ABSTRACT
Objetivo: Identificar fortalezas, obstáculos, cambios en el entorno y capacidades de los equipos y unidades de apoyo en atención primaria, con el objetivo de proporcionar atención de alta calidad en un área de salud integrada. Diseño: Estudio de métodos mixtos basado en la matriz DAFO y el análisis CAME. Emplazamiento: Atención primaria, Comunidad Valenciana. Participantes: En total han participado 271 profesionales de los diferentes colectivos y representantes de asociaciones de pacientes, 99 en la fase de captura de ideas, 154 en la fase de elaboración de la matriz DAFO y 18 en la fase de elaboración del análisis CAME. Intervenciones: Se condujo un análisis DAFO-CAME a partir del cual se establecieron líneas de acción. La captura de información se realizó mediante grupos nominales, la fase de consenso integrando al conjunto de profesionales mediante Delphi y conferencia de consenso. Mediciones principales: Priorización de propuestas para mantener las fortalezas, afrontar las amenazas, explotar las oportunidades, corregir las debilidades en el marco de un plan de acción de un área de salud integrada. Resultados: Se propusieron un total de 82 ideas diferentes (20 fortalezas, 40 debilidades, 4 amenazas, 12 oportunidades y 6 amenazas-oportunidades). Este análisis condujo a un plan estratégico con 7 líneas y 33 acciones/intervenciones priorizadas. Conclusiones: Atención integrada buscando fórmulas colaborativas entre niveles asistenciales, redefinición de roles, soluciones digitales, capacitación del personal y mejoras en equipamientos y procesos de soporte, junto a medidas para afrontar el envejecimiento de la población y las necesidades de centros sociosanitarios constituyen los retos sobre los que actuar.(AU)
Objective: To identify strengths, obstacles, changes in the environment, and capabilities of primary care teams and support units, with the aim of providing high-quality care in an integrated healthcare area. Design: Mixed methods study based on the SWOT matrix and CAME analysis. Location: Primary care, Valencian community. Participants: A total of 271 professionals from different collectives and patient association representatives participated. 99 in the idea generation phase, 154 in the SWOT matrix development phase, and 18 in the CAME analysis development phase. Interventions: A SWOT-CAME analysis was conducted, from which action lines were established. Information capture was carried out through nominal groups, and the consensus phase involved integrating all professionals through Delphi and consensus conference techniques. Main measurements: Prioritization of proposals to maintain strengths, address threats, exploit opportunities, and correct weaknesses within the framework of an integrated healthcare area action plan. Results: A total of 82 different ideas were proposed (20 strengths; 40 weaknesses; 4 threats; 12 opportunities; 6 threats-opportunities), which, once prioritized, were translated into 7 lines and 33 prioritized actions/interventions (CAME analysis). Conclusions: Integrated care, seeking collaborative approaches between care levels, redefining roles, digital solutions, staff training, and improvements in equipment and support processes, along with measures to address the aging population and the needs of socio-sanitary centers, constitute the challenges to be addressed.(AU)
Subject(s)
Humans , Male , Female , Primary Health Care/organization & administration , Primary Health Care/trends , Quality of Health Care , Patient Care , House Calls , Spain , Health Management , Health SystemsABSTRACT
OBJECTIVE: To identify strengths, obstacles, changes in the environment, and capabilities of primary care teams and support units, with the aim of providing high-quality care in an integrated healthcare area. DESIGN: Mixed methods study based on the SWOT matrix and CAME analysis. LOCATION: Primary care, Valencian community. PARTICIPANTS: A total of 271 professionals from different collectives and patient association representatives participated. 99 in the idea generation phase, 154 in the SWOT matrix development phase, and 18 in the CAME analysis development phase. INTERVENTIONS: A SWOT-CAME analysis was conducted, from which action lines were established. Information capture was carried out through nominal groups, and the consensus phase involved integrating all professionals through Delphi and consensus conference techniques. MAIN MEASUREMENTS: Prioritization of proposals to maintain strengths, address threats, exploit opportunities, and correct weaknesses within the framework of an integrated healthcare area action plan. RESULTS: A total of 82 different ideas were proposed (20 strengths; 40 weaknesses; 4 threats; 12 opportunities; 6 threats-opportunities), which, once prioritized, were translated into 7 lines and 33 prioritized actions/interventions (CAME analysis). CONCLUSIONS: Integrated care, seeking collaborative approaches between care levels, redefining roles, digital solutions, staff training, and improvements in equipment and support processes, along with measures to address the aging population and the needs of socio-sanitary centers, constitute the challenges to be addressed.
