[Validation of a questionnaire to assess patient safety culture in healthcare managers: Psychometric properties and usability]. / Validación de un cuestionario para evaluar la cultura de seguridad del paciente en directivos de la salud: propiedades psicométricas y usabilidad.

AIM: To validate a reduced and applicable to distinct location version of the only validated questionnaire of patient safety culture in managers in Spanish language. METHOD: Questionnaire validation study. Community of Madrid 2022. Reduction/adaptation of the original questionnaire: Giménez-Aibar-Gutiérrez, 2013 Questionnaire was reduced from 85 items to 25; those local or not applicable were removed. Pre-test: Semi-structured survey on comprehension and response scale. There was no need to modify the questionnaire. VALIDATION: It was tested in 39 primary care managers without care activity. Internal consistency (α Cronbach), content validity (experts) and construct validity (factor analysis) were analysed. Usability analysis: Survey on time spent and non-response rate. RESULTS: α Cronbach=0.894. Content validity: Experts deemed questionnaire was complete. Factor analysis: five factors explain 68% of variance. The factors corresponded to the dimensions of the theoretical construct. Factors, internal consistency of each and correlation with global score were: commitment with patient safety: α Cronbach=0.793, r=0.778; P<.001; procedures/reporting: α Cronbach=0.83, r=0.806; P<.001; attitudes with patient safety: α Cronbach=0.766, r=0.596; P<.001; clinicians involving: α Cronbach=0.773, r=0.798; P<.001; patient safety communication: α Cronbach=0.615, r=0.518; P=.001; usability survey: 95% thought spent time was adequate. Non-response rate was 0%, except one item. CONCLUSION: In this work, a reduced and adapted version of questionnaire of Giménez-Aibar-Gutiérrez was validated at distinct location (Madrid region). Psychometric properties and usability, which were found, suggest that the reduced questionnaire is a reliable, valid and usable instrument to assess patient safety culture in managers of any place.

[Impact of the COVID-19 pandemic on patient safety incident and medication error reporting systems]. / Impacto de la pandemia COVID-19 en los sistemas de notificación de incidentes de seguridad del paciente y errores de medicación.

BACKGROUND AND AIM: To determine the impact of the COVID-19 pandemic on the epidemiology of safety incidents (SI) and medication errors (ME) reported to the CISEMadrid notification system in the hospital and primary care settings of the Madrid Health Service (SERMAS). MATERIALS AND METHODS: Observational and descriptive study with a retrospective analysis of data including all CISEMadrid notifications from 01-Jan-2018 to 31-Dec-2020, from 33 hospitals and 262 health care centres of the SERMAS. The two periods in 2020 with the greatest increase in COVID-19 cases were identified to compare incidents reported in the pre-pandemic and pandemic periods. RESULTS: 36,494 incidents were reported. Comparing both periods, an overall decrease in pandemic notifications of 60.7% was observed, being higher in primary care, falling to 33% of previous levels. The reduction in notifications was similar in the peaks and valleys of the waves. The three most frequent SIs in both periods and care settings were: diagnostic tests, medical devices/equipment/clinical furniture and organisational management/citations. In ME, dose failure and inappropriate selection were the most frequent in both settings and periods. There were no relevant differences in patient consequences in both periods. CONCLUSIONS: During the pandemic, patient safety notifications decreased although the most frequent types remained the same, as did their impact on the patient, both in hospitals and in primary care. The safety culture of organisations is a critical aspect for the maintenance of reporting systems.

Análisis de la calidad de vida laboral y de los factores relacionados con esta, en un área de atención primaria / Analysis of occupational quality of life and related factors in a primary health care unit

