Red Europea de Seguridad del Paciente y Calidad (Eupean Network for Patient Safety and Quality of Care). Desarrollo y resultados preliminares en Europa y en el Sistema Nacional de Salud / European Union Network for Patient Safety and Quality of Care (PASQ). Development and preliminary results in Europe and in the Spanish National Health System

Antecedentes: La acción cooperativa conocida como European Union Network for Patient Safety and Quality of Care (PaSQ) pretende promover la seguridad del paciente (SP) en la Unión Europea (UE) y facilitar el intercambio de experiencias entre los Estados Miembros y otras organizaciones interesadas en aspectos relacionados con la calidad asistencial (CA), la SP y la participación de los pacientes. En este artículo se presentan el desarrollo y los resultados preliminares de esta iniciativa, especialmente en el Sistema Nacional de Salud español (SNS). Desarrollo y metodología de trabajo: PaSQ se desarrolló a través de 7 paquetes de trabajo, liderados por diferentes países, que estaban orientados prioritariamente a: a) el intercambio de buenas prácticas sobre CA y SP que habían sido identificadas a través de cuestionarios específicos y seleccionadas a través de criterios explícitos consensuados, y b) la implementación de prácticas clínicas seguras (PCS) de comprobada efectividad, acordadas por los Estados Miembros de la Unión Europea. Evolución de la acción cooperativa: Se identificaron 482 buenas prácticas (39% remitidas por profesionales españoles). Se realizaron un total de 34 eventos en la UE, 11 con participación española, que permitieron compartir algunas de estas buenas prácticas. Un total de 194 centros sanitarios (49% españoles) están implementando las 4 PCS acordadas (higiene de manos, cirugía segura, conciliación de la medicación y escala de detección temprana de deterioro clínico en pediatría). Logros alcanzados y perspectivas futuras: PaSQ está facilitando reforzar la colaboración entre organizaciones y profesionales a nivel de la UE y del SNS en torno a la SP y la CA (AU)

Background: The joint action, European Union Network for Patient Safety and Quality of Care: PaSQ, aims to promote patient safety (PS) in the European Union (EU) and to facilitate the exchange of experiences among Member States (MS) and stakeholders on issues related to quality of care, PS, and patient involvement. The development and preliminary results are presented here, especially as regards the Spanish National Health System (SNHS). Development and methodology: PaSQ is developed through 7 work packages, primarily aimed at sharing good practices (GP), which were identified using specific questionnaires and selected by means of explicit criteria, as well as to implement safe clinical practices (SCP) of proven effectiveness and agreed among MS. Evolution of the joint action: A total of 482 GP (39% provided by Spanish professionals) were identified. The 34 events organised in the EU, 11 including Spanish participation, facilitate sharing these practices. A total of 194 Health Care centres (49% in Spain) are implementing SCP (hand hygiene, safe surgery, medication reconciliation, and paediatric early warning scores). Achievements and future perspectives: PaSQ is making it possible to strengthen collaboration between organizations and professionals at EU and SNHS level regarding PS and quality of care (AU)

[European Union Network for Patient Safety and Quality of Care (PASQ). Development and preliminary results in Europe and in the Spanish National Health System]. / Red Europea de Seguridad del Paciente y Calidad (Eupean Network for Patient Safety and Quality of Care). Desarrollo y resultados preliminares en Europa y en el Sistema Nacional de Salud.

BACKGROUND: The joint action, European Union Network for Patient Safety and Quality of Care: PaSQ, aims to promote patient safety (PS) in the European Union (EU) and to facilitate the exchange of experiences among Member States (MS) and stakeholders on issues related to quality of care, PS, and patient involvement. The development and preliminary results are presented here, especially as regards the Spanish National Health System (SNHS). DEVELOPMENT AND METHODOLOGY: PaSQ is developed through 7 work packages, primarily aimed at sharing good practices (GP), which were identified using specific questionnaires and selected by means of explicit criteria, as well as to implement safe clinical practices (SCP) of proven effectiveness and agreed among MS. EVOLUTION OF THE JOINT ACTION: A total of 482 GP (39% provided by Spanish professionals) were identified. The 34 events organised in the EU, 11 including Spanish participation, facilitate sharing these practices. A total of 194 Health Care centres (49% in Spain) are implementing SCP (hand hygiene, safe surgery, medication reconciliation, and paediatric early warning scores) ACHIEVEMENTS AND FUTURE PERSPECTIVES: PaSQ is making it possible to strengthen collaboration between organizations and professionals at EU and SNHS level regarding PS and quality of care.

