Benchmarking estratégico aplicado a la gestión de riesgos asistenciales en Quirónsalud / No disponible

INTRODUCCIÓN: La metodología del benchmarking estratégico aplicado a la gestión de riesgos comenzó a utilizarse en el año 2016 en la Compañía Quirónsalud y fue el punto de partida para la implantación de los objetivos de calidad asistencial y de seguridad del paciente. OBJETIVO GENERAL: Realizar un seguimiento continuo y sistemático de las líneas estratégicas marcadas en la Estrategia de Seguridad del Paciente y evaluar su grado de cumplimiento. METODOLOGÍA: Mediante un análisis de debilidades, amenazas, fortalezas y oportunidades (DAFO), se identificaron 17 riesgos, para los que se establecieron objetivos e indicadores. Se utilizó la información disponible en el Conjunto Mínimo Básico de Datos (CMBD) y los indicadores definidos por la Agency for Healthcare Research and Quality (AHRQ), los indicadores de calidad de la hospitalización del grupo Helios (EIQI ́s) y el indicador de cirugía precoz en fractura de cadera de la Organización para la Cooperación y el Desarrollo Económico (OCDE). También se incorporaron los indicadores en el Observatorio de Resultados del Servicio Madrileño de Salud (SERMAS) y los de la Central de Resultados del Servicio Catalán de Salud (CatSalut). RESULTADOS: Entre los resultados obtenidos en 2019 cabe destacar el porcentaje de hospitales que han experimentado una mejora continuada en los indicadores. Implantación de rondas de seguridad trimestrales con participación de la dirección >90%. El % Checklists en cirugía programada >85%. El % de pacientes ingresados con registro de la 5ª constante > 79%. El % de intervenciones por fractura de cadera a las 48h tras ingreso > 78%.Los porcentajes de compromiso (abordaje del objetivo) y de cumplimiento (alcanzar la meta corporativa o superar lo pactado con la Dirección Corporativa) de los indicadores, han experimentado un crecimiento progresivo en los últimos años situándose en 2019 en un 94% y en un 85% respectivamente. CONCLUSIONES: El benchmarking estratégico mejora la eficacia en la gestión de riesgos asistenciales porque permite realizar análisis comparados, identificar y compartir buenas prácticas e introduce el elemento de competencia entre los hospitales promoviendo el compromiso con la estrategia

INTRODUCTION: The strategic benchmarking methodology applied to risk management began to be applied at Quirónsalud Company in 2016. This was the starting point for the implementation of the Company's healthcare quality objectives, including the patient safety objectives. GENERAL OBJECTIVE: To assess the degree to which Quirónsalud facilities comply with the strategy lines set forth in the group-wide patient-safety strategy program. METHODS: Through an analysis of strengths, weaknesses, opportunities and threats (SWOT), 17 threats were identified. This were used to set company-wide targets and indicators. The set of quality indicators were obtained from the information available in the minimum basic data set (MBDS), the indicators defined by the Agency for Healthcare Research and Quality (AHRQ), the hospital-quality indicators of the Helios group (EIQI ́s) and the early hip fracture surgery indicator of the Organization for Economic Co-operation and Development (OECD). In addition, some of the indicators included in the Observatorio de Resultados del Servicio Madrileño de Salud (SERMAS) and the Central de Resultados de Servicio Catalán de Salud (CatSalut) were also incorporated. RESULTS: Among the results obtained in year 2019, the percentage of hospitals that have experienced continuous improvement in the indicators should be highlighted. Implementation of quarterly executive walkarounds > 90%. The % of checklists used in elective surgery > 85%. The % of inpatients evaluated for the 'Fifth Vital Sign' > 79%. The % of hip-fracture surgeries performed within 48h of admission > 78%.There has been a progressive increase over recent years in the degree of commitment to (target approach) and fulfillment (achieve the corporate goal or exceed what was agreed with the Corporate Management) of indicators (94% and 85%, respectively).CONCLUSIONS: Strategic benchmarking improves effective management of care-related risks by allowing comparative analysis, enabling organizations to identify and share best practices, and by introducing an element of competition between hospitals, thereby driving commitment to organization-wide strategy

ROS-Induced JNK and p38 Signaling Is Required for Unpaired Cytokine Activation during Drosophila Regeneration.

Upon apoptotic stimuli, epithelial cells compensate the gaps left by dead cells by activating proliferation. This has led to the proposal that dying cells signal to surrounding living cells to maintain homeostasis. Although the nature of these signals is not clear, reactive oxygen species (ROS) could act as a signaling mechanism as they can trigger pro-inflammatory responses to protect epithelia from environmental insults. Whether ROS emerge from dead cells and what is the genetic response triggered by ROS is pivotal to understand regeneration of Drosophila imaginal discs. We genetically induced cell death in wing imaginal discs, monitored the production of ROS and analyzed the signals required for repair. We found that cell death generates a burst of ROS that propagate to the nearby surviving cells. Propagated ROS activate p38 and induce tolerable levels of JNK. The activation of JNK and p38 results in the expression of the cytokines Unpaired (Upd), which triggers the JAK/STAT signaling pathway required for regeneration. Our findings demonstrate that this ROS/JNK/p38/Upd stress responsive module restores tissue homeostasis. This module is not only activated after cell death induction but also after physical damage and reveals one of the earliest responses for imaginal disc regeneration.