[Experience of the quality program of the clinical documentation department of the Hospital of Galdacano]. / Experiencia del programa de calidad del Servicio de Documentación Clínica del Hospital de Galdácano.

BACKGROUND: The management of quality is a key tool to improve efficacy of Spanish hospitals. Hospital quality programs and those of each department/unit are based on self-evaluation with the principle of there being things to be improved and have demonstrated their efficacy. The aim of the present study was to demonstrate the applicability of the methodology of quality in a Department of Clinical Documentation. METHODS: Four indicators of quality in the quality program were measured in the form of indexes over 18 months in a department of clinical documentation of a general hospital. RESULTS: Index of filing errors: 0.1%, index of history availability: 98%, index of histories not in place: 6.4 to 11.1, index of reclaimable histories: 3.1 to 5.2. CONCLUSIONS: The methodology of quality is applicable to a department of clinical documentation with its development being useful in detecting problems as the first step in improving quality.

[Transesophageal Doppler color echocardiography in the evaluation of patients after percutaneous mitral valvuloplasty]. / Eco Doppler color transesofágico en la valoración de los pacientes tras valvuloplastia mitral percutánea.

To determine the value of transesophageal ultrasound in the assessment of patients after percutaneous mitral valvuloplasty, 42 patients were studied by transthoracic (TTE) and transesophageal (TEE) two-dimensional and color Doppler echocardiography. All of them were studied as out-patients and without complications. We describe the technique, planes of examination and the advantages that this new acoustic window offers in patients after balloon valvuloplasty regarding to: detection of thrombus in the left atrium (LA), visualization of spontaneous echo contrast in the LA, evaluation of mitral regurgitation (MR), detection of small atrial septal defects (ASD) and evaluation of the stage of the commissures of the mitral valve. We detected thrombus by TEE, in 5/42 vs 1/42 by TTE approach. Spontaneous echo contrast was found in 35/42 by TEE and none by TTE. Small ASDs were visualized in 10/42 patients vs 2/42 by TTE. No differences were found in the evaluation of MR and mitral valve commissures either by TEE or TTE. We conclude that transesophageal echocardiography is a well-tolerated technique in outpatients which complements and improves the information obtained by the transthoracic approach in patients after balloon mitral valvuloplasty.