Fundamento. El objetivo fue determinar la valoración de los profesionales sobre su calidad de vida laboral y los factores que se relacionan con esta. Métodos. Diseño: Estudio observacional transversal. Encuesta. Métodos. Emplazamiento: Área 1 de atención primaria del SERMAS. Métodos. Participantes: Respuesta voluntaria y confidencial a la encuesta solicitada a todos los trabajadores del Área. Métodos. Mediciones principales: Tipo de unidad, situación laboral, función directiva, tiempo trabajado, presión asistencial, ruralidad, categoría profesional, puntuación media de la encuesta y puntuación en cada uno de los 11 factores que explora. Se utilizó la encuesta Q-Labors 56. Resultados. La proporción de respuestas alcanzó el 58% (n=883). La puntuación media+/-desviación típica fue de 3,0+/-0,47 (sobre un máximo de 5) en global. En los factores peor puntuados fue 2,07+/-1,03 en salario, 2,33+/-0,88 en sobrecarga y 2,44+/-0,92 en promoción, y en los factores mejor puntuados 3,74+/-0,76 en relaciones interpersonales y 3,72+/-0,62 en relaciones con pacientes. El mejor modelo de regresión logística encontrado para explicar la puntuación global superior a 3 incluía solo la función directiva, la situación laboral y la categoría profesional. Conclusiones. La puntuación de la calidad de vida laboral encontrada ha sido de 3 puntos en una escala de 1 a 5. La variable más determinante ha sido la categoría profesional. No se ha encontrado influencia de la carga asistencial, del tiempo trabajado o de la ruralidad. Los factores con peor puntuación fueron el salario, la sobrecarga y la promoción mientras que las relaciones con compañeros y pacientes fueron los mejor puntuados(AU)

Background. To determine the professionals` valuation on his quality of worklife and the factors related to this one. Methods. Design: Observacional transversely study. Questionnaire Methods. Setting: Area 1 of primary care. SERMAS Methods. Participants: Voluntary and confidential response to the questionnaire requested all the workers. Methods. Main measurements: Unit type, labour statement, manager rol, work years old, work burden, rural environment, profession, punctuation average of the questionnaire and punctuation in each of 11 questionnaire factors. Questionnaire Q-Labors 56 was used. Results. Answers ratio 58% (n=883). The average punctuation+/-standard deviation was 3,0+/-0,47 (maximum punctuation 5) globally. The worse punctuated factors were salary (2,07+/-1,03), burden (2,33+/-0,88) and promotion (2,44+/-0,92), and the best punctuated factors were interpersonal relations (3,74+/-0,76) and patients relations (3,72+/-0,62). The best logistic regression model to explain global punctuation more than 3 included only manager rol, labour statement and profession. Conclusions. The punctuation of quality worklife was 3 in a scale from 1 to 5. The most determinant variable has been the profession. Influence of Work burden, Work years old or Rural environment wasn´t found. The worse valuated factors were salary, burden and promotion. Interpersonal relations and patients relations were them the best punctuated(AU)

[Analysis of occupational quality of life and related factors in a primary health care unit]. / Análisis de la calidad de vida laboral y de los factores relacionados con esta, en un área de atención primaria.

BACKGROUND: To determine the professionals' valuation on his quality of worklife and the factors related to this one. DESIGN: Observacional transversely study. Questionnaire Setting: Area 1 of primary care. SERMAS Participants: Voluntary and confidential response to the questionnaire requested all the workers. MAIN MEASUREMENTS: Unit type, labour statement, manager rol, work years old, work burden, rural environment, profession, punctuation average of the questionnaire and punctuation in each of 11 questionnaire factors. Questionnaire Q-Labors 56 was used. RESULTS: Answers ratio 58% (n=883). The average punctuation±standard deviation was 3,0±0,47 (maximum punctuation 5) globally. The worse punctuated factors were salary (2,07±1,03), burden (2,33±0,88) and promotion (2,44±0,92), and the best punctuated factors were interpersonal relations (3,74±0,76) and patients relations (3,72±0,62). The best logistic regression model to explain global punctuation more than 3 included only manager rol, labour statement and profession. CONCLUSIONS: The punctuation of quality worklife was 3 in a scale from 1 to 5. The most determinant variable has been the profession. Influence of Work burden, Work years old or Rural environment wasn't found. The worse valuated factors were salary, burden and promotion. Interpersonal relations and patients relations were the best punctuated.

