Definición de indicadores para una atención centrada en el paciente diabético tipo II. Estudio de consenso.

OBJECTIVE: Define a minimum set of indicators for person-focused-care applying for type 2 diabetes mellitus (DM2), as a complementary metric to current clinical-healthcare indicators. METHODS: Qualitative consensus-building study (involving professionals and patients) structured in three stages: Metaplan to capture information, Delphi to agree on criteria and indicators, and consensus conference to ensure feasibility and relevance of the proposal. RESULTS: Consensus was reached on a total of nine indicators upon: shared decision-making, self-care, adherence, renal function screening, activities of daily living, individualized therapeutic plan, vascular risk assessment, working life and human treatment. These indicators were grouped into three dimensions: the person with oneself, the person with one's family, and the person with the health system. CONCLUSIONS: These indicators make it possible to establish alternative metrics to determine the degree of progress in a person-centered attention in case of DM2.

Healthcare accreditation as trigger of organisational change: The view of professionals.

BACKGROUND: Healthcare accreditation seeks to promote the organisational change in healthcare organisations from an approach that values the level of progress achieved through a validated reference framework. The aim of this paper is to analyse the role played by accreditation through the experience perceived by health professionals during the process of self-assessment and external evaluation, taking into account three dimensions of analysis: focus on the patient, internal organisation and leadership, and impact on the clinical aspects of healthcare. MATERIAL AND METHODS: Design: Semi-structured interviews with key informants from clinical management units (CMU) within the Andalusian Health System (Spain). PARTICIPANTS: The key informants in each CMU were the clinical leader, the head of nursing and two health professionals (doctors and nurses). A qualitative research protocol was employed to conduct the semi-structured interviews (n=52 interviews) with physicians and nurses, in order to analyse their experience with the accreditation process. RESULTS: The analysis identified four main outcomes related to the accreditation process perceived by professionals: (1) A benchmarking conceptualisation of the process; (2) Improvements in patient-centred care, quality of clinical records, and organisational culture of the units; (3) Improvement of patient safety culture; (4) As negative outcomes, a slight perception of bureaucratisation and standardisation of the clinical practice. CONCLUSIONS: The described initiative of accreditation process in Andalusia (Spain) is widely perceived as positive by health professionals since it fosters the organisational change, although it also has a slightly negative bureaucratisation effect on clinical practice.

Proceso de atención al paciente con urticaria aguda y crónica. Documento de consenso de la sección territorial andaluza de la Academia Española de Dermatología y Venereología / Clinical Pathway for Patients with Acute or Chronic Urticaria: A Consensus Statement of the Andalusian Section of the Spanish Academy of Dermatology and Venereology (AEDV)

La incorporación de nuevos fármacos al arsenal terapéutico, la actualización de las guías de práctica clínica y los hallazgos fisiopatológicos recientemente comunicados hacen que el manejo y conocimiento de la urticaria sea un tema de candente actualidad. La Sección territorial andaluza de la AEDV ha desarrollado un proceso de atención en el que se describen el recorrido del paciente, las características de calidad de las actuaciones y las recomendaciones para la toma de decisiones en los pacientes con urticaria. Presentamos un enfoque centrado en el paciente, y en el que se muestra su devenir en el sistema sanitario y la interrelación entre la atención primaria y hospitalaria, garantizando un punto clave, su continuidad asistencial

Attention has been focused on new ways to understand and manage urticaria ever since the recent addition of novel drugs to the therapeutic arsenal, the updating of clinical practice guidelines, and the publication of pathophysiologic insights. The Andalusian Section of the Spanish Academy of Dermatology and Venereology (AEDV) has developed a clinical pathway that defines quality-of-care characteristics and makes recommendations on decision-making affecting patients with urticaria. We present a patient-centered approach to care, in which the patient's clinical pathway through the health care system includes links between primary and hospital care to ensure continuity a key feature of quality

Proceso de atención a las personas con lesiones quísticas y tumorales benignas. Documento de consenso de la sección territorial andaluza de la Academia Española de Dermatología Médico-Quirúrgica y Venereología / Process of Care for Patients With Benign Cysts and Tumors: Consensus Document of the Andalusian Regional Section of the Spanish Academy of Dermatology and Venereology (AEDV)

Las lesiones cutáneas benignas representan un motivo de consulta frecuente, tanto en atención primaria como en las consultas de dermatología. Sin embargo, existe una amplia variabilidad en el acceso de los usuarios al diagnóstico y tratamiento de las lesiones cutáneas benignas, debido principalmente a que no se establecieron criterios explícitos y homogéneos para el abordaje de los pacientes con lesiones benignas. Con el objetivo principal de reducir la variabilidad en la atención a las personas con lesiones quísticas o tumorales benignas la Sección Territorial Andaluza de la AEDV ha desarrollado un proceso de atención en el que se describen el recorrido del paciente, las características de calidad de las actuaciones y las recomendaciones para la toma de decisiones en este tipo de lesiones

Benign skin lesions are a common reason for visits to primary care physicians and dermatologists. However, access to diagnosis and treatment for these lesions varies considerably between users, primarily because no explicit or standardized criteria for dealing with these patients have been defined. Principally with a view to reducing this variability in the care of patients with benign cysts or tumors, the Andalusian Regional Section of the Spanish Academy of Dermatology and Venereology (AEDV) has created a Process of Care document that describes a clinical pathway and quality-of-care characteristics for each action. This report also makes recommendations for decision-making with respect to lesions of this type

Process of Care for Patients With Benign Cysts and Tumors: Consensus Document of the Andalusian Regional Section of the Spanish Academy of Dermatology and Venereology (AEDV). / Proceso de atención a las personas con lesiones quísticas y tumorales benignas. Documento de consenso de la sección territorial andaluza de la Academia Española de Dermatología Médico-Quirúrgica y Venereología.

