[Implemented actions in the Spanish National Health System to improve patient safety culture]. / Acciones desarrolladas para avanzar en seguridad del paciente en el Sistema Nacional de Salud español.

BACKGROUND: The Ministry of Health, Consumption and Social Welfare (MHCSW) since 2005 has been promoting, in collaboration with the Autonomous Communities (AC) and the Scientific Societies (SC), among them the Spanish Society for Healthcare Quality (SSHCQ), the Patient Safety Strategy (PSS). PSS 2015-2020 develops relevant aspects of patient safety (PS), such as risk management, reporting and learning systems (RLS), as well as promoting an adequate response when an adverse event (AE) unexpectedly occurs. The present work describes the current situation of the different AC in relation to these topics. MATERIAL AND METHODS: A Descriptive study, based on a survey developed ad hoc within the framework of the agreement between the MHCSW and SSHCQ, was conducted at national level. The questions' topics, prepared by consensus of the work team, considered the implementation of RLS and AE analysis, and legal protection for professionals involved in an AE in the AC. RESULTS: A total of 17 surveys were collected (16 AC and INGESA). All ACs had a RLS, a structure to support PS activities but very heterogeneous. Some ACs had a response plan to an AE and had established a coordination protocol with legal services to support patients and professionals involved in an AE. Some ACs had enacted some laws and regulations to facilitate PS culture. CONCLUSIONS: The ACs have risk management structures that lead the plans in PS, reporting and learning systems and have experience in the analysis of near miss and AE. However, a regulatory change that increases the legal safety of professionals to provide an adequate response to the AEs is a priority. This challenge should involve leaders of health organizations, scientific societies and professional associations, national and regional health authorities as it has been done in other European countries.

[What regulations have launched autonomous communities to going forward on patient safety culture in healthcare organizations?] / ¿Qué normativas han desarrollado las comunidades autónomas para avanzar en cultura de seguridad del paciente en sus organizaciones sanitarias?

INTRODUCTION: Patient Safety Culture is based on learning from incidents, developing preventive strategies to reduce the likelihood to happen and recognizing and accompanying those who have suffered unnecessary and involuntary harm derived from the health care received. To go ahead on patient safety culture entails facilitating the implementation of these behaviors and attitudes in healthcare professionals. Objective was to describe the regulations of some autonomous communities and national proposals for regulations changes. MATERIAL AND METHODS: Search of normative changes made in the autonomous communities of Catalonia, Navarra and the Basque Country. Proposals for legislative changes at national level were agreed. RESULTS: Activities and normative changes made in the autonomous communities of Catalonia, Navarre and the Basque Country are described and proposals for normative changes at the national level at short-term and long-term changes are made. In such a way that it is easier to advance in creating culture of patient safety in the whole National Health System CONCLUSION: Currently there is no global regulation that facilitates to advance in patient safety culture. Changes at the national legislation level are essential. It is at the Inter-territorial Council where the proposed legislative amendment should be defined, promoted by the representatives of the health systems of the autonomous communities.