[Synthetic indicator of compliance with standards for Quality Units of health centers and multicenter prospective pilot study]. / Indicador sintético de cumplimiento de estándares para Unidades de Calidad de centros sanitarios y estudio de pilotaje prospectivo multicéntrico.

BACKGROUND AND OBJECTIVE: In Spain, Quality Units play a key and unique role in advising healthcare centers on the methodology of healthcare quality. The objectives of the study were to develop computer algorithms to obtain a synthetic indicator of standard compliance for Quality Units and to pilot its functioning in these units. MATERIALS AND METHODS: The Excel program was used to establish evaluation algorithms, and quantitatively interrelate and weight various categories of standards, as a computer evaluation tool, to build a continuous improvement cycle system, and offer a global synthetic indicator of compliance. The tool was tested in a prospective multicenter pilot study, in which coordinators of Quality Units from different health centers and care settings participated, to evaluate the usefulness of the tool and compliance with the standards, in addition to analyzing the content validity of each standard. RESULTS: The formulas for the structured computer algorithms were developed, consecutively, in a «PLAN-DO-CHECK-ACT¼ improvement cycle for the 9 categories of standards, resulting in a single synthetic indicator of compliance. Twenty-one Quality Units participated in the piloting. The overall average compliance rate for the synthetic indicator was 55.63% with differences between centers (P=.002) and between categories (P<.0001), but not by autonomous communities (P=.86) or by areas (P=.97). Content validity was ensured through the variable of «understanding¼ of the standards (P<.001), and through their «justification¼ with documentary evidence (P<.001). CONCLUSIONS: The computer tool with the synthetic indicator have allowed for the evaluation of standard compliance in Quality Units of healthcare centers.

[Development and validation of standards for quality units of health centers]. / Desarrollo y validación de estándares para unidades de calidad de centros sanitarios.

OBJECTIVE: In Spain, the Quality Units advise health centres, services and professionals on the methodology of continuous improvement of the quality of care. A system based on good practice standards could provide these units with a tool to improve their results and value their work. The objective was to develop, agree on and validate standards, to properly guide and orient the functions, results and continuous improvement of the Quality Units in health centers. MATERIAL AND METHODS: A qualitative-quantitative, prospective and cross-sectional study was carried out, applying the Metaplan method, the e-Delphi technique and a simulation study. The participants were coordinators of these units, belonging to 14 Spanish Autonomous Communities and distributed in four experts' panels. They agreed on the standards to be used and evaluated the different types of validity. RESULTS: The 204 standards proposed by the scientific committee were reduced to 157 with Metaplan, to 110 with e-Delphi, and to 96 with the committee's final review (87.3% consensus, content validity). The construct validity showed a Cronbach's alpha >0.7 (P<.001); the validity of content was reaffirmed in the simulation workshop (80% "understood" each other, P<.001; and there was "documentary evidence" in 84%, P<.001); face validity was accepted (75% "related to quality dimensions", P<.001); and the validity of the criteria was verified with a sensitivity of 84.2%, a specificity of 98.3%, and a kappa index of 0.84. CONCLUSIONS: Valid standards have been developed for Quality Units in health centers.

[Influence of physical activity on radiotherapy-treated breast cancer patients: A systematic review]. / Influencia del ejercicio físico sobre los síntomas de la radioterapia en pacientes con cáncer de mama: revisión sistemática.

INTRODUCTION: The number of survivors with cancer is growing worldwide, but the adverse effects of the radiotherapy are still frequent, affecting effort capacity, respiratory function and quality of life. The objective is to know how the physical exercise influences the respiratory function and tolerance to effort, in pacients with breast cancer after the radiotherapy treatment. MATERIALS AND METHODS: The searches were carried out in the databases of Pubmed, PEDro, Web Of Science, Cochrane, EMBASE, UptoDate and Tripdatabase. Were included studies with patients with breast cancer treated with radiotherapy and included in an exercise program. The main results were: maximum oxygen consumption, 6 minutes walking test, forced vital capacity, vital capacity, forced expiratory volume in 1 second, total lounge capacity, inspiratory capacity, and the diffusion capacity of the lungs for carbon monoxide. RESULTS: The results show an increase of the effort capacity with 15% improvements in the maximum oxygen consumption and 6.675% in the 6 minutes walking test, while they are limited for the respiratory function. CONCLUSIONS: The physical exercise is effective for improve the effort capacity in pacients with breast cancer treated with radiotherapy, without changes in the respiratory function. Nevertheless, new studies are necessary to investigate deeply how the physical exercise influences in those pacients, and the ideal design of the programs.

[Proposals by the Spanish Society of Quality in Healthcare (SECA) for the recovery of the National Health Service after the COVID-19 pandemic]. / Propuestas de la SECA para la recuperación del Sistema Nacional de Salud tras la pandemia por SARS-CoV-2.

