-
Multicenter Study
[Clinical safety audits for primary care centers. A pilot study].
- Míriam Ruiz Sánchez, Francisco Borrell-Carrió, Cristina Ortodó Parra, Neus Fernàndez I Danés, and Anna Fité Gallego.
- Medicina de Familia y Comunitaria, EAP Centre SAP Delta del Llobregat, Unitat Docent de Costa de Ponent, ICS, Barcelona, España. mirusa77@hotmail.com
- Aten Primaria. 2013 Aug 1; 45 (7): 341348341-8.
ObjectiveTo identify organizational processes, violations of rules, or professional performances that pose clinical levels of insecurity.DesignDescriptive cross-sectional survey with customized externally-behavioral verification and comparison of sources, conducted from June 2008 to February 2010.SettingThirteen of the 53 primary care teams (PCT) of the Catalonian Health Institute (ICS Costa de Ponent, Barcelona).ParticipantsEmployees of 13 PCT classified into: director, nurse director, customer care administrators, and general practitioners.MethodsNon-random selection, teaching (TC)/non-teaching, urban (UC)/rural and small/large (LC) health care centers (HCC). A total of 33 indicators were evaluated; 15 of procedures, 9 of attitude, 3 of training, and 6 of communication. Level of uncertainty: <50% positive answers for each indicator.Exclusion Criteriano collaboration.ResultsA total of 55 professionals participated (84.6% UC, 46.2% LC and 76.9% TC). Rank distribution: 13 customer care administrators, 13 nurse directors, 13 HCC directors, and 16 general practitioners. Levels of insecurity emerged from the following areas: reception of new medical professionals, injections administration, nursing weekend home calls, urgent consultations to specialists, aggressive patients, critical incidents over the agenda of the doctors, communication barriers with patients about treatment plans, and with immigrants.Discussion And ConclusionsClinical safety is on the agenda of the health centers. Identified areas of uncertainty are easily approachable, and are considered in the future system of accreditation of the Catalonian Government. General practitioners are more critical than directors, and teaching health care centers, rural and small HCC had a better sense of security.Copyright © 2012 Elsevier España, S.L. All rights reserved.
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