Factores relacionados con la satisfacción del paciente en los servicios de urgencias hospitalarios / Factors related to patient satisfaction with hospital emergency services

Objetivos Conocer las variables de calidad percibida que se relacionan con la satisfacción e identificar la influencia de los factores sociodemográficos en el grado de satisfacción del usuario de las urgencias hospitalarias. Métodos Encuesta telefónica con cuestionario de elaboración propia a una muestra de 3600 usuarios de los servicios de urgencias de nueve hospitales públicos durante los años 2008 y 2009.ResultadosEl modelo ajustado que incluye todas las variables de calidad percibida y las variables sociodemográficas explicó el 47,1% de la varianza (R2 corregida). De todas las variables independientes incluidas, sólo ocho resultaron significativas para predecir la satisfacción del paciente. Estas variables hacen referencia al trato del personal médico (p = 0,041), la profesionalidad del personal de enfermería (p = 0,010) y del celador (p = 0,022), la infraestructura (limpieza y confort) (p = 0,033 y 0,008), la información recibida al alta (p = 0,000), el tiempo pasado en urgencias (p = 0,000) y la percepción de tratamiento-diagnóstico sin fallos (p = 0,028).Conclusiones Los resultados obtenidos con la aplicación del cuestionario permitieron identificar las áreas donde implantar acciones correctoras mediante la identificación de las variables que influyen en la satisfacción del paciente de urgencias, así como la identificación de posibles factores de confusión a controlar para su utilización en la comparación de resultados entre diferentes hospitales. El cuestionario de satisfacción en urgencias es un instrumento útil para evaluar y mejorar la calidad asistencial (AU)

Objectives To determine the perceived quality variables related to satisfaction and to identify the influence of sociodemographic factors on user satisfaction with hospital emergencies. Methods A telephone survey was conducted with a specifically designed questionnaire for use in a sample of 3,600 users of hospital emergency services in nine public hospitals in 2008 and 2009.ResultsThe adjusted model including all perceived quality and sociodemographic variables explained 47.1% of the variance (adjusted R2). Of all the independent variables included, only eight were significant in predicting the level of patient satisfaction. These variables were related to the patient's opinion of the relationship with medical staff (p = 0.041), nurses’ and porters’ professionalism (p = 0.010 and 0.022), infrastructure (cleanliness and comfort) (p = 0.033 and 0.008), information received at discharge (p = 0.000), waiting time in the emergency department (p = 0.000) and the perception of treatment-diagnosis without failure (p = 0.028).Conclusions The variables influencing emergency patients’ satisfaction were determined, allowing areas where corrective action could be introduced to be identified. In addition, possible confounding factors that should be controlled for when comparing results among distinct hospitals were identified. The emergency satisfaction questionnaire is a useful instrument to evaluate and improve quality of care(AU)

[Factors related to patient satisfaction with hospital emergency services]. / Factores relacionados con la satisfacción del paciente en los servicios de urgencias hospitalarios.

OBJECTIVES: To determine the perceived quality variables related to satisfaction and to identify the influence of sociodemographic factors on user satisfaction with hospital emergencies. METHODS: A telephone survey was conducted with a specifically designed questionnaire for use in a sample of 3,600 users of hospital emergency services in nine public hospitals in 2008 and 2009. RESULTS: The adjusted model including all perceived quality and sociodemographic variables explained 47.1% of the variance (adjusted R(2)). Of all the independent variables included, only eight were significant in predicting the level of patient satisfaction. These variables were related to the patient's opinion of the relationship with medical staff (p = 0.041), nurses' and porters' professionalism (p = 0.010 and 0.022), infrastructure (cleanliness and comfort) (p = 0.033 and 0.008), information received at discharge (p = 0.000), waiting time in the emergency department (p = 0.000) and the perception of treatment-diagnosis without failure (p = 0.028). CONCLUSIONS: The variables influencing emergency patients' satisfaction were determined, allowing areas where corrective action could be introduced to be identified. In addition, possible confounding factors that should be controlled for when comparing results among distinct hospitals were identified. The emergency satisfaction questionnaire is a useful instrument to evaluate and improve quality of care.

Propiedades métricas de las escalas de competencia profesional y trato del personal sanitario de servicios de consultas externas hospitalarias / Psychometric properties of scales of professional competence and treatment by health personnel in outpatient hospital surgeries

El objetivo de este trabajo es el estudio de las propiedades psicométricas de dos escalas de valoración de la calidad percibida y satisfacción de usuarios de consultas externas de Servicios de Salud. En concreto estas escalas evalúan la Competencia Profesional (CP) y Trato del Personal (TP). Se trabajó con una muestra de 2.017 sujetos usuarios de consultas externas del Servicio Murciano de Salud durante los años 2008 y 2009. Los resultados muestran una consistencia interna de 0,68 para la escala CP y de 0,75 para la escala TP. Los resultados del análisis factorial exploratorio indican que ambas medidas son unidimensionales. Las puntuaciones obtenidas en estas escalas correlacionaron positivamente con la puntuación en satisfacción global de los pacientes. Las escalas han mostrado su utilidad para detectar áreas de mejora y planificar estrategias de intervención (AU)