BACKGROUND: The SARS-CoV-2 pandemic has demanded responses for which the National Health System (NHS) was not prepared. The Spanish Society for Quality in Healthcare (SECA) has the mission of promoting quality in healthcare and contributing to its proper functioning. OBJECTIVE: To present SECA recommendations to ensure the quality and safety of patients in the recovery of the NHS following the impact of the SARS-CoV-2 pandemic and the possibility of a resurgence. METHODS: Qualitative study to seek consensus with the participation of 49 representatives of the different stakeholders (patients, managers, professionals, academics and researchers). The areas to be explored were: lessons learned, management of new care demands from COVID-19 patients, recompositing of templates, strengthening the resilience of professionals, new role of patients and contingency plans. RESULTS: Four hundred and twenty-eight proposals were submitted. Once duplicates were deleted and similar proposals were merged, their number was reduced to 120. Of these, 60 proposals were prioritized and grouped into two categories of measures: (1) to recover the Health System (equity, accessibility, effectiveness, efficiency, safety, patient experience and work morale) and (2) to deal with possible outbreaks. CONCLUSION: SECA responds to its commitment to society with recommendations to ensure quality of healthcare and patient safety in the COVID-19 Era.

Propuestas de la SECA para la recuperación del Sistema Nacional de Salud tras la pandemia por SARS-CoV-2 / Proposals by the Spanish Society of Quality in Healthcare (SECA) for the recovery of the National Health Service after the COVID-19 pandemic

JUSTIFICACIÓN: La pandemia por SARS-CoV-2 ha exigido respuestas para las que el Sistema Nacional de Salud (SNS) no estaba preparado. La Sociedad Española de Calidad Asistencial (SECA) tiene la misión de impulsar la calidad en el ámbito sanitario y de contribuir a su adecuado funcionamiento. OBJETIVO: Presentar recomendaciones de la SECA para asegurar la calidad y la seguridad de los pacientes en la recuperación del SNS tras el impacto de la pandemia por SARS-CoV-2 y ante la posibilidad de un rebrote. MÉTODO: Estudio cualitativo de búsqueda de consenso con participación de 49 representantes de los diferentes grupos de interés (pacientes, directivos, profesionales, académicos e investigadores). Las áreas a explorar fueron: lecciones aprendidas, gestión de nuevas demandas asistenciales de pacientes COVID-19, recomposición de plantillas, fortalecimiento de la resiliencia de los profesionales, nuevo rol del paciente y planes de contingencia. RESULTADOS: Se aportaron 428 recomendaciones. Una vez eliminadas las duplicidades y unificado similitudes se redujeron a 120. De estas, se priorizaron 60 recomendaciones que fueron agrupadas en 2 bloques: 1) para la recuperación del SNS (equidad, accesibilidad, efectividad, eficiencia, seguridad, experiencia de pacientes y moral laboral) y 2) para afrontar posibles rebrotes. CONCLUSIÓN: La SECA responde a su compromiso con la sociedad con recomendaciones para asegurar la calidad y seguridad de pacientes en la era COVID-19

BACKGROUND: The SARS-CoV-2 pandemic has demanded responses for which the National Health System (NHS) was not prepared. The Spanish Society for Quality in Healthcare (SECA) has the mission of promoting quality in healthcare and contributing to its proper functioning. OBJECTIVE: To present SECA recommendations to ensure the quality and safety of patients in the recovery of the NHS following the impact of the SARS-CoV-2 pandemic and the possibility of a resurgence. METHODS: Qualitative study to seek consensus with the participation of 49 representatives of the different stakeholders (patients, managers, professionals, academics and researchers). The areas to be explored were: lessons learned, management of new care demands from COVID-19 patients, recompositing of templates, strengthening the resilience of professionals, new role of patients and contingency plans. RESULTS: Four hundred and twenty-eight proposals were submitted. Once duplicates were deleted and similar proposals were merged, their number was reduced to 120. Of these, 60 proposals were prioritized and grouped into two categories of measures: (1) to recover the Health System (equity, accessibility, effectiveness, efficiency, safety, patient experience and work morale) and (2) to deal with possible outbreaks. CONCLUSION: SECA responds to its commitment to society with recommendations to ensure quality of healthcare and patient safety in the COVID-19 Era

Estudio descriptivo de la incapacidad temporal en el sector sanitario de Cataluña (2009-2012) / Descriptive study of sickness absence in the health care sector of Catalonia (2009-2012)