Benign skin lesions are a common reason for visits to primary care physicians and dermatologists. However, access to diagnosis and treatment for these lesions varies considerably between users, primarily because no explicit or standardized criteria for dealing with these patients have been defined. Principally with a view to reducing this variability in the care of patients with benign cysts or tumors, the Andalusian Regional Section of the Spanish Academy of Dermatology and Venereology (AEDV) has created a Process of Care document that describes a clinical pathway and quality-of-care characteristics for each action. This report also makes recommendations for decision-making with respect to lesions of this type.

Clinical Pathway for Patients with Acute or Chronic Urticaria: A Consensus Statement of the Andalusian Section of the Spanish Academy of Dermatology and Venereology (AEDV). / Proceso de atención al paciente con urticaria aguda y crónica. Documento de consenso de la sección territorial andaluza de la Academia Española de Dermatología y Venereología.

Attention has been focused on new ways to understand and manage urticaria ever since the recent addition of novel drugs to the therapeutic arsenal, the updating of clinical practice guidelines, and the publication of pathophysiologic insights. The Andalusian Section of the Spanish Academy of Dermatology and Venereology (AEDV) has developed a clinical pathway that defines quality-of-care characteristics and makes recommendations on decision-making affecting patients with urticaria. We present a patient-centered approach to care, in which the patient's clinical pathway through the health care system includes links between primary and hospital care to ensure continuity-a key feature of quality.

Evaluación y aprendizaje del 27 Congreso de la Sociedad Española de Calidad Asistencial / Assessment and learning from the 27th Conference of the Spanish Society for quality in healthcare

Objetivo. Analizar los resultados del 27 Congreso de la Sociedad Española de Calidad Asistencial (SECA) celebrado en Sevilla (octubre de 2009). Material y método. Estudio descriptivo, retrospectivo, utilizando como fuente de información la base de datos de los comités del congreso. Población. Todas las comunicaciones recibidas (1.231). Evaluación de las comunicaciones por 36 parejas de evaluadores mediante criterios explícitos puntuables y asignación como experiencias o comunicaciones electrónicas. La satisfacción de los participantes en el congreso y en los talleres fue evaluada mediante un cuestionario anónimo. Resultados. Se aceptaron 1.213 comunicaciones. La puntuación media del total de comunicaciones aceptadas fue de 6,38±0,95 puntos. Las experiencias tienen una puntuación media de 7,55±0,41 puntos, mientras que las comunicaciones electrónicas tienen una puntuación media de 6,26±0,9 puntos. En cifras absolutas son Andalucía y Cataluña las comunidades autónomas que más comunicaciones presentaron (557 y 140, respectivamente) aunque, tras el cálculo de la tasa por millón de habitantes, la Región de Murcia (76,43) y Andalucía (67,91) obtuvieron las cifras más elevadas. Conclusiones. La evaluación de comunicaciones y la organización de un congreso de ámbito nacional son un proceso metodológicamente complejo. La rendición de cuentas de las acciones y decisiones realizadas por los Comités Organizador y Científico son un requisito ético de transparencia(AU)

Objective. To analyse the results of the 27th Conference of the Spanish Society for Quality in Health Care (SECA) held in Seville (October 2009). Material and methods. A retrospective descriptive study was conducted using the conference databases. Population. All abstracts received (1231). 36 pairs of reviewers using explicit criteria evaluated abstracts and assignment as Experiences or Electronic Communications. Participant satisfaction in the Conference and Workshops was evaluated by an anonymous questionnaire. Results. A total of 1213 communications were accepted. The average score of accepted abstracts was 6.38±0.95 points. Experiences had an average score of 7.55±0.41 points, while Electronic Abstracts had an average score of 6.26±0.9 points. Andalusia (557) and Catalonia (140) had the highest amount of abstracts in the Conference, but Murcia and Andalusia obtained the highest rates per million inhabitants. Conclusions. The assessment of abstracts and organising a national conference are methodologically complex processes. Accountability for actions and decisions made by the Organising and Scientific Committees are an ethical requirement of transparency(AU)

[Assessment and learning from the 27th Conference of the Spanish Society for quality in healthcare]. / Evaluación y aprendizaje del 27 Congreso de la Sociedad Española de Calidad Asistencial.

OBJECTIVE: To analyse the results of the 27th Conference of the Spanish Society for Quality in Health Care (SECA) held in Seville (October 2009). MATERIAL AND METHODS: A retrospective descriptive study was conducted using the conference databases. POPULATION: All abstracts received (1231). 36 pairs of reviewers using explicit criteria evaluated abstracts and assignment as Experiences or Electronic Communications. Participant satisfaction in the Conference and Workshops was evaluated by an anonymous questionnaire. RESULTS: A total of 1213 communications were accepted. The average score of accepted abstracts was 6.38 ± 0.95 points. Experiences had an average score of 7.55 ± 0.41 points, while Electronic Abstracts had an average score of 6.26 ± 0.9 points. Andalusia (557) and Catalonia (140) had the highest amount of abstracts in the Conference, but Murcia and Andalusia obtained the highest rates per million inhabitants. CONCLUSIONS: The assessment of abstracts and organising a national conference are methodologically complex processes. Accountability for actions and decisions made by the Organising and Scientific Committees are an ethical requirement of transparency.