Proyecto de mejora del Proceso de Atención Continuada domiciliaria en Atención Primaria: rediseño y AMFE / Improving the continuous care process in primary care during weekends and holidays. Redesigning and FMEA

Objetivo. Describir el proyecto de mejora aplicado al proceso de atención continuada (ATC) de sábados y festivos en el Área 4 de Atención Primaria (AP) de Madrid, para garantizar una atención segura y libre de fallos en los cuidados domiciliarios de los fines de semana. Material y método. El proceso de ATC se identificó como de riesgo por la Unidad Funcional de Gestión de Riesgos (UFGR) del Área, además presentaba quejas: de las enfermeras que realizan la atención y de pacientes. En 2009 se realiza un DAFO (debilidades, amenazas, fortalezas y oportunidades) que evidenció problemas. Posteriormente se diseña un proyecto de mejora que se desarrolla en las fases: 1. Rediseño y mejora del proceso. 2. Aplicación AMFE al nuevo proceso. 3. Pilotaje. 4. Formación a las enfermeras. 5. Implantación en todo el Área. 6. Encuesta de satisfacción a las enfermeras de ATC. Resultados. El rediseño del proceso, proporcionó mejoras como la automatización y aumento de la eficiencia. Posteriormente a la implantación de las medidas de mejora, no se han producido nuevas reclamaciones de pacientes y ha mejorado la satisfacción de las enfermeras de ATC medida a través de encuesta. Al aplicar el AMFE se priorizaron fallos y se pusieron en marcha acciones de mejora. Conclusiones. La mejora del proceso y sobre todo su automatización, ha sido un gran avance para mejorar la seguridad. El AMFE nos ha resultado una herramienta útil y práctica que ha permitido implantar importantes acciones, igualmente se ha conseguido mejorar la satisfacción de las enfermeras que realizan la ATC(AU)

Objective. To describe a project carried out in order to improve the process of Continuous Health Care (CHC) on Saturdays and bank holidays in Primary Care, area number 4, Madrid. The aim of this project was to guarantee a safe and error-free service to patients receiving home health care on weekends. Materials and method. The urgent need for improving CHC process was identified by the Risk Management Functional Unit (RMFU) of the area. In addition, some complaints had been received from the nurses involved in the process as well as from their patients. A SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis performed in 2009 highlighted a number of problems with the process. As a result, a project for improvement was drawn up, to be implemented in the following stages: 1. Redesigning and improving the existing process. 2. Application of failure mode and effect analysis (FMEA) to the new process. 3. Follow up, managing and leading the project. 4. Nurse training. 5. Implementing the process in the whole area. 6. CHC nurse satisfaction surveys. Results. After carrying out this project, the efficiency and level of automation improved considerably. Since implementation of the process enhancement measures, no complaints have been received from patients and surveys show that CHC nurse satisfaction has improved. Results. By using FMEA, errors were given priority and enhancement steps were taken in order to: Inform professionals, back-up personnel and patients about the process. Improve the specialist follow-up report. Provide training in ulcer patient care. Conclusion. The process enhancement, and especially its automation, has resulted in a significant step forward toward achieving greater patient safety. FMEA was a useful tool, which helped in taking some important actions. Finally, CHC nurse satisfaction has clearly improved(AU)

[Improving the continuous care process in primary care during weekends and holidays: redesigning and FMEA]. / Proyecto de mejora del Proceso de Atención Continuada domiciliaria en Atención Primaria: rediseño y AMFE.

OBJECTIVE: To describe a project carried out in order to improve the process of Continuous Health Care (CHC) on Saturdays and bank holidays in Primary Care, area number 4, Madrid. The aim of this project was to guarantee a safe and error-free service to patients receiving home health care on weekends. MATERIALS AND METHOD: The urgent need for improving CHC process was identified by the Risk Management Functional Unit (RMFU) of the area. In addition, some complaints had been received from the nurses involved in the process as well as from their patients. A SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis performed in 2009 highlighted a number of problems with the process. As a result, a project for improvement was drawn up, to be implemented in the following stages: 1. Redesigning and improving the existing process. 2. Application of failure mode and effect analysis (FMEA) to the new process. 3. Follow up, managing and leading the project. 4. Nurse training. 5. Implementing the process in the whole area. 6. CHC nurse satisfaction surveys. RESULTS: After carrying out this project, the efficiency and level of automation improved considerably. Since implementation of the process enhancement measures, no complaints have been received from patients and surveys show that CHC nurse satisfaction has improved. By using FMEA, errors were given priority and enhancement steps were taken in order to: Inform professionals, back-up personnel and patients about the process. Improve the specialist follow-up report. Provide training in ulcer patient care. CONCLUSION: The process enhancement, and especially its automation, has resulted in a significant step forward toward achieving greater patient safety. FMEA was a useful tool, which helped in taking some important actions. Finally, CHC nurse satisfaction has clearly improved.