[Evaluation of the maturity of a Urology Department in terms of Quality. Management and Quality improvement operative objectives]. / Evaluación de la madurez de un Servicio de Urología en términos de calidad. Objetivos operativos de gestión y mejora de la calidad.

OBJECTIVES: The objective of quality management is the identification of improvement areas to achieve total client and other involved agents satisfaction. In this paper we describe the start up of a Quality Improvement Plan (QIP) in a Urology Department. METHODS: We assessed the current maturity and performance of the Unit by means of self-evaluation with a questionnaire adapted to the 2009 ISO 9004 standard by all the professionals in the unit (Physicians and Nurses). All the items in the questionnaire are based in attributes and evaluation lines gathered in the five chapters of the Standard. The areas of improvement were identified and specific objectives were established and collected in the QIP with indicators for their measurement, responsible individuals, chronogram and results evaluation. After implementation of the quality improvement actions, a second self-evaluation was performed to start a new cycle. RESULTS: After the first evaluation we observed a high global performance (61%). Analyzed by sections, the highest level was achieved in the human resources management chapter (73%) and the lowest in quality management (30%) due to the absence of a process management approach. After identification of improvement areas, we defined projects and activities to be developed, in the process management context. The second evaluation, after the implementation of process management in the unit, showed an improvement in the maturity level of the Unit, reaching an 83%. CONCLUSIONS: The management of a clinical department cannot be limited to continuous improvisation. A process management approach is necessary, finishing with the usual defects of the generated product (variability, errors, omissions, waiting lists). Excellence in the quality of health care is an essential objective in every healthcare organization and standardization models, such as 2009 ISO 9004 standard, are the right way for that purpose.