[Quality control systems implementation in the Spanish Dialysis Units]. / Implantación de sistemas de gestión de calidad en las unidades de nefrología españolas.

OBJECTIVE: The aim of this study was to evaluate and analyze the implementation of a Quality Management Systems (QMS) and the use of Clinical Performance measures by the Nephrology Services and Hemodialysis Units in Spain. METHOD: The Quality Management Work Group of the Spanish Society of Nephrology (SEN) realized a survey that was directed to all the Spanish Nephrology Services and Hemodialysis Units. No exclusion criteria were defined for the study. The survey was based on a multichotomous self completing "Ad Hoc" questionnaire. RESULTS: The survey was answered by 46.7% of the polled centers (44.5% were public hospitals and 55.5% private centers). Of those replying the survey 70 % had a QMS, with a higher implementation in the area of Hemodialysis (HD). The ISO 9001-2000 was the prefer QMS model chosen by 76.4% of the centers. 68.6% of the centers with a QMS were certified by an external Auditing Group. 91.7% of the Nephrology Services and Hemodialysis units were using some clinical practice guideline. A high percentage of the centers had medical protocols and nursing plans (> 90%). A significantly higher implementation of QMS was observed in Private Hospitals and Hemodialysis Units (88.8 %) when compared to public Hospitals (46.1%) (X2: 31.5; p < 0.001). The ISO 9000 Standard certification was selected by 78,3% of the private centers and by 21,7% of the public centers (X2: 37.3; p < 0.001). The certification or accreditation were done by an external auditing group in 68. 1% of the private centers compared to 31.9% for the public Hospitals (X2: 24.8; p < 0.001). Although the rate of answers prevents from extracting definitive conclusions, the result seems to indicate that in the Spanish Nephrology Community a clear trend exists towards the use QMS. This tendency suggests, that in the near future, there will be a progressive implementation and routine use of QMS in the Nephrology Community in Spain.