[Improving the systematization of benchmarking in public health services]. / Avanzando en la sistematización del benchmarking en servicios de salud pública.

Continuous management improvement should be an aspiration for all public sector organizations. External comparison or benchmarking identifies good practices in similar organizations. For public health services, it is not easy to obtain such indicators. The objectives of this paper are to describe the process of conducting a benchmarking exercise for a public health agency, and to share its results. For this purpose, agencies that may be compared were identified, and their websites were searched for annual reports or other documents with indicators of the activities or results of public health services. Limitations and contextual aspects of the indicators of the different organizations were identified, as well as ways to improve their comparability. Finally, a set of 19 indicators is proposed, as an initial core for quality management comparisons.

[A public health surveillance system applied to climate change for cities]. / Un sistema de vigilancia de salud pública para el cambio climático en las ciudades.

This paper makes a first proposal for a public health surveillance system for climate change in cities, and describes the process that led to its definition. After several years of monitoring different aspects related to climate change and its impact, the public health services of Barcelona made a preliminary proposal and gathered a working group of experts to discuss and review it. Four categories of components were defined: climate data, health impacts of climate change and its determinants, contributions of the city to mitigation (especially those with health co-benefits), and actions to reduce vulnerability to extreme events. They were broken in twelve components, with indicators for each. The proposal was further refined with subsequent reviews, and is being used by the city public health services involved in this field.

[Improving the control of food allergy and intolerance risks in school settings: qualitative inputs from focus groups]. / Mejorando el control del riesgo por alergias e intolerancias alimentarias en los comedores escolares: aportaciones cualitativas de los grupos focales.

This paper describes the use of focus groups as part of the evaluation of programmes to control food allergy and intolerance (FAI) in school settings in the city of Barcelona (Spain). After fostering their adoption and as a qualitative component of their evaluation, the public health services ran two focus groups, one with people from schools that manage their own kitchen, and another from companies that outsource this service. There were 28 participants from 46% of the centres invited. All the schools seem to have implemented a self-control programme on FAI. Although outsourcing companies already had a programme, the schools that managed their own service mostly adopted the programme promoted by the public health services. The number of schoolchildren with reported FAI reduced after the programme, as it required more rigorous documentation from families.

[Advances in the management of an animal shelter]. / Avances en la gestión de un centro de acogida de animales de compañía.

Changes in the Barcelona animal shelter from 2002 to 2005 are presented. In 2003, routine euthanasia of unclaimed stray animals was discontinued, due to a political decision of the city council. Changes were also made in the management of the shelter: from January 2003 to July 2004 the shelter was operated by an animal protection organization, and then directly again by the city public health agency. Management of the shelter by the animal welfare organization was associated with an increase in the proportion of dogs rescued and adopted. The suspension of routine euthanasia was associated with a marked increase in the number of stray dogs. Canine distemper became endemic in the shelter until late 2004, due to a certain unwillingness to use euthanasia to control infection transmission. Direct operation by public health services in a context of transparency and high social expectations has led to the development and adoption of standardized work protocols in the shelter, improving quality.