Una alternativa de auditoría en psiquiatría más cercana a Europa y al residente / An alternative way of auditing in psychiatry, closer to Europe and the trainee

Introducción. En este trabajo se presenta la experiencia de una auditoría externa piloto realizada en el Servicio de Psiquiatría del Hospital Príncipe de Asturias de Alcalá de Henares, y los beneficios derivados del modelo de la UEMS (Unión Europea de Médicos Especialistas) aquí expuesto. En España, los sistemas de evaluación y calidad de formación de los especialistas están bien establecidos. Existen todavía aspectos que se pueden mejorar. El modelo de auditoría de la UEMS reconoce la diversidad de programas de los distintos países miembros, pero trata de estandarizar la calidad de la formación mediante el proceso de auditorías externas. Objetivo. Mostrar un modelo más centrado en la formación del residente, con mayor participación de éste y de las sociedades profesionales y científicas. Materiales y métodos. Se expone la experiencia de auditoría externa realizada en una unidad de psiquiatría siguiendo el modelo de la UEMS. Resultados. Se analizan los beneficios de este tipo de auditorías en el proceso de revisión de la formación de los residentes. Conclusión. Este tipo de auditorías favorece la supervisión del sistema de formación de residentes y promueve el acercamiento a los estándares de calidad de la Unión Europea, garantizando que los residentes obtengan el mejor nivel de formación (AU)

Introduction. This paper relates the experience of a pilot external audit visit conducted at the University Hospital Príncipe de Asturias in Alcalá de Henares and its benefits, following the UEMS (Union Européenne des Médecins Spécialistes) model. In Spain, systems of evaluation and quality of the specialists training are well established. Some aspects can be still improved. The UEMS model of audit, recognises the diversity of programs in member countries, but is trying to standardize the quality of training through external audits. Aim. To show a model that mainly focuses on the training of residents with a greater participation of them and professional and scientific societies. Materials and methods. To exhibit the experience of an external audit visit in a Psychiatry unit following the UEMS model. Results. Multiple benefits derive from this kind of audits in the revision and improvement of the residents' training. Conclusion. This kind of audits provides an assessment of the resident's training system and encourages movement towards European Union standards of quality, ensuring that all trainees get the highest standard of training which can be provided (AU)

Compulsory treatment in the community: considerations for legislation in Europe.

In late 2008, the Regional Office for Europe of the World Health Organization (WHO, 2008) issued a report based on a survey of the policies and practices for mental health within its area of operation. Forty-two European states were examined and a great diversity in practice was recorded. Almost everywhere, the report suggested, policy making and legislative initiatives were seen; since 2005, some 57% of the countries studied had adopted new mental health policies and 48% had introduced new legislation. Many countries were reported to be closing mental hospital beds and replacing them with community-based services. In some countries, however, the report suggested, desks in ministries were collapsing under the weight of policies that had never been implemented, and compliance with legislation by planners and psychiatrists was distinctly variable. The WHO felt that even the role that general practitioners played in treating people with mental illness was limited in many European states and that the availability of home treatment options, assertive outreach for people with complex mental health needs and community-based early intervention was not only variable but often severely limited. Given the wide discrepancies of procedure and practice, it was difficult for the WHO to gain any clear perspective on such legislative matters as arrangements for compulsory care in the community.

Training in Europe in perspective.

In psychiatric medicine, as in other fields, Europe offers a diversity of history and academic tradition that belies its limited geographical area. There are numerous centres of excellence - in psychiatric research, service innovation and practice - and many countries have internationally recognised and excellent training schemes in psychiatry. But uniformity of practice is seldom in evidence.