The aim of this study was to analyze the psychometric properties of two scales that assess the perceived quality and patient satisfaction with outpatient surgery in the Health Service of Murcia. These scales assess the degree of Professional Competence (PC) and Personnel Treatment (PT). The scales were administered to a sample of 2017 users of outpatient surgery in the Health Service of Murcia during the years 2008 and 2009. Exploratory factor analysis indicates a unidimensional structure for each scale. Internal consistency was adequate: .68 for PC and .75 for PT. The correlation between the PC scale and patients’ global satisfaction was positive and statistically significant. The correlation between the PT scale and patients’ global satisfaction was also statistically significant. The scales have shown their utility to detect areas of improvement and to plan intervention strategies (AU)

[Psychometric properties of scales of professional competence and treatment by health personnel in outpatient hospital surgeries]. / Propiedades métricas de las escalas de competencia profesional y trato del personal sanitario de servicios de consultas externas hospitalarias.

The aim of this study was to analyze the psychometric properties of two scales that assess the perceived quality and patient satisfaction with outpatient surgery in the Health Service of Murcia. These scales assess the degree of Professional Competence (PC) and Personnel Treatment (PT). The scales were administered to a sample of 2017 users of outpatient surgery in the Health Service of Murcia during the years 2008 and 2009. Exploratory factor analysis indicates a unidimensional structure for each scale. Internal consistency was adequate: .68 for PC and .75 for PT. The correlation between the PC scale and patients' global satisfaction was positive and statistically significant. The correlation between the PT scale and patients' global satisfaction was also statistically significant. The scales have shown their utility to detect areas of improvement and to plan intervention strategies.

Análisis de los problemas, relacionados con medicamentos, detectados en un hospital general / Analysis of drug-related problems detected in a general hospital

Fundamento: Desde que se prescribe un fármaco hasta que éste tiene efecto en el paciente, pueden surgir los denominados problemas relacionados con los medicamentos (PRM). En el presente trabajo se describe la metodología empleada en nuestro hospital para identificar, prevenir y resolver los PRM. El objetivo principal es valorar la prevalencia y las características de los PRM detectados y los resultados de las intervenciones realizadas. Material y métodos: Se han analizado los PRM durante un período de un año, en un hospital general de 450 camas, con sistema de distribución de medicamentos en dosis unitarias (SDMDU) en el 100% de ellas. Diariamente, el farmacéutico revisa todos los tratamientos que se han procesado en el SDMDU. Una vez identificado un paciente con un PRM, se comunica la recomendación terapéutica por escrito a través de la "Notificación farmacoterapéutica", y se registra la respuesta obtenida trascurridas 48 h. Resultados: Durante el período de estudio hubo 17.180 ingresos y se detectaron 4.859 PRM. El mayor porcentaje de PRM (54%) corresponde a medicamentos no incluidos en la Guía Farmacoterapéutica (MNIGFT); un 88% de ellos fue por fármacos susceptibles de sustitución por un medicamento incluido en la GFT. Otro grupo importante de intervenciones corresponde al grupo de las interacciones medicamentosas, recomendaciones sobre administración de medicamentos, alertas sobre alergias e indicación de monitorización farmacoterapéutica. Los fármacos mayormente implicados pertenecían al sistema cardiovascular. Las intervenciones fueron aceptadas en un 41,7%. Conclusiones: La aplicación del programa de atención farmacéutica propuesto se ha mostrado útil para detectar, prevenir y resolver PRM. De cualquier modo, dada la repercusión del problema, es necesario establecer un sistema estandarizado que permita el seguimiento del tratamiento farmacoterapéutico

Background: Drug-related problems (DRP) can arise between the time a drug is prescribed until it has an effect on the patient. The present study describes the methodology used in our hospital to identify, prevent and resolve DRP. The main objective of this study was to determine the prevalence and characteristics of the DRP detected and the results of the pharmaceutical interventions performed to resolve these events. Material and methods: DRP were analyzed during a 1-year period in a general 450-bed hospital with a unit-dose drug distribution system (UDDDS) in all beds. A pharmacist reviewed all drugs processed in the UDDDS daily. When a DRP was identified, the therapeutic recommendation was communicated in writing through standard form, and the response obtained after 48 hours was registered. Results: During the study period, there were 17180 admissions and 4859 DRP were detected. The highest percentage of DRP (54%) corresponded to drugs not included in the drug formulary and 88% of these DRP were due to drugs that could have been substituted for drugs included in the drug formulary. Another important group of pharmaceutical interventions corresponded to drug interactions, recommendations on drug administration, allergy alerts, and indications for pharmacotherapeutic monitoring. The most frequently involved drugs were those acting on the cardiovascular system. A total of 41.7% of pharmaceutical interventions were accepted. Conclusions: The application of the program proposed was useful for detecting, preventing and resolving DRP. Given the repercussions of DRP, a standardized system that would allow follow-up of drug treatment is required

[Evaluation and improvement in the quality of the program of preventive activities and health promotion]. / Evaluación y mejora de la calidad del Programa de Actividades Preventivas y Promoción de la Salud.

