FUMEPOC: early detection of chronic obstructive pulmonary disease in smokers.

BACKGROUND: Currently is not feasible using conventional spirometry as a screening method in Primary Care especially among smoking population to detect chronic obstructive pulmonary disease in early stages. Therefore, the FUMEPOC study protocol intends to analyze the validity and reliability of Vitalograph COPD-6 spirometer as simpler tool to aid screening and diagnosis of this disease in early stages in primary care surgery. STUDY DESIGN: An observational, descriptive study of diagnostic tests, undertaken in Primary Care and Pneumology Outpatient Care Centre at San Juan Hospital and Elda Hospital. All smokers attending the primary care surgery and consent to participate in the study will undergo a test with Vitalograph COPD-6 spirometer. Subsequently, a conventional spirometry will be performed in the hospital and the results will be compared with those of the Vitalograph COPD-6 test. DISCUSSION: It is difficult to use the spirometry as screening for early diagnose test in real conditions of primary care clinical practice. The use of a simpler tool, Vitalograph COPD-6 spirometer, can help in the early diagnose and therefore, it could improve the clinical management of the disease.

Gestión de riesgos desde la visión de la gestión hospitalaria / Risk management from the point of view of hospital administration

Los efectos o acontecimientos adversos (EA) son en parte evitables. Sólo un reconocimiento de sus posibles causas permite adoptar estrategias eficaces en su disminución. Entre las causas de los EA están la complejidad de los procesos asistenciales, la evolución de la tecnología en lo referente a métodos de diagnóstico y tratamiento, las dificultades en la declaración de casos y una merma en las políticas de gestión orientadas a la seguridad. Se propone que la mesogestión (entendida como eslabón intermedio entre las políticas sanitarias y la gestión clínica) establezca medidas orientadas a la disminución de los EA mediante: la orientación de la organización a los procesos y más concretamente al paciente, las mejoras en los sistemas de información vertical y transversal, el apoyo del principio de autonomía del paciente reconocido en la Ley, la activación de mecanismos de seguridad y la búsqueda de soluciones en la poco explotada relación entre el mundo sanitario y el mundo jurídico

Adverse effects or events (AE) are partly avoidable. Only identification of their possible causes can allow effective strategies to be adopted to reduce them. Among these causes are the complexity of the healthcare processes, the development of technology for methods of diagnosis and treatment, difficulties in the reporting of cases, and the reduction in safety-oriented management policies. We propose that meso-management (defined as an intermediate link between health policy and clinical management) should establish measures aimed at decreasing AE through: orienting the organization to processes and more specifically to the patient, improving vertical and transversal information systems, supporting the principle of patient autonomy, which is recognized by law, activating safety mechanisms, and searching for solutions in the little exploited relationship between the health sector and the legal world