[Results of a management plan for surgical waiting lists for hip and knee replacements]. / Resultados de un plan de gestión de listas de espera quirúrgica de prótesis articulares.

This study describes the implementation of a management plan for surgical joint replacement waiting lists and its results after 3 years. The plan was based on the following: unification of information and scheduling, periodic review, clinical guidelines, management of demand, prioritization according to need, and increasing the services provided. During the first year, the plan succeeded in revealing the real waiting list, with 23% more patients than previously included. Three years later, 16% of the patients had not turned up for surgery after being scheduled; the mean length of hospital stay for joint replacements had been reduced by 4 days; 59.5% of the patients joining the list had been assessed with a prioritization instrument, and the number of joint replacements had increased by 16% with a reduction of 14.7% in patients waiting for joint replacements. The resolution time for these procedures had also decreased by 3 months for knee arthroplasty and by 1 month for hip arthroplasty.

Resultados de un plan de gestión de listas de espera quirúrgica de prótesis articulares / Results of a management plan for surgical waiting lists for hip and knee replacements

Se describe un plan de gestión de las listas de espera quirúrgicas de prótesis articulares de cadera y rodilla y sus resultados a los 3 años. El plan de gestión se basó en la unificación de la información y programación, depuración periódica, guía clínica, gestión de la demanda, priorización por necesidad e incremento de la oferta. Durante el primer año se consiguió aflorar la lista de espera real, con un 23% más de pacientes de los contabilizados hasta entonces. A los 3 años, se depuró la lista en un 16% de los pacientes, se disminuyó la estancia media de estos procedimientos en 4 días, se evaluó el 59,5% de los pacientes con un instrumento de priorización y se incrementó la actividad de artroplastias en un 16%. Se redujo en un 14,7% los pacientes en espera de prótesis articulares y el tiempo de resolución de estos procedimientos disminuyó en 3 meses para las artroplastias de rodilla y en un mes para las de cadera

This study describes the implementation of a management plan for surgical joint replacement waiting lists and its results after 3 years. The plan was based on the following: unification of information and scheduling, periodic review, clinical guidelines, management of demand, prioritization according to need, and increasing the services provided. During the first year, the plan succeeded in revealing the real waiting list, with 23% more patients than previously included. Three years later, 16% of the patients had not turned up for surgery after being scheduled; the mean length of hospital stay for joint replacements had been reduced by 4 days; 59.5% of the patients joining the list had been assessed with a prioritization instrument, and the number of joint replacements had increased by 16% with a reduction of 14.7% in patients waiting for joint replacements. The resolution time for these procedures had also decreased by 3 months for knee arthroplasty and by 1 month for hip arthroplasty

Conocimiento y satisfacción de los médicos de atención primaria sobre su hospital de referencia / Primary care doctors’ knowledge of their referral hospital and satisfaction with it

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Identificación precoz e intervención breve en lesionados de tráfico con presencia de alcohol: primeros resultados / Early identification and brief intervention in alcohol-related traffic casualties: preliminary results

Objetivo: comprobar la efectividad de la intervención breve para reducir el consumo de alcohol en accidentados de tráfico con alcoholemia positiva, sin dependencia del alcohol. Metodología: cribado de los lesionados de tráfico que acuden a urgencias de traumatología mediante un test de alcohol en saliva e intervención sobre los pacientes positivos. Los pacientes son evaluados y aleatoriamente distribuidos en grupos de Intervención Breve e Intervención Mínima. El seguimiento telefónico se hace al mes 3, 6 y 12.Resultados: Hasta el 30 de Octubre de 2002, se incluyeron en el estudio 709 lesionados, habiéndose realizado la prueba del alcohol en 696. 93 pacientes dieron positivo (13,4 por ciento) y pudo intervenirse en 66 de ellos. El 50 por ciento puntuaba positivo en el test AUDIT (puntuación media: 7,6). Los pacientes fueron distribuidos aleatoriamente entre intervención breve (30) e intervención mínima (36). El 77 por ciento de pacientes tiene seguimiento. El 79,4 por ciento de los pacientes intervenidos ha reducido el consumo de alcohol, a los 3 meses y el 66,7 por ciento por ciento, al año. Sobre todo disminuye el binge drinking (consumo copioso concentrado), el más peligroso para la conducción. A los 3 meses, ha reducido su consumo un porcentaje superior (en el límite de la significación estadística) de pacientes en el grupo de Intervención Breve. AI año, no se observan diferencias entre ambos grupos de intervención. La magnitud de la reducción es significativamente mayor en quienes tenían un resultado basal positivo en el test AUDIT. Conclusiones: Aunque las muestras son homogéneas, es prematuro dar resultados de efectividad tanto por el tamaño aún reducido de los grupos estudiados, como porque todavía se incluyen pacientes y se están siguiendo los ya incluidos (AU)

Objective: to test the effectiveness of a brief intervention in reducing alcohol consumption in traffic casualties with positive blood alcohol concentration, and without alcohol dependency. Methods: screening traffic casualties attending an emergency/trauma department, using an alcohol-saliva test, with intervention for positive patients. After assessment, patients are randomly allocated into either a brief or minimal intervention group. Phone follow-up takes place at month 3, 6,and 12. Results: 709 traffic casualties had been included in the study by the end of October 2002. 696 patients had the alcohol test, which was positive in 93 cases (13.4%). Intervention was possible with 66. Half of them had a positive AUDIT, with a mean score of 7.6. Patients were randomly allocated to brief intervention (30) and minimal intervention (36) groups. Followup has been made on 77%. 79.4% of patients who received an intervention had reduced alcohol consumption at month 3, and 66.7% still had a reduced consumption at month 12. Among consumption measures, binge drinking – the most dangerous for drivingshows the most important drop. At month 3, the percentage of patients who had reduced their intake was higher (at the limit of statistical significance) in the Brief Intervention group. At month 12, there are no apparent differences between the two intervention groups. The reduction in consumption is significantly greater among those who scored positive in the AUDIT at baseline. Conclusion: Although the samples are homogeneous, it’s too early to give effectiveness results, both because of the still small number of patients, and because we are still recruiting them and following-up those already enrolled (AU)