Subject(s)
Aging , Health Facilities , Porphyrins , Humans , Aged , Consensus , Primary Health CareABSTRACT
Technological development of dual-energy computed tomography (DECT) can play an important role in head and neck area. Multiple innovative applications have evolved, optimizing images, achieving metallic artifact reduction, differentiating materials with better primary tumor delineation, thyroid cartilage and bone invasion. Furthermore, quantification algorithms allow measuring iodine concentration, reflecting the blood supply of a lesion indirectly. DECT enables acquiring images with lower radiation doses and iodine intravenous contrast load to obtain the same CT values.. However, DECT uses ionizing radiation, which does not occur with MRI, and requires long post-processing times. Artifacts on iodine maps may be a potential source of pseudolesions. Besides, photon-counting CT scanners are a promising technique that may displace some DECT advantages. A review analyzing the current status of DECT applied to head and neck imaging from the scope of strengths, weaknesses, opportunities, and threatsanalysis would be very interesting to facilitate a realistic, fact-based, data-driven look of this technique.
Subject(s)
Iodine , Tomography, X-Ray Computed , Algorithms , Artifacts , Magnetic Resonance ImagingABSTRACT
El desarrollo tecnológico de la tomografía computarizada de energía dual (TCED) en el área de la cabeza y el cuello ha supuesto un avance importante, ya que se han desarrollado múltiples aplicaciones para optimizar las imágenes y reducir los artefactos metálicos, así como para diferenciar los materiales, permitiendo una mejor delineación del tumor primario, del cartílago tiroideo y la invasión ósea. Además, los algoritmos de cuantificación permiten medir la concentración de yodo, lo que refleja el flujo de sangre que llega a una lesión de forma indirecta. Permite adquirir imágenes con menores dosis de radiación y menor cantidad de contraste yodado para obtener los mismos valores de TC. Sin embargo, utiliza radiaciones ionizantes y el posprocesamiento de las imágenes consume tiempo, y los artefactos en los mapas de yodo pueden suponer una fuente potencial de pseudolesiones. Además, los escáneres de TC con tecnología de recuento de fotones son una técnica prometedora que puede desplazar algunas de las ventajas de la TCED.Esta revisión hace un análisis de la TCED aplicada a las imágenes de cabeza y cuello desde el ámbito del análisis de las fortalezas, oportunidades, debilidades y amenazas para facilitar una visión realista, basada en datos, de esta técnica.(AU)
Technological development of dual-energy computed tomography (DECT) can play an important role in head and neck area. Multiple innovative applications have evolved, optimizing images, achieving metallic artifact reduction, differentiating materials with better primary tumor delineation, thyroid cartilage and bone invasion. Furthermore, quantification algorithms allow measuring iodine concentration, reflecting the blood supply of a lesion indirectly.DECT enables acquiring images with lower radiation doses and iodine intravenous contrast load to obtain the same CT values. However, DECT uses ionizing radiation, which does not occur with MRI, and requires long post-processing times. Artifacts on iodine maps may be a potential source of pseudolesions. Besides, photon-counting CT scanners are a promising technique that may displace some DECT advantages.A review analyzing the current status of DECT applied to head and neck imaging from the scope of strengths, weaknesses, opportunities, and threatsanalysis would be very interesting to facilitate a realistic, fact-based, data-driven look of this technique.(AU)
Subject(s)
Tomography, X-Ray Computed/adverse effects , Neck/diagnostic imaging , Head/diagnostic imaging , Process Optimization , Radiology , Diagnostic ImagingABSTRACT
INTRODUCCIÓN: Desde el Grupo de Expertos es posible plantear las siguientes conclusiones siguiendo el modelo DAFO de análisis (debilidades, amenazas, fortalezas y oportunidades).