OBJECTIVE: To confirm that the use of the programme of preventive activities and health promotion (PPAHP) for adults in a health district has improved over time. DESIGN: Retrospective and transversal descriptive study. SETTING: Primary care, Molina la Ribera Health District, Murcia, Spain. PATIENTS AND PARTICIPANTS: The target population was the health district s patients between 18 and 79 years old seen during the 2 periods of study: 16,236 from 1-05-1995 to 30-04-1996 and 17,377 from 1-07-2003 to 30-06-2004. Randomised sampling stratified for age and sex of the clinical records of the target population gave these samples: 140 at the first evaluation and 250 at the second (95% CI). MEASUREMENTS: Two internal-audit, retrospective evaluations were made, by means of review of clinical records by health professionals at the centre (peer review). The variables reviewed were activities of PPAHP for adults. RESULTS: The overall improvement attained was 64.45% (Pareto Diagram). All PPAHP activities (except Anamnesis for Metrorrhagia) showed significant improvement in compliance (P < .05). The PPAHP activity with the highest degree of improvement was Mammography, which went up from 3.70% (+/-7.12) of compliance (first evaluation) to 83.87% (+/-12.95) (second evaluation). CONCLUSIONS: Degree of compliance with PPAHP improved with time, except for anamnesis on metrorrhagia. The activity with the greatest degree of improvement was mammography.

Evaluación y mejora de la calidad del Programa de Actividades Preventivas y Promoción de la Salud / Evaluation and improvement in the quality of the programme of preventive activities and health promotion

Objetivo. Comprobar que la aplicación de las actividades del Programa de Actividades Preventivas y Promoción de la Salud (PAPPS) del adulto sobre la población de una zona de salud ha mejorado con el tiempo. Diseño. Estudio descriptivo, retrospectivo y transversal. Emplazamiento. Atención primaria, zona de Salud Molina la Ribera. Pacientes y participantes. La población diana fueron los pacientes de la zona de salud, de 18-79 años de edad, atendidos durante los 2 períodos de estudio: 16.236 del 1 de mayo de 1995 al 30 de abril de 1996, y 17.377 del 1 de julio de 2003 al 30 de junio de 2004. Las muestras se obtuvieron por muestreo aleatorio estratificado por edad y sexo, de las historias clínicas de la población diana: 140 en la primera evaluación y 250 en la segunda (intervalo de confianza del 95%). Mediciones. Se realizaron las 2 evaluaciones por auditoría interna y retrospectiva, mediante revisión de historias clínicas por parte de profesionales sanitarios del centro (peer-review). Las variables revisadas fueron las actividades del PAPPS del adulto. Resultados. El área de mejora global alcanzada fue del 64,45% (gráfico de Pareto). Todas las actividades del PAPPS (excepto la anamnesis por metrorragia) tuvieron una mejora significativa en su cumplimiento (p < 0,05). La actividad del PAPPS con mayor grado de mejora fue la mamografía, que pasó del 3,70% ± 7,12 de cumplimiento en la primera evaluación al 83,87% ± 12,95 en la segunda. Conclusiones. El grado de cumplimiento de las actividades del PAPPS ha mejorado con el tiempo, excepto la anamnesis sobre metrorragia. La mamografía fue la actividad con mayor grado de mejora

Objective. To confirm that the use of the programme of preventive activities and health promotion (PPAHP) for adults in a health district has improved over time. Design. Retrospective and transversal descriptive study. Setting. Primary care, Molina la Ribera Health District, Murcia, Spain. Patients and participants. The target population was the health district´s patients between 18 and 79 years old seen during the 2 periods of study: 16 236 from 1-05-1995 to 30-04-1996 and 17 377 from 1-07-2003 to 30-06-2004. Randomised sampling stratified for age and sex of the clinical records of the target population gave these samples: 140 at the first evaluation and 250 at the second (95% CI). Measurements. Two internal-audit, retrospective evaluations were made, by means of review of clinical records by health professionals at the centre (peer review). The variables reviewed were activities of PPAHP for adults. Results. The overall improvement attained was 64.45% (Pareto Diagram). All PPAHP activities (except Anamnesis for Metrorrhagia) showed significant improvement in compliance (P<.05). The PPAHP activity with the highest degree of improvement was Mammography, which went up from 3.70% (±7.12) of compliance (first evaluation) to 83.87% (±12.95) (second evaluation). Conclusions. Degree of compliance with PPAHP improved with time, except for anamnesis on metrorrhagia. The activity with the greatest degree of improvement was mammography