¿Nos resistimos a la prevención? Grupos focales para generar ideas que aumenten el cumplimiento / Do we resist prevention? Focal groups to generate ideas that increase compliance

OBJETIVO. Identificar intervenciones a introducir que aumenten el cumplimiento de cuatro actividades preventivas de alto impacto en la salud y de bajo cumplimiento (consejo antitabaco, despistaje prácticas sexuales de riesgo, información anticoncepción, control de cifras tensionales), así como detectar las resistencias y dificultades de los clínicos a estas intervenciones y actividades. DISEÑO. Estudio cualitativo con grupos focales. EMPLAZAMIENTO. Un Área de Salud urbana de Madrid. Años 1999-2000. PARTICIPANTES. Tres grupos: a) de todos los gestores y técnicos de las direcciones asistenciales del Área (10 participantes), b) de representantes de los clínicos, elegidos por éstos, uno por cada Equipo de Atención Primaria (EAP) (20 participantes) y c) de líderes clínicos seleccionados por los autores (15 participantes). MÉTODO. Técnica de grupos focales, con una sesión de unas dos horas, con moderador y observador externo. Se realizó registro de las opiniones clave. RESULTADOS. Se identificaron las siguientes ideas: a) pegatinas/flash, b) modificación de la hoja/plan de actividades preventivas del adulto, c) recordatorios escritos en la consulta, d) revisión de historias antes del comienzo de la consulta, e) marcar cifras tensionales descontroladas, f) definir normas de calidad en enfermería, g) talleres formativos a los profesionales, h) recordatorios escritos en las derivaciones a especialistas, i) sesiones recordatorio, j) auditorías internas. Se identificaron resistencias y dificultades en las intervenciones a, b, g y h. CONCLUSIONES. Para incrementar cuatro intervenciones preventivas de alto impacto en salud y de bajo cumplimiento se han encontrado intervenciones, sin hallar resistencias o dificultades, centradas en la realización de recordatorios y evaluaciones

OBJECTIVE. Identify interventions to be introduced, that increase compliance of four high impact preventive activities in health and low compliance (anti-smoking advise, screening of sexual practices of risk, contraception information, control of blood pressure values), and to detect the resistances and difficulties of the clinicians to these interventions and activities. DESIGN. Qualitative study with focal groups. SITE. Urban Health Area in Madrid. Years 1999-2000. PARTICIPANTS. Three groups: a) of all the managers and technicians of the health care administrations of the Area (10 participants), b) of the representatives of the clinicians, chosen by the clinics, one for each primary care team (PCT) (20 participants), c) of the clinical leaders chosen by the authors (15 participants). METHOD. Technique of focal groups, with one two-hour session, with moderator and external observer. Registry of the key opinions was done. RESULTS. The following ideas were identified: a) stickers/flash, b) modification of the sheet/plan of adult preventive activities, c) reminders written in the out-patient clinic, d) review of clinical records before beginning the visit, e) indicate uncontrolled blood pressure values, f) define nursing quality guidelines, g) educational workshops for the professionals, h) written reminders in the referrals to specialists, i) reminder sessions, j) internal audits. Resistances and difficulties in the interventions a, b, g, and h were identified. CONCLUSIONS. To increase four high impact preventive interventions in health and low compliance, interventions have been found, without finding resistances or difficulties, focused on the conduction of reminders and performance of evaluations

La mitad de las tiras de glucemia capilar que utilizan nuestros pacientes tiene una dudosa indicación / Half the capillary glycaemia strips that our patients use have doubtful indication

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[Do the complaints of primary care users vary with the care model?]. / Son diferentes las quejas de los usuarios de atención primaria según el modelo de atención?

OBJECTIVES: 1. To compare the traditional model (TM) and Primary Care teams (PCTs) on the index of complaints. 2. To determine whether the reasons for complaints vary with the care model. DESIGN: An observational, cross-sectional study. SETTING: Primary Care Area 4, INSALUD, Madrid, covering 526,987 inhabitants. PARTICIPANTS: The complaints presented at PC Centres during 1993 were included. Those presented for reasons not concerning the centre were excluded. In all, 448 complaints were studied. MEASUREMENTS AND MAIN RESULTS: Significant differences were found in the general index of complaints according to the care model. Statistically significant differences were detected between PCT and the TM for complaints due to disagreement with the treatment and disagreement with the follow-up procedures. CONCLUSIONS: Since the indicators of prescription profiles and the following of procedures are better in PCTs than in the TM, perhaps patients should be encouraged to participate more in the taking of clinical decisions. This would help the introduction of improvements both in the technical quality of treatment and in the follow-up of chronic diseases to be perceived as such by patients. At present, as this study suggests, they are causes of greater dissatisfaction.