Subject(s)
Cooking , Food Preferences , Humans , Spain , Terminology as TopicABSTRACT
Objetivo: Identificar la percepción sobre clima y cultura de seguridad, y determinar la prevalencia de eventos adversos en el personal de enfermería de una clínica de primer nivel. Métodos: Estudio descriptivo, transversal y prospectivo, desarrollado en una clínica de medicina familiar del sur de la ciudad de México. Se aplicó el cuestionario Hospital survey on patient safety culture. Se utilizó estadística descriptiva. Los datos se capturaron y analizaron en el programa estadístico SPSS versión 22. Resultados: Aceptaron participar en el estudio 27 profesionales de enfermería. El promedio de edad fue de 44.7 años. Cerca del 15% refirió percibir un clima de seguridad del paciente entre excelente y muy bueno. El 66.7% del personal de enfermería describió no haber notificado ningún evento adverso. La dimensión retroalimentación y comunicación sobre errores con 75.3% aparece globalmente como fortaleza. En las debilidades percibidas, destacan 2 dimensiones: respuesta no punitiva a los errores con 61.7% y dotación de personal con 62%, ambas corresponden al área o rubro de cultura de seguridad en el nivel servicio. Conclusiones: Cerca de la tercera parte de los entrevistados no habían reportado ningún evento adverso en los últimos años, además de que solo un poco más de la mitad refirió percibir un clima de seguridad del paciente entre aceptable y superior.
Objective: To identify the perception on climate and culture of safety and prevalence of adverse events among nurses in a first level clinic. Methods: This is a descriptive, transversal and prospective study conducted in a family medicine clinic located at the south of Mexico City. The questionnaire hospital survey on patient safety culture was used. Descriptive statistics were obtained and analyzed with spss v22. Results: A total of 27 nurses agreed to participate in the study. The average age of the participants was 44.7 years old. Close to 15% said they perceive a patient safety climate between excellent and very good. The 66.7% describe having not noticed any adverse event. The dimension of feedback and communication about errors with 75.3% appears globally as a strength. In the perceived weaknesses, 2 dimensions stand out: non-punitive response to errors with 61.7% and staffing with 62% both correspond to the area or culture of service-level safety culture. Conclusions: Approximately one third of the interviewed had not reported any adverse event during the previous years, while a little more than half perceive a patient safety climate between acceptable and superior.
Objetivo: Identificar a percepção sobre clínica e cultura de segurança, e determinar a prevalência de eventos adversos em enfermeiras/os de uma clínica de primeiro nível. Métodos: Estudo descritivo, transversal e prospetivo, desenvolvido em uma clínica de medicina familiar do sul da Cidade do México. Aplicou-se o questionário hospital survey on patient safety culture: utilizou-se estatística descritiva, os dados capturaram-se e analisaram no programa estatístico spss versão 22. Resultados: Aceitaram participar no estudo vinte e sete enfermeiras/os. A média de idade foi de 44.7 anos. Cerca do 15 % refere perceber um clima de segurança do paciente entre excelente e muito bom. O 66.7% das enfermeiras/os descrevem não ter notificado nenhum evento adverso. A dimensão dos erros de feedback e comunicação com 75,3% aparece globalmente como uma fortaleza. Em debilidades percebidas, existem duas dimensões: nenhuma resposta punitiva a erros com 61,7% e de pessoal com 62%, tanto para a área ou categoria de cultura de segurança no nível de serviço. Conclusões: Cerca da terceira parte 2 entrevistados não tinham reportado algum evento adverso nos últimos anos, além disso que um pouco mais da metade refere perceber um clima de segurança do paciente entre aceitável e superior.
