How should healthcare be reported in Catalonia? Qualitative study with healthcare leaders.

BACKGROUND: The Results Centre is the name of a project that, since 2012, has been openly publishing the results of each healthcare centre in Catalonia, with the idea of promoting benchmarking among centres and transparency toward society. As the project evolves, it has become increasingly necessary to adapt its contents and formats. The objective of this study is to identify the preferences and expectations of healthcare leaders regarding the Results Centre. METHODS: A qualitative study was conducted using the nominal group technique. Five nominal groups were created with the participation of 58 professionals (26 from hospital care, 16 from primary care, and 16 from long-term care centres). The areas of analysis were: (1) what the Results Centre of the future should be like; (2) what information needs should be addressed; and (3) what novelties should be incorporated to stimulate quality improvement. The spontaneity of ideas, intensity of recommendations, and intergroup consistency were analysed. The study was conducted in April 2019. RESULTS: The requirements reported by the participants to be met by the Results Centre included: being a tool for benchmarking and strategic decision-making; adjusted and segmented indicators; non-clinical information (patient experience, socio-economic status, etc.); and data accessible to all stakeholders, including citizens. The ideas were consistent across the different levels of care, although the intensity of recommendations varied depending on their content. CONCLUSIONS: Regional agencies that are accountable for health outcomes should be consistently committed to adapting to the needs of different stakeholders in the health system. This project is an example of how this requirement has been addressed in Catalonia.

Patient Satisfaction with Pre-Hospital Emergency Services. A Qualitative Study Comparing Professionals' and Patients' Views.

Objective: To describe patient satisfaction with pre-hospital emergency knowledge and determine if patients and professionals share a common vision on the satisfaction predictors. Methods: A qualitative study was conducted in two phases. First, a systematic review following the PRISMA protocol was carried out searching publications between January 2000 and July 2016 in Medline, Scopus, and Cochrane. Second, three focus groups involving professionals (advisers and healthcare providers) and a total of 79 semi-structured interviews involving patients were conducted to obtain information about what dimensions of care were a priority for patients. Results: Thirty-three relevant studies were identified, with a majority conducted in Europe using questionnaires. They pointed out a very high level of satisfaction of callers and patients. Delay with the assistance and the ability for resolution of the case are the elements that overlap in fostering satisfaction. The published studies reviewed with satisfaction neither the overall care process nor related the measurement of the real time in responding to an emergency. The patients and professionals concurred in their assessments about the most relevant elements for patient satisfaction, although safety was not a predictive factor for patients. Response capacity and perceived capacity for resolving the situation were crucial factors for satisfaction. Conclusions: Published studies have assessed similar dimensions of satisfaction and have shown high patient satisfaction. Expanded services resolving a wide number of issues that can concern citizens are also positively assessed. Delays and resolution capacity are crucial for satisfaction. Furthermore, despite the fact that few explanations may be given due to a lack of face-to-face attention, finding the patient's location, taking into account the caller's emotional needs, and maintaining phone contact until the emergency services arrive are high predictors of satisfaction.

Identificación de los conflictos éticos en la atención sociosanitaria. Un estudio exploratorio / Identification of ethical conflicts in health and social services. An exploratory study

Objetivo: El objetivo principal de este estudio es identificar y clasificar los conflictos éticos que más comúnmente se plantean y más preocupan a los profesionales de la atención sociosanitaria, tanto en la asistencia domiciliaria como en la asistencia institucionalizada. Material y método: Se obtuvo la opinión de profesionales expertos mediante reuniones semiestructuradas y las opiniones recogidas mediante encuesta después de la sesión de presentación del comité en centros sociosanitarios. Se realizó un estudio exploratorio con un total de 4 grupos de discusión semiestructurados (grupos focales), con la participación de distintos perfiles profesionales de la asistencia domiciliaria e institucionalizada en la atención sociosanitaria con experiencia reconocida. Resultados: Los conflictos más frecuentes y que más inquietud crean a los profesionales de la atención sociosanitaria, la mayoría de ellos comunes, entre los niveles institucional y de atención domiciliaria son la relación entre profesionales, la pertinencia de actividades terapéuticas, la relación con la familia, el respeto por las preferencias del paciente y las derivadas de la gestión de los recursos sociales y organizativos. Conclusiones: La identificación de conflictos éticos mediante estudios exploratorios permite diferenciar los temas con potencial riesgo ético en una especialidad terapéutica como, por ejemplo, la atención sociosanitaria. Que se produzca un conflicto u otro depende, en última instancia, del tipo de asistencia prestada

Objective: The main objective of this study was to identify and classify the most common ethical conflicts faced by health professionals working in outpatient and inpatient services. Material and method: a) Expert opinions gathered through semi-structured meetings; b) opinions gathered through a questionnaire distributed after a presentation by an ethics committee in health and social services' centers; and c) an exploratory study with 4 focus groups in which distinct professionals with recognized experience from home and hospital care services participated. Results: The most frequent conflicts faced by health and social services professionals, most of which were common to outpatient and inpatient care, concerned the relationship among health professionals, the appropriateness of therapeutic activities, the relationship with the patient's family, respect for patients' preferences, and conflicts arising from the management of social resources and organizational issues. Conclusions: Identifying ethical conflicts through exploratory studies allows topics likely to pose ethical dilemmas to be differentiated in a specific therapeutic area such as healthcare. The presence of one type of ethical conflict or another depends on the type of healthcare provided