Objetivo: Describir la incidencia y evolución de la incapacidad temporal (IT) por contingencias comunes y profesionales en la población trabajadora de los centros sanitarios de Cataluña. Métodos: La población de estudio estuvo constituida por los 25.964 trabajadores de 30 centros sanitarios de Cataluña, durante el período 2009-2012. La información sobre los episodios de IT se obtuvo de los registros de las Direcciones de Recursos Humanos. Se definieron unos indicadores de IT, y se calcularon las tasas de incidencia de IT y la evolución temporal, según la duración y tipo de episodio, y el tamaño y actividad de los centros sanitarios. Resultados: La evolución temporal de las tasas de incidencia de IT por contingencia común mostró una tendencia a la disminución en el período 2009-2012. Los centros de pequeño tamaño tuvieron tasa de IT por contingencia común inferior que los de mayor tamaño (p<0,001). Los centros sociosanitarios son los que presentaron mayores tasas de IT por contingencia común, especialmente la de muy corta duración (p<0,001). . Los centros de atención primaria tuvieron las tasas más bajas de IT por contingencia profesional siendo la más elevada la de los centros sociosanitarios, especialmente la de larga duración (p<0.01). Conclusiones: Las diferencias observadas en las tasas de incidencia de IT según el tipo de actividad del centro sanitario podrían deberse a diferencias en las condiciones de trabajo

Objective: To describe the incidence and evolution of sickness absence (SA) for non-occupational and occupational illness/injury in the population of workers in Catalonian Health Centers based on the definition of a set of common indicators. Methods: The study population consisted of 25,964 workers from 30 health centers in Catalonia, during 2009-2012. Information on SA episodes was obtained from records of the Directorate of Human Resources. SA indicators were defined, and SA incidence rates and temporal evolution were calculated, depending on the length and type of episode, and the size and activity of health centers. Results: SA incidence rates for non-occupational illness and injury showed a decreasing trend during 2009-2012. Smaller centers had lower SA rates for non-occupational conditions than larger centers (p<0,001). . Social health centers had higher SA rates of non-occupational illness and injury, especially those with a very short duration (p<0.001). Primary care centers had the lowest SA occupational illness and injury rates, with the highest rates occurring in the social health centers, especially long-term centers (p<0.01). Conclusions: The differences in incidence rates of SA detected by type of activity of the health centers could be due to differences in working conditions

En búsqueda de las experiencias de los pacientes / In search of patient experiences

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Health literacy y salud / Health literacy and health

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Cultura de seguridad clínica en cirugía ortopédica y traumatología. Influencia de una intervención formativa / Patient safety culture in orthopaedics surgery. Influence of a training activities plan

Objetivo: Conocer las características de la cultura de seguridad clínica en cirugía ortopédica y traumatología, valorando la influencia de una intervención formativa en su tendencia evolutiva. Población y metodología: Estudio observacional ecológico con intervención formativa. La población objeto de estudio fueron los profesionales del Servicio de Cirugía Ortopédica y Traumatología del Hospital Clínic Universitario de Barcelona. Se utilizó la versión española del cuestionario HSOPS para valorar la cultura de seguridad clínica. Resultados: El porcentaje de respuestas válidas obtenidas fue superior al 60% en las dos mediciones de la cultura realizadas. Las 12 dimensiones consideradas mejoraron su tendencia. El trabajo en equipo dentro del servicio se identificó como una dimensión de fortaleza del modelo. Conclusiones: La intervención formativa ha consolidado una tendencia favorable. La mejora de la cultura de seguridad clínica requiere tiempo y actuaciones periódicas (AU)

Objective: The purpose of this paper is to measure patient safety culture in orthopaedics surgery and to assess the influence of a training activities plan. Methodology: We performed an ecological observational study with a training intervention. Study population included all professionals of Orthopaedics and Traumatology Service of the Clinic Hospital of Barcelona. We used the Spanish version questionnaire HSOPS in order to evaluate safety culture among staff. Results: The percentage of valid questionnaires obtained was above 60% in the two surveys of patient safety culture. The twelve dimensions considered have improved trend. Teamwork climate inside the unit has been identified as a stronghold dimension. Conclusions: The training intervention developed has consolidate a positive trend. The improvement of the patient safety culture needs time and continual actions (AU)

Aplicación de técnicas de marketing en la gestión clínica de un servicio de obstetricia y ginecología / Application of marketing techniques in the clinical management of an obstetrics and gynaecology department

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Grado de satisfacción del usuario tras el traslado de un recién nacido entre hospitales de la misma ciudad / The user’s degree of satisfaction after the transfer of a new born baby between hospitals in the same city

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[Multihospital systems and their reality in Catalonia]. / Els sistemes multihospitalaris i la seva realitat a catalunya.

The objective of this article is to compare the development of hospital systems in USA with multi-hospitals or other hospital association formulas that currently exist in Catalonia. Our purpose is to check if the theory, that has influenced the development of these hospital systems in US is consistent with the hospital systems in Catalonia, specifically in the cases of: Consorci Hospitalari de Catalunya, Unió Catalana d'Hospitals, future Consorci d'Hospitals de Barcelona, among others. In addition we analyze the consequences that would appear if the Public Hospital Network of Catalonia (xarxa hospitalaria d'utilització pública: XHUP) (1) is considered as a hospital system; that is, considering this Hospital Network as a hospital system in coexistence with other preexistent hospitals, could take advantage in the financial management as well as in the introduction in the market simulation systems to stimulate the efficiency in the provision of public hospitals.