Información de eventos adversos a pacientes y familiares / Adverse events open disclosure to patients and relatives

Objetivo: Realizar un revisión bibliográfica sobre la información de incidentes y eventos adversos a pacientes y familiares, así como revisar las principales políticas, guías institucionales y aspectos legales relacionados con dicho proceso. Material y método: Se consultaron diferentes fuentes electrónicas y en papel y se utilizó Pub-med como motor de búsqueda principal. Resultados: El sistema sanitario debe buscar la manera de cubrir las necesidades y expectativas de los pacientes cuando ocurre un evento adverso a través del cuidado, soporte emocional e información relativa al evento. Las guías éticas y profesionales establecen la responsabilidad de los profesionales y de las instituciones de desvelar los errores cometidos durante la atención sanitaria. Existen muchas barreras que dificultan llevar a cabo este complejo proceso. La formación de los profesionales y el desarrollo de guías institucionales pueden favorecer el cumplimiento. Los aspectos legales deben ser abordados a nivel local y evaluar el impacto real de un desarrollo legislativo específico sobre la efectividad del proceso. Conclusión: En nuestro ámbito no existen recomendaciones específicas en relación a la información a pacientes y familiares sobre eventos adversos. Se requieren propuestas consensuadas que den respuesta de forma científica y multidisciplinar a esta cuestión con importantes connotaciones tanto éticas como legales (AU)

Objective: Perform a literature review on incidents and adverse events open disclosure to patients and relatives, as well as to review major policies, institutional guides and legal aspects related to this process. Material and method: Different electronic and paper sources were consulted; Pub-med was used as main search engine. Results: The health system must find a way of meeting the needs and expectations of patients, emotional support and information on the event when an adverse event occurs through care. Ethical and professional guidelines set out the professionals and institutions responsibility of revealing the mistakes made during the health care. There are many barriers that make it difficult to carry out this complex process. The training of professionals and the development of institutional guides can encourage compliance. The legal aspects should be dealt with at local level and to assess the real impact of a specific legislative development on the effectiveness of the process. Conclusion: In our area, there are no specific recommendations in relation to the adverse event information to patients and relatives. Required consensus proposals that respond in a scientific and multidisciplinary manner to this question with important connotations both ethical and legal (AU)

Conferencia de consenso sobre información de eventos adversos a pacientes y familiares / Consensus conference on providing information of adverse events to patients and relatives

Objetivo. Elaborar unas recomendaciones sobre «Información de eventos adversos a pacientes y familiares», mediante la realización de una conferencia de consenso. Material y métodos. Se realizó una revisión bibliográfica de la evidencia disponible, de las principales publicaciones de políticas y guías internacionales y la legislación específica desarrollada en algunos países sobre dicho proceso. La revisión bibliográfica constituyó la base para dar respuesta a una serie de preguntas planteadas en una sesión pública. Un grupo de expertos presentaron la mejor evidencia disponible interaccionando con las partes interesadas. Al término de la sesión un jurado, interdisciplinario y multiprofesional, estableció las recomendaciones finales de la conferencia de consenso. Resultados. Las principales recomendaciones abogan por el interés de elaborar políticas y guías institucionales en nuestro ámbito que favorezcan el proceso de información sobre eventos adversos a los pacientes. Se destaca la necesidad de formación de los profesionales en habilidades de comunicación y en seguridad del paciente, así como el desarrollo de estrategias de soporte a los profesionales que se ven implicados en un evento adverso. Se considera evaluar el interés e impacto de legislación específica que ayudará a la implantación de dichas políticas. Conclusiones. Es necesario un cambio cultural a todos los niveles, matizado y adaptado a las circunstancias específicas sociales y culturales de nuestro ámbito social y sanitario, e implicar a todos los actores del sistema para crear un marco de confianza y credibilidad en el que pueda hacerse efectivo el proceso de información sobre eventos adversos (AU)

Objective: To develop recommendations regarding «Information about adverse events to patients and their families», through the implementation of a consensus conference. Material and methods: A literature review was conducted to identify all relevant articles, the major policies and international guidelines, and the specific legislation developed in some countries on this process. The literature review was the basis for responding to a series of questions posed in a public session. A group of experts presented the best available evidence, interacting with stakeholders. At the end of the session, an interdisciplinary and multi-professional jury established the final recommendations of the consensus conference. Results: The main recommendations advocate the need to develop policies and institutional guidelines in our field, favouring the patient adverse events disclosure process. The recommendations emphasize the need for the training of professionals in communication skills and patient safety, as well as the development of strategies for supporting professionals who are involved in an adverse event. The assessment of the interest and impact of specific legislation that would help the implementation of these policies was also considered. Conclusions: A cultural change is needed at all levels, nuanced and adapted to the specific social and cultural aspects of our social and health spheres, and involves all stakeholders in the system to create a framework of trust and credibility in which the processing of information about adverse events may become effective (AU)

[Consensus conference on providing information of adverse events to patients and relatives]. / Conferencia de consenso sobre información de eventos adversos a pacientes y familiares.

