Conjunto de indicadores de calidad y seguridad para hospitales de la Agencia Valenciana de Salud

Improving Nursing Assessment in Adult Hospitalization Units: A Secondary Analysis

The main objective of this study was to analyze the impact of a multifaceted strategy to improve the assessment of functional capacity, risk of pressure injuries, and risk of falls at the time of admission of patients in adult hospitalization units. This was a secondary analysis of the VALENF project databases during two periods (October-December 2020, before the strategy, and October-December 2021, after the strategy). The quantity and quality of nursing assessments performed on patients admitted to adult hospitalization units were evaluated using the Barthel index, Braden index, and Downton scale. The number of assessments completed before the implementation of the new strategy was n = 686 (28.01%), versus n = 1445 (58.73%) in 2021 (p < 0.001). The strategy improved the completion of the evaluations of the three instruments from 63.4% (n = 435) to 71.8% (n = 1038) (p < 0.001). There were significant differences depending on the hospitalization unit and the assessment instrument (p < 0.05). The strategy employed was, therefore, successful. The nursing assessments show a substantial improvement in both quantity and quality, representing a noticeable improvement in nursing practice. This study was not registered.

[Primary care specific scorecards as management tools]

INTRODUCTION

Specific Scorecards are a key element to improve strategic lines aimed at enhancing intermediate health outcomes. Their implementation, involving professionals, requires identifying indicators linked to the outcomes of healthcare actions that the scientific literature may endorse. In addition, the inclusion of objectives that can be defined by parameterized by indicators of intermediate results in the health centre program contract, conveys the relevance of health actions and their impact on health.

OBJECTIVE

To describe the design, development and outcomes of the specific scorecards of indicators of intermediate health outcomes in the Primary Care information system (eSOAP) in order to promote the involvement of professionals in strategic management from clinical management.

METHODS

Phase 1: description of the process (preparation and publication of 147 indicators, 46 of them of chronicity). Phase 2: observational descriptive study on the use of professionals and managers and data on the intermediate health outcomes obtained.

RESULTS

A total of 268,849 reports were generated in 2017, with 35,835 reports of specific balanced scorecard (20%) being downloaded in just 6 months. One-quarter (25%) of the indicators of the Centre program contract are intermediate results. The percentage of diabetic patients controlled was 39.2%, and has improved significantly (P<.05) in 5 years.

DISCUSSION

The specific scorecards with indicators of intermediate outcomes linked to strategic lines and their inclusion in the program contracts enables professionals to become involved in clinical and strategic management and improves the decision making of professionals and managers.

[Efficiency indicators to contribute to sustainability of health services in Spain]

OBJECTIVE

Identifying a minimum set of efficiency indicators calculated from current information sources. Interventions adopted from the analysis of these indicators could contribute to health services sustainability.

METHOD

We applied the discussion group technique. A total of 23 quality coordinators from around the country and the representatives of the regional quality societies in SECA (Spanish Society for Quality in Healthcare) participated.

RESULTS

Ten efficiency indicators useful for integrated management areas were identified and accepted, 5 in the area of primary care and 5 for hospital management.

CONCLUSION

The efficiency indicators agreed upon could contribute to the sustainability of the health system without this affecting the quality of care.