Lineamientos para emisión de certificados de habilitación de establecimientos de atención para la salud, públicos y privados: unidad técnica normativa 2019 / Guidelines for the issuance of certificates of authorization of health care establishments, public and private: normative technical unit 2019

El objetivo del documento es la normalización de los criterios mínimos que deben cumplir los establecimientos de salud para su funcionamiento. Además, es un modelo básico para ser certificado, previo a solicitar la licencia sanitaria. Contiene unos fundamentos legales, así como las definiciones de rigor en torno al tema central. Incluye las indicaciones a seguir, para la solicitud de inspección, previo a la certificación. Incluye el anexo: "Guía de inspección de condiciones de habilitación de establecimientos de atención para la salud" (anexo A). También, "Modelo de certificación de habilitación" (anexo B). "Categorías de establecimientos regulados por DRACES" (anexo C). El anexo D y último, contiene todo el fundamento legal que deben conocer quienes soliciten ser habilitados.

The new CMS emergency preparedness final rule and its impact on healthcare in 2017.

The new CMS Final Rule on Emer- gency Preparedness will be a major change for hospitals and many other types of healthcare providers, the authors claim. One of the most im- portant changes for hospitals will be the requirement to do the Security Risk Assessments and matching Emergency Plans for each separate facility, every year, instead of only doing a consolidated risk assess- ment on all facilities in one report. Failure to comply could have a major and disastrous economic im- pact on a hospital or other health care facility. In this article they pro- vide information and access to re- sources for complying.

Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. Final rule.

This final rule establishes national emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers to plan adequately for both natural and man-made disasters, and coordinate with federal, state, tribal, regional, and local emergency preparedness systems. It will also assist providers and suppliers to adequately prepare to meet the needs of patients, residents, clients, and participants during disasters and emergency situations. Despite some variations, our regulations will provide consistent emergency preparedness requirements, enhance patient safety during emergencies for persons served by Medicare- and Medicaid-participating facilities, and establish a more coordinated and defined response to natural and man-made disasters.

Portafolios de planificación, organización y gestión del Jefe de Servicios Clínicos / Chairman of Clinical Departments planification, organizational and management portfolio

La metodología del portafolio se usa ampliamente, incluida la formación médica permanente y la formación de especialistas por el sistema de residencias. Algunas instituciones españolas (la Universidad Nacional de Educación a Distancia y la Escuela Nacional de Sanidad) están aplicando un portafolio de siete dimensiones al ámbito de la Gestión Clínica, que podría ser utilizado como marco conceptual y lista de comprobación para elaborar diferentes documentos de planificación, programación, o evaluación en las nuevas experiencias innovadoras de Unidades de Gestión Clínica. Este artículo expone brevemente el Protocolo, considera sus potencialidades, y concluye señalando la importancia del buen gobierno y la rendición de cuentas en el nuevo profesionalismo médico

Portfolio methodology is widely applied to training, particularly in medical education and for medical trainees. Some Spanish Institutions (National University of Distance Learning and National School of Public Health) are using a seven dimension Portfolio in the field of Clinical Management, which could be used as conceptual framework and checklist for building up different documents for planning, programming and evaluating the new experiences of Clinical Units based on clinical management initiatives. This paper describe the Portfolio in short, takes into consideration its potential use, and concludes addressing the relevance of good governance and accountability for the medical professionalism

Why did ISO 9001:2008 system fail to deliver?

This article is based on an actual investigation undertaken, and summarises the subsequent report's findings and observations. It has been anonymised for obvious reasons. In May 2013 an analysis was undertaken by a multidisciplinary team that compared an NHS Trust estates department's managerial systems against the NHS national recommendations. The conclusions stated that: 'There was a systemic failure across a large number of topics generating intolerable/substantial risks to the organisation, its staff, and patients; this despite the department's managerial systems being accredited to the International Standard ISO 9001:2008'. The natural question raised when presented with this demonstrable and auditable evidence was: 'Why did the ISO 9001:2008 system fail?'