Subject(s)
Humans , Male , Female , Safety , Nursing , CultureABSTRACT
Se realizó un estudio descriptivo, observacional y retrospectivo, auxiliándonos de diversas técnicas cuanticualitativas (cuestionario y grupos focales) con el propósito de describir las afectaciones más frecuentes sufridas por los vecinos del Consejo Popular Miramar, del municipio Playa, víctimas de la penetración del mar que provocó el huracán Wilma en esta localidad costera, e identificar las fortalezas y debilidades que exhibe esta comunidad para enfrentar las nefastas consecuencias derivadas de eventos de tal naturaleza. Predominaron las afectaciones de orden material, seguidas de los daños a la salud mental, entre los que se destacan: las crisis nerviosas o de ansiedad, el estado de ánimo abatido y los trastornos del sueño. Las fortalezas identificadas fueron la voluntad política del Estado y del Gobierno de la localidad, quienes garantizaron una eficaz estructura organizativa para el enfrentamiento de estas situaciones, la existencia de un mapa de riesgo en el municipio en el que se destacan las zonas más sensibles, la efectividad de los medios masivos de comunicación en la difusión de los partes meteorológicos seguidos por todo nuestro pueblo, y entre las amenazas más notorias, el mal estado de los desagües y de viviendas, así como la pobre percepción de riesgo de la población y la insuficiente preparación de vecinos y líderes comunitarios informales(AU)
Authors made a retrospective, observational and descriptive study using different quantitative and qualitative techniques (questionnaire and focal groups) to describe the more frequent affectations suffered by neighbors of Miramar Popular Council of Playa municipality, victims of sea penetration caused by Vilma hurricane in this coastal locality, and to identify the strengths and weakness exhibiting this community to confront the awful consequences derived from events like this. There was a predominance of affectation of material order, followed by damages to mental health which include nervous crises or of anxiety, dejected mood state, and sleep disorders. Strengths identified were the State and Government politic will of the locality, who guaranteed an efficient organization structure to confront of these situations, existence of a risk map in municipality in which be emphasized the more sensible zones, effectiveness of massive media of communication in the dissemination of meteriological reports followed by all our people, the poor conditions of drains and of the houses, as well as the poor risk perception from people, and the insufficient preparation of neighbors and informal community leaders(AU)
Subject(s)
Humans , Natural Disasters , /adverse effects , Social Problems/psychology , Epidemiology, Descriptive , Retrospective Studies , Observational Studies as TopicABSTRACT
Se realizó un estudio descriptivo, observacional y retrospectivo, auxiliándonos de diversas técnicas cuanticualitativas (cuestionario y grupos focales) con el propósito de describir las afectaciones más frecuentes sufridas por los vecinos del Consejo Popular Miramar, del municipio Playa, víctimas de la penetración del mar que provocó el huracán Wilma en esta localidad costera, e identificar las fortalezas y debilidades que exhibe esta comunidad para enfrentar las nefastas consecuencias derivadas de eventos de tal naturaleza. Predominaron las afectaciones de orden material, seguidas de los daños a la salud mental, entre los que se destacan: las crisis nerviosas o de ansiedad, el estado de ánimo abatido y los trastornos del sueño. Las fortalezas identificadas fueron la voluntad política del Estado y del Gobierno de la localidad, quienes garantizaron una eficaz estructura organizativa para el enfrentamiento de estas situaciones, la existencia de un mapa de riesgo en el municipio en el que se destacan las zonas más sensibles, la efectividad de los medios masivos de comunicación en la difusión de los partes meteorológicos seguidos por todo nuestro pueblo, y entre las amenazas más notorias, el mal estado de los desagües y de viviendas, así como la pobre percepción de riesgo de la población y la insuficiente preparación de vecinos y líderes comunitarios informales.
Authors made a retrospective, observational and descriptive study using different quantitative and qualitative techniques (questionnaire and focal groups) to describe the more frequent affectations suffered by neighbors of Miramar Popular Council of Playa municipality, victims of sea penetration caused by Vilma hurricane in this coastal locality, and to identify the strengths and weakness exhibiting this community to confront the awful consequences derived from events like this. There was a predominance of affectation of material order, followed by damages to mental health which include nervous crises or of anxiety, dejected mood state, and sleep disorders. Strengths identified were the State and Government politic will of the locality, who guaranteed an efficient organization structure to confront of these situations, existence of a risk map in municipality in which be emphasized the more sensible zones, effectiveness of massive media of communication in the dissemination of meteriological reports followed by all our people, the poor conditions of drains and of the houses, as well as the poor risk perception from people, and the insufficient preparation of neighbors and informal community leaders.
