La Gestión de las reclamaciones en el Plan de Calidad Hospitalario

[Towards a safety culture in the neonatal unit: Six years experience]

INTRODUCTION

A safety culture is the collective effort of an institution to direct its resources toward the goal of safety.

MATERIAL AND METHODS

An analysis is performed on the six years of experience of the Committee on the Safety of Neonatal Patient. A mailbox was created for the declaration of adverse events, and measures for their correction were devised, such as case studies, continuous education, prevention of nosocomial infections, as well as information on the work done and its assessment.

RESULTS

A total of 1287 reports of adverse events were received during the six years, of which 600 (50.8%) occurred in the neonatal ICU, with 15 (1.2%) contributing to death, and 1282 (99.6%) considered preventable. Simple corrective measures (notification, security alerts, etc.) were applied in 559 (43.4%), intermediate measures (protocols, monthly newsletter, etc.) in 692 (53.8%), and more complex measures (causal analysis, scripts, continuous education seminars, prospective studies, etc.) in 66 (5.1%). As regards nosocomial infections, the prevention strategies implemented (hand washing, insertion and maintenance of catheters) directly affected their improvement. Two surveys were conducted to determine the level of satisfaction with the Committee on the Safety of Neonatal Patient. A rating 7.5/10 was obtained in the local survey, while using the Spanish version of the Hospital Survey on Patient Safety Culture the rate was 7.26/10.

CONCLUSIONS

A path to a culture of safety has been successfully started and carried out. Reporting the adverse events is the key to obtaining information on their nature, etiology and evolution, and to undertake possible prevention strategies.

[Changes in the complaints made to a General and Gastrointestinal Surgery Department after a change in hospital structure and function]

OBJECTIVE

The complaints to a medical service are a measure of the quality of health care perceived by the patients. The aim of this study was to analyse the differences found in the percentage of complaints made to the General and Gastrointestinal Surgery Department (GGSD) with the changes made due to moving to a new hospital.

MATERIAL AND METHODS

A longitudinal study of the percentage of complaints made to the GGSD in two 6 month periods in the same year (periods A and B). The Department was moved to a new hospital between the two periods. The percentage complaints associated with the hospital and outpatient activity is compared.

RESULTS

The percentage complaints made to the GGSD was 3.02% directed at the hospital service and 0.44% to outpatient care. When both periods were compared, a statistically significant difference was observed in the hospital complaints (A: 3.74% vs B: 2.20%, P=.006) and in the outpatient complaints (A: 0.53% vs. B: 0.34%, P=.005). It could also be shown that there was a continuous significant correlation in the parallel decrease in the hospital and outpatient complaints (R:0.988 P<.001).

CONCLUSIONS

The structural and functional change due to moving to a new hospital showed that the percentage of complaints made to the GGSD changed significantly in the period studied. Prospective multicentre studies are required to evaluate whether these results can be extrapolated to other services.

[Not Available]

OBJECTIVE

To analyse the written complaints made by users of the Primary Health Centre in Taco, Tenerife (Spain).

METHOD

We designed an observational, cross-sectional study. All the complaint forms from the period 2003-2004 were analysed. We used the ODDUS classification system.

RESULTS

A total of 126 complaints were made, representing 2.0 complaints per thousand inhabitants/year. Fifty nine percent were answered in the following month. Seventy three percent were women with a mean age of 40.3±12.1 years (range, 19-75). They were directed at the family doctor (31.7%), management (29.4%) and administration (16.7%). The most common complaints by categories were: a) organisation-administration (47.6%), related to a disagreement with institutional rules (11.1%), difficulties with reception desk (10.3%), suspension/cancellation of an appointment (10.3%), and appointment programme (7.1%); b) care (45.2%) referring to delay in care (28.6%) and inappropriate treatment (9.5%); c) limitations of the building infrastructure (7.1%).

CONCLUSIONS

The family physician is the person who receives the majority of complaints, mainly due to a delay in treating the patient. Complaints made by users in Primary Care are a useful method of finding out patient dissatisfaction. They can help us to improve the quality of the assistance in Health Centre.