Método de implantación de una acción de mejora en el Servicio de Ginecología del Hospital Universitario Nuestra Sra. de Candelaria / No disponible

En el sector sanitario asistimos a un creciente número de experiencias de autoevaluación deacuerdo al modelo EFQM. Este trabajo muestra el proceso seguido en un hospital público de 900camas localizado en Tenerife, Islas Canarias, en la aplicación de los criterios del modelo EFQM y elproceso para dinamizar el centro donde una experiencia similar había fracasado 5 años antes.Material y métodos. Tras una autoevaluación con el modelo EFQM se identificaron un conjuntode puntos fuertes y áreas de mejora. De las 10 priorizadas, la selección de indicadores para evaluarel core business del centro fue la más destacada. Después de valorar diferentes alternativas, segúnlos criterios impacto, esfuerzo y resultados, se focalizó en los principales procesos del centro que cursarancon hospitalización. Dado que dos de esos procesos estaban vinculados al Servicio de Ginecología,se constituyó un grupo entre facultativos, enfermería, gestores y técnicos para la selección deindicadores de parto, cesárea e histerectomía.Resultados. Siguiendo los criterios de accesibilidad, adecuación, riesgo, eficiencia, satisfacción yefectividad, el equipo de trabajo seleccionó 14 indicadores para la evaluación de parto, cesárea e histerectomía.Conclusiones. La aplicación del modelo EFQM requiere realizar cambios previos en los serviciosde soporte a la gestión. Nos permitió encontrar un foro común, donde facultativos, enfermería,gestores y técnicos pudieron encontrar no sólo nuevos indicadores, sino una nueva forma de ver lascosas para trabajar con un método

An increasing number of self-evaluation experiences developed in the health care sector in Spainwith the application of the European Foundation for Quality Management Excellence Model –EFQMis being seen.This work shows the process of applying the EFQM criteria to a 900 beds public hospitalin Tenerife, Canary Islands as well as the process to dynamize the hospital where a previous processin the same model had failed five years before.Methods. After a self-evaluation with the EFQM model, the organization identified a combinationof strong points and areas of improvement. A total of 10 areas of improvement were selectedto be carried out, that of the selection of indicators to evaluate “core business” of the site standingout the most.After evaluating the different alternatives, according to the criteria of impact, effortand results, focus was placed on the main processes with hospitalization of the site. Given thatthese processes belonged to the Gynecology Department of the hospital, a team formed by doctors,managers, nurses and technicians was formed to select the indicators for delivery, caesareanand hysterectomy.Results. According to accessibility, adequacy, risk, efficiency, satisfaction and effectivity, the workteam selected 14 indicators for evaluation of the caesarean, delivery and hysterectomy.Conclusions. Application of the European Foundation for Quality Management Excellence Modelrequires previous changes in the clinical management support. It allows us to find a common panelwhere doctors, nurses, managers and technicians not only can find new indicators but also a newpoint of view in order to work with a method

Bacteria in midguts of field-collected Anopheles albimanus block Plasmodium vivax sporogonic development.

Bacterial infections were investigated in midguts of insectary and field-collected Anopheles albimanus Weidemann from southern Mexico. Serratia marcescens, Enterobacter cloacae and Enterobacter amnigenus 2, Enterobacter sp., and Serratia sp. were isolated in field samples obtained in 1998, but only Enterobacter sp. was recovered in field samples of 1997 and no bacteria were isolated from insectary specimens. These bacteria were offered along with Plasmodium vivax infected blood to aseptic insectary An. albimanus, and the number of infected mosquitoes as well as the oocyst densities assessed after 7d. Plasmodium vivax infections in mosquitoes co-infected with En. amnigenus 2, En. cloacae, and S. marcensces were 53, 17, and 210 times, respectively, lower than in control mosquitoes, and the mean oocyst density in mosquitoes co-infected with En. cloacae was 2.5 times lower than in controls. Mortality was 13 times higher in S. marcensces-infected mosquitoes compared with controls. The overall midgut bacterial infection in mosquito field populations may influence P. vivax transmission, and could contribute to explain the annual variations in malaria incidence observed in the area.