1264 / Qualitative improvement in human resources and equipment of local dispensaries in rural areas

SPAIN
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Implementation of Patient Safety initiatives / Activities
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Topic of the reported practice
Quality improvement project
Aim and the benefit of the Patient Safety Practice
 
The area of influence of our primary care center is about 156 km2, and includes 4 townships and attends a total population of 12941 citizens. Due to geographic peculiarities clinical assistence is organized in one major clinic in Sant Joan de Vilatorrada and 5 local dispensaires, which have a total population of 1086 people.

Our intervention is aiming to:
- Reduce the response time to attend medical emergencies in remote areas.
- Provide the dispensaries with homogeneous and sufficient equipment and medication in order to standardize the response in front of any clinical demand or emergency which might occur in the area of influence.
- Integrate local dispensaries with those quality control procedures related to medication and disposable materials which are already established in Sant Joan de Vilatorrada’s clinic.
Description of the Patient Safety Practice
 
We have followed the cotinuous quality improvement methodology by following the 4 phases of the cycle "PDCA": P: Plan, D: Do, C: Check, A: Act. Once the experience has been planned, it has been progressively developed: • One nurse is assigned to attend all the local dispensaires. • Initially only one room in each local dispensary is equiped with medical devices. Medication stocks and disposable materials are homogenized. • One doctor is assigned to attend all the local dispensaires. At this point, the nurse and the doctor still visit at different times in each dispensary. • Local dispesaries are finally equiped with a second room, so that both professionals can attend their patients simultaniously and timetables can be unified. • In order to give fast response to any critical health situation that might occur in the area, two backpacks are organized containing all the medical devices and drugs required. These are carried from on dispensary to an other by the professionals. As a result of our experience, one clinical team designed to attend exclusively all the local dispensaries is created. By this, we have optimized the time assigned for clinical assistence both for patients and for clinicians and nurses, because instead of having 5 different clinical teams attending the dispensaires now there’s just one team which attends all of them. In terms of security, we have obtained potential benefit for patients because: - Citizens living in the area can be visited by the same clinical team in any of the dispensaries. - There has been an improve in accessibility because there’s a wider range off available visit times. - In case of emergency, there are two health professionals who have rapid access and can offer rapid response in a shorter space of time. Needless to say that this is specially relevant in improving patient’s outcomes in remote or isolated areas. In terms of quality and efficiency we have simplified the monthly check-list procedures in the local dispensaries because we have optimized and standardized the medications stocks and disposable materials. Finally, these procedures have been integrated with those already being applied in Sant Joan de Vilatorrada's clinic.
Attachment of relevant written information and/or photos, as appropriate
2015112702080528727_WP4_ANNEXED.doc
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Team level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
No
A measurement after full implementation of the reported practice was obtained
No
Evaluation of a "positive" effect of the reported practice on Patient Safety
Effect not known or the intervention has not yet been evaluated
Type of before-and after evaluation
There is no specified text here
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Primary care
Community care facility
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Not known
Specification of implementation in another health care setting(s)
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Successful implementation's level  of this Patient Safety Practice across settings
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Involved health care staff
 
Physicians
Nurses
Administrative support (secretary, clerk, receptionist etc.)
Clinical manager
Quality manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
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Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
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Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
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List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Motivated staff
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
Yes
Description of used incentives, if any.
The main incentive was that the clinical team which attends local dispensaires work only morning turns, whilst the reast of the staff working in Sant Joan de Vilatorrada's clinic have both morning and afternoon turns.
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
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Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
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Contact information
 
Name: Elena Serra
Country: SPAIN
Organisation: Institut Catala de la Salut
E-mail: eserra.cc.ics@gencat.cat
Phone: 670926002
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