applied in the whole Area. Seven Level 1 SP (which fulfil the ideal conditions) were identified as simple SP. The main barriers were due to lack of training, culture, leadership of the management teams and professionals of the centre and lack of knowledge of the SPs. Conclusions. A large number of SP has been prepared by the UFGRS, with simple SP being identified for PC. The majority of these have to do with the safe use of drugs and vaccines(AU)

[Identification of simple safe practices in a primary care area]. / Identificación de las prácticas seguras simples en un área de atención primaria.

OBJECTIVES: To assess the safe practices (SP) prepared by the Health Risk Management Functional Unit (UFGRS), according to their complexity of introduction and the impact on patient safety, and to identify simple SP. MATERIAL AND METHODS: A number of important SP have been prepared by the UFGRS of Madrid Health Area 4 Primary Care (PC). They were subsequently assessed according to their complexity of introduction and their potential impact on patient safety, simple SP (SSP) for the prevention of adverse events, low complexity of introduction and impact on patient safety. Lastly, the barriers to their effective introduction were identified, and actions were designed to overcome these barriers. RESULTS: Of the 50 PS prepared, 42 have been applied in the whole Area. Seven Level 1 SP (which fulfil the ideal conditions) were identified as simple SP. The main barriers were due to lack of training, culture, leadership of the management teams and professionals of the centre and lack of knowledge of the SPs. CONCLUSIONS: A large number of SP has been prepared by the UFGRS, with simple SP being identified for PC. The majority of these have to do with the safe use of drugs and vaccines.

Proyecto de mejora del Proceso de Atención Continuada domiciliaria en Atención Primaria: rediseño y AMFE / Improving the continuous care process in primary care during weekends and holidays. Redesigning and FMEA

Objetivo. Describir el proyecto de mejora aplicado al proceso de atención continuada (ATC) de sábados y festivos en el Área 4 de Atención Primaria (AP) de Madrid, para garantizar una atención segura y libre de fallos en los cuidados domiciliarios de los fines de semana. Material y método. El proceso de ATC se identificó como de riesgo por la Unidad Funcional de Gestión de Riesgos (UFGR) del Área, además presentaba quejas: de las enfermeras que realizan la atención y de pacientes. En 2009 se realiza un DAFO (debilidades, amenazas, fortalezas y oportunidades) que evidenció problemas. Posteriormente se diseña un proyecto de mejora que se desarrolla en las fases: 1. Rediseño y mejora del proceso. 2. Aplicación AMFE al nuevo proceso. 3. Pilotaje. 4. Formación a las enfermeras. 5. Implantación en todo el Área. 6. Encuesta de satisfacción a las enfermeras de ATC. Resultados. El rediseño del proceso, proporcionó mejoras como la automatización y aumento de la eficiencia. Posteriormente a la implantación de las medidas de mejora, no se han producido nuevas reclamaciones de pacientes y ha mejorado la satisfacción de las enfermeras de ATC medida a través de encuesta. Al aplicar el AMFE se priorizaron fallos y se pusieron en marcha acciones de mejora. Conclusiones. La mejora del proceso y sobre todo su automatización, ha sido un gran avance para mejorar la seguridad. El AMFE nos ha resultado una herramienta útil y práctica que ha permitido implantar importantes acciones, igualmente se ha conseguido mejorar la satisfacción de las enfermeras que realizan la ATC(AU)

Objective. To describe a project carried out in order to improve the process of Continuous Health Care (CHC) on Saturdays and bank holidays in Primary Care, area number 4, Madrid. The aim of this project was to guarantee a safe and error-free service to patients receiving home health care on weekends. Materials and method. The urgent need for improving CHC process was identified by the Risk Management Functional Unit (RMFU) of the area. In addition, some complaints had been received from the nurses involved in the process as well as from their patients. A SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis performed in 2009 highlighted a number of problems with the process. As a result, a project for improvement was drawn up, to be implemented in the following stages: 1. Redesigning and improving the existing process. 2. Application of failure mode and effect analysis (FMEA) to the new process. 3. Follow up, managing and leading the project. 4. Nurse training. 5. Implementing the process in the whole area. 6. CHC nurse satisfaction surveys. Results. After carrying out this project, the efficiency and level of automation improved considerably. Since implementation of the process enhancement measures, no complaints have been received from patients and surveys show that CHC nurse satisfaction has improved. Results. By using FMEA, errors were given priority and enhancement steps were taken in order to: Inform professionals, back-up personnel and patients about the process. Improve the specialist follow-up report. Provide training in ulcer patient care. Conclusion. The process enhancement, and especially its automation, has resulted in a significant step forward toward achieving greater patient safety. FMEA was a useful tool, which helped in taking some important actions. Finally, CHC nurse satisfaction has clearly improved(AU)

[Improving the continuous care process in primary care during weekends and holidays: redesigning and FMEA]. / Proyecto de mejora del Proceso de Atención Continuada domiciliaria en Atención Primaria: rediseño y AMFE.

OBJECTIVE: To describe a project carried out in order to improve the process of Continuous Health Care (CHC) on Saturdays and bank holidays in Primary Care, area number 4, Madrid. The aim of this project was to guarantee a safe and error-free service to patients receiving home health care on weekends. MATERIALS AND METHOD: The urgent need for improving CHC process was identified by the Risk Management Functional Unit (RMFU) of the area. In addition, some complaints had been received from the nurses involved in the process as well as from their patients. A SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis performed in 2009 highlighted a number of problems with the process. As a result, a project for improvement was drawn up, to be implemented in the following stages: 1. Redesigning and improving the existing process. 2. Application of failure mode and effect analysis (FMEA) to the new process. 3. Follow up, managing and leading the project. 4. Nurse training. 5. Implementing the process in the whole area. 6. CHC nurse satisfaction surveys. RESULTS: After carrying out this project, the efficiency and level of automation improved considerably. Since implementation of the process enhancement measures, no complaints have been received from patients and surveys show that CHC nurse satisfaction has improved. By using FMEA, errors were given priority and enhancement steps were taken in order to: Inform professionals, back-up personnel and patients about the process. Improve the specialist follow-up report. Provide training in ulcer patient care. CONCLUSION: The process enhancement, and especially its automation, has resulted in a significant step forward toward achieving greater patient safety. FMEA was a useful tool, which helped in taking some important actions. Finally, CHC nurse satisfaction has clearly improved.