OBJECTIVE: To develop recommendations regarding «Information about adverse events to patients and their families¼, through the implementation of a consensus conference. MATERIAL AND METHODS: A literature review was conducted to identify all relevant articles, the major policies and international guidelines, and the specific legislation developed in some countries on this process. The literature review was the basis for responding to a series of questions posed in a public session. A group of experts presented the best available evidence, interacting with stakeholders. At the end of the session, an interdisciplinary and multi-professional jury established the final recommendations of the consensus conference. RESULTS: The main recommendations advocate the need to develop policies and institutional guidelines in our field, favouring the patient adverse events disclosure process. The recommendations emphasize the need for the training of professionals in communication skills and patient safety, as well as the development of strategies for supporting professionals who are involved in an adverse event. The assessment of the interest and impact of specific legislation that would help the implementation of these policies was also considered. CONCLUSIONS: A cultural change is needed at all levels, nuanced and adapted to the specific social and cultural aspects of our social and health spheres, and involves all stakeholders in the system to create a framework of trust and credibility in which the processing of information about adverse events may become effective.

National hand hygiene campaigns in Europe, 2000-2009.

Hand hygiene represents the single most effective way to prevent healthcare-associated infections. The World Health Organization, as part of its First Global Patient Safety Challenge, recommends implementation of multi-faceted strategies to increase compliance with hand hygiene. A questionnaire was sent by the European Centre for Disease Prevention and Control to 30 European countries, regarding the availability and organisation of their national hand hygiene campaigns. All countries responded. Thirteen countries had organised at least one national campaign during the period 2000-2009 and three countries were in the process of organising a national campaign. Although the remaining countries did not have a national campaign, several reported regional and local hand hygiene activities or educational resources on national websites.

[The Spanish National Health System patient safety strategy, results for the period 2005-2007]. / Resultados de la estrategia en seguridad del paciente del Sistema Nacional de Salud español, período 2005-2007.

BACKGROUND AND OBJECTIVES: In 2005 the Spanish National Health System (SNHS) implemented a strategy aimed at improving patient safety in Spanish healthcare centres. SPECIFIC AIMS: Promote and develop knowledge of patient safety and a patient safety culture among health professionals and patients; design and implement adverse event information and reporting systems for learning purposes; introduce recommended safe practices in SNHS centres; promote patient safety research and public and patient involvement in patient safety policies. MATERIAL AND METHOD: An Institutional Technical Committee was created with representatives from all the Spanish regions. All national organizations involved in healthcare quality and patient safety took part in the project. The strategy follows the WHO World Alliance for Patient Safety and Council of Europe recommendations. Budget allocated in the period 2005-2007: approximately EUR35 million. RESULTS: Around 5,000 health professionals were educated in PS concepts. Several studies were conducted on: adverse events in Hospitals and Primary Care, as well as studies to obtain information on health professionals' perceptions on safety, the use of medications and the situation regarding hospital-acquired infections. All the regions have introduced safe clinical practices related with the strategy. CONCLUSIONS: The strategy has been implemented in all the Spanish regions. Awareness was raised among health professionals and the public. A network of alliances has been set up with the regions, universities, schools, agencies and other organizations supporting the strategy.

[Strategic measures for patient safety in the National Health System: on-line training resources and access to scientific knowledge]. / Acciones estratégicas en seguridad del paciente para el Sistema Nacional de Salud. Recursos on-line en formación y acceso al conocimiento científico.

INTRODUCTION: Patient safety (PS) is a priority strategy included in the Quality Plan for the Spanish National Health System and its first objective is to promote PS culture among professionals and patients. The Internet is playing a key role in the access to clinical evidence and in the training of health professionals. MATERIAL AND METHOD: A multidisciplinary working group was created, who defined the criteria to help improve clinical practice in the field of patient safety, by making available and using web-based patient safety training resources and information. RESULTS: Taking advantage of the possibilities offered by the Internet in terms of training, two online self-training tutorials were developed on risk management, patient safety and adverse event prevention. A Newsletter was also launched, together with two specific patient safety Supplements. Moreover, to extend the reach of the PS Strategy, a patient safety web page and weblog were created, in addition to a collaborative (internal) working group tool. Excelenciaclinica.net was also developed; a meta-search engine specialized in evidence-based information for health professionals, to make it easier to access reliable and valuable information. Health professionals were also allowed to consult, free of charge, reliable health information resources, such as the GuiaSalud platform, the Cochrane Library Plus and the resources of the Joanna Briggs Institute. CONCLUSIONS: The involvement of health professionals in these measures and the role that these measures may be expected to play in the development of a premium-quality health service.