Top-down and bottom-up approaches to health care quality: the impacts of regulation and report cards.

The high cost of the US health care system does not buy uniformly high quality of care. Concern about low quality has prompted two major types of public policy responses: regulation, a top-down approach, and report cards, a bottom-up approach. Each can result in either functional provider responses, which increase quality, or dysfunctional responses, which may lower quality. What do we know about the impacts of these two policy approaches to quality? To answer this question, we review the extant literature on regulation and report cards. We find evidence of both functional and dysfunctional effects. In addition, we identify the areas in which additional research would most likely be valuable.

[Patient safety in management contracts]. / La seguridad del paciente en los contratos de gestión.

Patient safety is becoming commonplace in management contracts. Since our experience in patient safety still falls short of other clinical areas, it is advisable to review some of its characteristics in order to improve its inclusion in these contracts. In this paper opinions and recommendations concerning the design and review of contractual clauses on safety are given, as well as reflections drawn from methodological papers and informal opinions of clinicians, who are most familiar with the nuances of safe and unsafe practices. After reviewing some features of these contracts, criteria for prioritizing and including safety objectives and activities in them, and key points for their evaluation are described. The need to replace isolated activities by systemic and multifaceted ones is emphasized. Errors, limitations and improvement opportunities observed when contracts are linked to indicators, information and adverse event reporting systems are analysed. Finally, the influence of the rules of the game, and clinicians behaviour are emphasised.

So they want you to be their medical director.

Clinicians, especially physicians, who become "medical directors" of facilities or agencies incur more responsibilities than they sometimes realize. Clinical administration, such as medical director roles and duties, creates personal, professional, management, and forensic issues. For some, their day-to-day work changes little; others experience a shift in duties and relationships, particularly duties to and relationships with the organization (as contrasted with its patients) that are unfamiliar to most clinical professionals. One who accepts such a position should understand the organization's needs and expectations and, within bounds of professional ethics, be prepared to meet them. Even medical directors of very small organizations, such as small private hospitals or clinics, routinely, and sometimes unknowingly, incur administrative and/or legal responsibilities for which they may later be held accountable.

[The relevance of clinical risk management]. / L'applicazione del risk management al contesto sanitario.

Medical activity includes a risk of possible injury or complications for the patients, that should drive the Health Care Institutions to introduce and/ or improve clinical Risk management instruments. Although Italy is still lacking a National project of Clinical Risk Management, a number of efforts have been made by different Italian Regions to introduce instruments of risk management. In addition, most of National Health Care Institutions include actually a Department specifically in charge to manage the clinical risk. Despite the practical difficulties, the results obtained until now suggest that the risk management may represent a useful instrument to contribute to the reduction of errors in clinical conduct. Indeed, the introduction of adequate instruments of prevention and management of clinical risk may help to ameliorate the quality of health care Institution services.

A customizable plan for effective claims management.

Claims administration is central to healthcare risk management. This article examines several key aspects of claims management and provides useful information for both new and experienced claims professionals. It offers tools and examples for inexperienced risk managers to master effective claims management practices and outlines suggestions that seasoned risk managers can use to update or validate their own processes. These claims management practices serve to protect the organization's assets and can be customized to meet each organization's needs.

Reglamento para la regulación, autorización, acreditación y control de establecimientos para la salud: acuerdo gubernativo No. 376-2007 / Regulation for the regulation, authorization, accreditation and control of health establishments: government agreement No. 376-2007

Tal como su nombre lo indica, el documento describe los requerimientos y condiciones, tanto para certificar establecimientos para la salud, como para su correcta y legal administración. Incluye las definiciones de los términos descritos en el título y su función dentro del reglamento. Además, otros conceptos como: "certificado de calidad", constancia de supervisión", "establecimientos de servicio social", entre otros. Están además, los requisitos para otorgar la licencia sanitaria a cada tipo de establecimientos, también descritos ampliamente en el acuerdo.