Benchmarking en el proceso de urgencias entre siete hospitales de diferentes comunidades autónomas / Benchmarking in the emergency unit process in 7 hospitals from different autonomous communities

Objetivo. Identificar y compartir los mejores resultados entre hospitales respecto al proceso de atención de urgencias, detectar las prácticas que expliquen las diferencias e identificar buenas prácticas. Material y método. Ámbito: 7 hospitales de diferentes comunidades autónomas. Periodo de estudio: 2005-2007. Se definieron los criterios de comparabilidad asegurando la homotecia. Se seleccionaron 11 criterios, y se establecieron 7 indicadores para comparar los hospitales, analizándose los datos de los últimos 3 años, estableciendo el benchmark (servicio con los mejores resultados) entre los centros. Se elaboró un cuestionario sobre el proceso, sobre las etapas, los resultados y los procedimientos usados en cada etapa del proceso en cada centro. Resultados. Se ha comprobado la homotecia entre los 7 hospitales, identificándose algunas diferencias entre centros. Se han analizado 7 indicadores, correspondiendo a 1.526.890 pacientes atendidos en el periodo de estudio. Se ha identificado un benchmark, con los mejores resultados en 4 de los indicadores: porcentaje de ingresos desde urgencias del 8,3%, presión de urgencias del 56,14%, tiempo de estancia en urgencias, 2h y 20min, y porcentaje de pacientes con estancia de más de 24h, 0,05%. Se han analizado las diferencias en las etapas del proceso, los recursos y procedimientos utilizados en cada etapa en el centro benchmark con el resto que puedan explicar mejores resultados. Conclusiones. Se ha establecido un conjunto de indicadores para identificar el benchmark entre los servicios de urgencias. Con dichos indicadores se ha establecido el benchmark(AU)

Objective. To identify and to share the results among hospitals regarding the process of attention at the Emergency Unit, and to detect the practices that explain the differences. Material and method. Setting: 7 hospitals of different regions in Spain. Period of study: 2005-2007. Firstly the comparability criteria were defined assuring the homotecia in the «emergency process». In order to fulfil the study objectives, 11 criteria were selected and every center sent the information of each one. 7 indicators were identified to compare hospitals processes’. Data regarding all the attentions provided during the study period was analyzed, establishing the benchmark among the centers. Finally, a questionnaire was elaborated for the process analysis, considering all the stages of the process, the resources and the procedures used in every stage, to be fulfilled in each hospital. Results. The homotecia has been verified in the 7 hospitals, with some differences between centers. 7 indicators have been analyzed in the different hospitals, corresponding to 1 526 890 patients attended in the study period. A benchmark has been identified, with the best results in four of seven indicators: % of admissions from urgencies: 8.3%, emergency pressure: 56.14%, emergency length of stay: 2 hs 20min, and % of patients with length stay > 24h: 0.05%. Differences between the stages of the process, resources and procedures used in every stage in the benchmark center have been analyzed. Conclusions. A set of indicators to compare Emergency Departments has been identified, letting us establish the benchmark(AU)

[Benchmarking in the emergency unit process in 7 hospitals from different autonomous communities]. / Benchmarking en el proceso de urgencias entre siete hospitales de diferentes comunidades autónomas.

OBJECTIVE: To identify and to share the results among hospitals regarding the process of attention at the Emergency Unit, and to detect the practices that explain the differences. SETTING: 7 hospitals of different regions in Spain. PERIOD OF STUDY: 2005-2007. Firstly the comparability criteria were defined assuring the homotecia in the «emergency process¼. In order to fulfil the study objectives, 11 criteria were selected and every center sent the information of each one. 7 indicators were identified to compare hospitals processes'. Data regarding all the attentions provided during the study period was analyzed, establishing the benchmark among the centers. Finally, a questionnaire was elaborated for the process analysis, considering all the stages of the process, the resources and the procedures used in every stage, to be fulfilled in each hospital. RESULTS: The homotecia has been verified in the 7 hospitals, with some differences between centers. 7 indicators have been analyzed in the different hospitals, corresponding to 1,526,890 patients attended in the study period. A benchmark has been identified, with the best results in four of seven indicators: % of admissions from urgencies: 8.3%, emergency pressure: 56.14%, emergency length of stay: 2 hs 20min, and % of patients with length stay > 24h: 0.05%. Differences between the stages of the process, resources and procedures used in every stage in the benchmark center have been analyzed. CONCLUSIONS: A set of indicators to compare Emergency Departments has been identified, letting us establish the benchmark.

Rotura uterina espontánea a las 15 semanas de gestación por percretismo placentario / Spontaneous uterine rupture at 15 weeks of gestation due to placenta percreta

Se han descrito pocos casos de placenta percreta durante el primer y el segundo trimestres de la gestación. Presentamos un caso de rotura y hemorragia uterina grave durante el segundo trimestre de gestación con diagnóstico histológico de placenta percreta (AU)