1293 / Creating the "Cutaneus Chronic Wound" unit

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
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
At the hospital we attend patients with a high level of dependence that require continuous care. With this project we pretend that all patients who need continuous care don't have it interrupted. Therefore we promote a knowledge network on the Northwest of Madrid through professionals training who work in this area and providing support to the figure of a specialist nurse in the care and treatment of skin wounds as consultant.
Description of the Patient Safety Practice
 
A management unit called Cutaneus Chronic Wounds Unit Clinic conducted by a specialist in those treatments. From this unit a working protocol, called "Working Protocol for the Improvement of Health Partnership Coordination and Continuity of Wound Care Cronichles Skin", is created. In the development of this protocol professionals from different care levels are involved. With the aim of spreading this protocol, a continuing education plan is created, aimed at nurses and nursing assistants. During 2014 and the first 9 months of 2015, they have formed a total of 151 professionals and 36 visits to health centers and residences in the area have been made. In Injuries Unit they have attended a total of 285 patients in 2014 and 771 patients from january to october 2015, referred from primary care. Our main objective is to improve the quality of life of all residents of the north west area of Madrid Community, independently of the sanitary assistance level in which they are now, targeting high risk situations to develop a difficult healing wound, as well as people who already have a lesion and need treatment, either in primary assistance, in the geriatric residence field, or in case of patients with fragility. The project starts in the Complex Wounds Unit (CWU), also called “O Ulcer in the north west area of Madrid Community” to continue with the assistance and improvement in the control of patients with complex wounds (CW). The hospital understands that the compromise with our groups of interest is essential for the success of our organization to comply with our mission. Confidence, stablished relationship with these groups will depend mainly of our image and reputation. Working with the interested parties will increase a valuable point to our organization. The achievement of the confidence as a benefit, new opportunities and challenges can be dealt in a shared synergy space and according with our policy and strategy, that could be part of our future. Our groups of interests are related with our organization and have an influence in the systematic operation of the project. We identify the following group of interests: 1. Patients and family 2. Madrid Health Service 3. Hospitals providing intensive care patients 4. Primary assistance health centres, mainly North west Assistance Direction 5. Geriatric residences in Sierra de Guadarrama district 6. Workers During 2014, 23 nursing consultations and 1112 discharges have been carried out in Guadarrama hospital. In these medical consultations, there has been a follow up in the domicile of the patient and this has produced 8 consultations in the CWU, so that the Cutaneous Wound Healing (CWH) support the performance and technical advice in the treatment and discharge in the Primary Assistance (PA) and to the main caregiver. Our aim is that professionals responsible for their care must have the immediate response in this Unit, so in this way to give continuity of treatment until healing is achieved and discharge of the patient. Also, once the patient´s stay in the hospital has finished, the professionals responsible for the patient transfer he/she to the community environment of Primary Assistance. The Cutaneous Wound Healing Unit is in contact and do the follow up. Our proposal is to increase the communication with Health centres of our area, visiting once a month the Health Centres of Guadarrama, San Lorenzo de El Escorial, Becerril de la Sierra and Cercedilla. Also, visiting affiliated sanitary residences who are in the assistance area. Finally, this improvement project propose the following for 2016: - Mutual respect: Personal and professional respect between the people of the hospital, independently of the professional job of individual characteristics of each person is the most important part of the hospital. - Working in a team: Working in a team and the coordination between different people, disciplines and hospital processes and even further to promote the synergy and human group´s strength.
Attachment of relevant written information and/or photos, as appropriate
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Regional or national 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
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Not known
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
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Yes
Specification of implementation in another health care setting(s)
Primary care
Successful implementation's level  of this Patient Safety Practice across settings
Yes, across multiple local/national health systems
Involved health care staff
 
Nurses
Health care assistants
Clinical manager
Quality manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Relative(s)
Point of time in which service user or their reprasentatives' involvement takes place
During the application of the Patient Safety Practice
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
No
Short description of the service users' level of involvement
Consultation, such as asking for information
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
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Management support
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
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
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: MIGUEL BARBAS MONJO
Country: SPAIN
Organisation: HOSPITAL GUADARRAMA
E-mail: miguelangel.barbas@salud.madrid.org
Phone: -34 635 666 636
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