ABSTRACT
En este trabajo se expone la actividad quirúrgica realizada durante la atención continuada (periodo deiempo no cubierto por la jornada laboral de funcionamiento de los servicios, con atención de urencasinternas y externas del hospital) en un Servicio de cirugia General. Los objetivos son conocer la patología intervenida, el tiempo invertido en la crugía y laefectividad y calidad de la cirugía urgente. El estudio clinico prospectivo se realizo con 245 pacientes operados durante la guardia de presencia física (misma cirujano) pr los especialistas de Cirugía General y del Aparato Digestivo del complejo Hospitalario Uniersitario de Albacete, hospital e tercer nivel, de 1 de agosto de 2004 al 31 de julio de 2005 (AU)
The aims of this prospective study are to determine the pathology requiring intervention in continuous nursing care (supervision with physical presence) in and for a General Surgery Department, the time employed in surgical care and the effectiveness and quality in emergency surgery. It is of great interest since there is no single set of rules about continuous nursing care, but rather very wide-ranging health legislation (AU)
Subject(s)
Humans , Surgery Department, Hospital/organization & administration , Quality of Health Care/organization & administration , Prospective Studies , Hospitals, University/organization & administrationABSTRACT
INTRODUCTION: Clinical Teams are framed within the New Organizational Models (1996) and Spanish national health system's Strategic Plan (1997). The objectives of the internal organization model are as follows: A) General: to implement health management systems in the health service. B) Specific: service, quality and financial improvement. MATERIAL AND METHOD: Methodology. 1. Jurisdiction. Self-managing despite having no separate legal status. 2. Creation: a) feasibility study and project viability. The drafting committee consisted of representatives of the Services' physicians, other health professionals and non-health employees (Representation and Participation Organizations), and explained the portfolio of specialty services and new diagnosis and treatment techniques to be implemented. Costs and a strategic analysis of the situation were evaluated. The project was approved by management and was sent to the Ministry of Health (formerly to the Territorial Health Agency (ratified) and to the Spanish national health system's General Directorate for Organization and Planning); b) homologation: institutional approval of health centers' self-management and the feasibility of the proposals. MATERIAL: 1. Resources. Resources of the assigned Services. 2. Structure. Horizontality, simplicity and operativity. 3. PURPOSE: a) clinical: role assigned to Specialized Care Services; b) management: responsibility for proper working order (actions), personnel performance (tasks), and custody and use of material resources (available resources), carried out with active and responsible participation of all departments. 4. Quality plan: patient-oriented care, evidence-based medicine (standards and protocols), evaluation of medical technologies (service corporation) and corporative quality guarantee. CONCLUSIONS: A voluntary, innovative, participative and decentralized management model.
Subject(s)
Hospital Planning , Hospitals, Public/organization & administration , National Health Programs/organization & administration , Patient Care Team/organization & administration , Humans , Models, Organizational , Organizational Objectives , Program Evaluation , SpainABSTRACT
Introducción. Las áreas clínicas se enmarcan en los Nuevos Modelos de Organización (1996) y en el Plan Estratégico del INSALUD (1997). Modelo organizativo interno cuyos objetivos son: a) generales: adoptar sistemas de gestión clínica e integral de la asistencia sanitaria, y b) específicos: mejora asistencial, de la calidad y económica. Material y método. Metodología. 1. Régimen jurídico: autonomía de gestión sin naturaleza jurídica propia. 2. Creación: a) estudio de factibilidad del proyecto. La comisión redactora la constituyen representantes de los facultativos de los servicios, del personal sanitario no facultativo y del personal no sanitario (órganos de representación y participación); explica la cartera de servicios y nuevas técnicas diagnósticas y de tratamiento a incorporar, evalúa costes y hace un análisis estratégico de la situación. El proyecto lo aprueba la gerencia y se envía a la Consejería de Sanidad (antaño, a la Dirección Territorial, que ratificaba, y a la Dirección General de Organización y Planificación del INSALUD), y b) homologación. Voluntad institucional de dotar a los centros sanitarios de autonomía de gestión y de factibilidad de las propuestas. Material. 1. Dotación: recursos de los servicios asignados. 2. Estructura: horizontalidad, simplicidad y operatividad. 3. Funciones: a) clínicas, las atribuidas a los servicios de atención especializada, y b) gestión, responsabilidad en el correcto funcionamiento (acciones), la actividad del personal (tareas) y la custodia y la utilización adecuadas de los recursos materiales (recursos disponibles), con la implicación activa y responsable de los profesionales. 4. Plan de calidad: atención centrada en el paciente, medicina basada en la evidencia científica (estándares y protocolos), evaluación de las tecnologías médicas (empresa de servicios) y garantía de calidad corporativa. Conclusiones. Modelo de gestión voluntario, innovador, participativo y descentralizado (AU)
Introduction. Clinical Teams are framed within the New Organizational Models (1996) and Spanish national health system's Strategic Plan (1997). The objectives of the internal organization model are as follows: A) General: to implement health management systems in the health service. B) Specific: service, quality and financial improvement. Material and method. Methodology. 1. Jurisdiction. Self-managing despite having no separate legal status. 2. Creation: a) feasibility study and project viability. The drafting committee consisted of representatives of the Services' physicians, other health professionals and non-health employees (Representation and Participation Organizations), and explained the portfolio of specialty services and new diagnosis and treatment techniques to be implemented. Costs and a strategic analysis of the situation were evaluated. The project was approved by management and was sent to the Ministry of Health (formerly to the Territorial Health Agency (ratified) and to the Spanish national health system's General Directorate for Organization and Planning); b) homologation: institutional approval of health centers' self-management and the feasibility of the proposals. Material. 1. Resources. Resources of the assigned Services. 2. Structure. Horizontality, simplicity and operativity. 3. Purpose: a) clinical: role assigned to Specialized Care Services; b) management: responsibility for proper working order (actions), personnel performance (tasks), and custody and use of material resources (available resources), carried out with active and responsible participation of all departments. 4. Quality plan: patient-oriented care, evidence-based medicine (standards and protocols), evaluation of medical technologies (service corporation) and corporative quality guarantee. Conclusions. A voluntary, innovative, participative and decentralized management model (AU)
