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Mira JJ, Torres D, Gil V, Carratalá C. Loneliness impact on healthcare utilization in primary care: A retrospective study. J Healthc Qual Res 2024:S2603-6479(24)00027-7. [PMID: 38670900 DOI: 10.1016/j.jhqr.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/13/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND An increased number of patients seek help for loneliness in primary care. OBJECTIVE To analyze whether loneliness was associated with a higher utilization of healthcare facilities. METHODS Observational, retrospective study based on the review of routinely coded data in the digital medical record system in a random sample of patients aged 65 or older, stratified by population size of their residence area. A minimum sample size was estimated at 892 medical records. Loneliness was defined as the negative feeling that arises when there is a mismatch between the quantity and quality of a person's social relationships and those, they desire. Thirty-three primary care nurses (30 females and 3 males) were reviewing the data. RESULTS A total of 932 medical records of patients were reviewed (72% belonged to female patients). Of these, 657 individuals were living alone (71.9%). DeJong Scale average scores was 8.9 points (SD 3.1, 95CI 8.6-9.1). The average annual attendance to primary care ranged from 12.2 visits per year in the case of family practice, 10.7 nurse, 0.7 social workers. The average number of home visits was 3.2, and the urgent consultations attended at health centers were 1.5 per year. Higher feelings of loneliness were associated with extreme values in the frequency of healthcare resource usage. Compared to their peers of the same age, the additional healthcare resource consumption amounted to €802.18 per patient per year. CONCLUSION Loneliness is linked to higher healthcare resource usage in primary care, with individuals experiencing poorer physical and mental health utilizing these resources up to twice as much as their peers of the same age.
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Affiliation(s)
- J J Mira
- Healthcare District Alicante-Sant Joan, Fisabio, Alicante, Spain; Health Psychology Department, Universidad Miguel Hernandez, Elche, Spain; RICAPPS (Research Network on Chronicity, Primary Care, and Prevention and Health Promotion), Spain.
| | - D Torres
- Healthcare District Alicante-Sant Joan, Fisabio, Alicante, Spain
| | - V Gil
- RICAPPS (Research Network on Chronicity, Primary Care, and Prevention and Health Promotion), Spain; Medicine Department, Universidad Miguel Hernandez, Sant Joan, Spain
| | - C Carratalá
- RICAPPS (Research Network on Chronicity, Primary Care, and Prevention and Health Promotion), Spain; Medicine Department, Universidad Miguel Hernandez, Sant Joan, Spain
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Mira JJ, Matarredona V, Tella S, Sousa P, Ribeiro Neves V, Strametz R, López-Pineda A. Unveiling the hidden struggle of healthcare students as second victims through a systematic review. BMC Med Educ 2024; 24:378. [PMID: 38589877 PMCID: PMC11000311 DOI: 10.1186/s12909-024-05336-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND When healthcare students witness, engage in, or are involved in an adverse event, it often leads to a second victim experience, impacting their mental well-being and influencing their future professional practice. This study aimed to describe the efforts, methods, and outcomes of interventions to help students in healthcare disciplines cope with the emotional experience of being involved in or witnessing a mistake causing harm to a patient during their clerkships or training. METHODS This systematic review followed the PRISMA guidelines and includes the synthesis of eighteen studies, published in diverse languages from 2011 to 2023, identified from the databases MEDLINE, EMBASE, SCOPUS and APS PsycInfo. PICO method was used for constructing a research question and formulating eligibility criteria. The selection process was conducted through Rayyan. Titles and abstracts of were independently screened by two authors. The critical appraisal tools of the Joanna Briggs Institute was used to assess the risk of bias of the included studies. RESULTS A total of 1354 studies were retrieved, 18 met the eligibility criteria. Most studies were conducted in the USA. Various educational interventions along with learning how to prevent mistakes, and resilience training were described. In some cases, this experience contributed to the student personal growth. Psychological support in the aftermath of adverse events was scattered. CONCLUSION Ensuring healthcare students' resilience should be a fundamental part of their training. Interventions to train them to address the second victim phenomenon during their clerkships are scarce, scattered, and do not yield conclusive results on identifying what is most effective and what is not.
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Affiliation(s)
- José Joaquín Mira
- Atenea Research. FISABIO, Alicante, Spain.
- Universidad Miguel Hernández, Elche, Spain.
| | | | - Susanna Tella
- Faculty of Health and Social Care, LAB University of Applied Sciences, Lappeenranta, Finland
| | - Paulo Sousa
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | | | - Reinhard Strametz
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), RheinMain UAS, Wiesbaden, Germany
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Gil-Hernández E, Carrillo I, Tumelty ME, Srulovici E, Vanhaecht K, Wallis KA, Giraldo P, Astier-Peña MP, Panella M, Guerra-Paiva S, Buttigieg S, Seys D, Strametz R, Mora AU, Mira JJ. How different countries respond to adverse events whilst patients' rights are protected. Med Sci Law 2024; 64:96-112. [PMID: 37365924 DOI: 10.1177/00258024231182369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Patient safety is high on the policy agenda internationally. Learning from safety incidents is a core component in achieving the important goal of increasing patient safety. This study explores the legal frameworks in the countries to promote reporting, disclosure, and supporting healthcare professionals (HCPs) involved in safety incidents. A cross-sectional online survey was conducted to ascertain an overview of the legal frameworks at national level, as well as relevant policies. ERNST (The European Researchers' Network Working on Second Victims) group peer-reviewed data collected from countries was performed to validate information. Information from 27 countries was collected and analyzed, giving a response rate of 60%. A reporting system for patient safety incidents was in place in 85.2% (N = 23) of countries surveyed, though few (37%, N = 10) were focused on systems-learning. In about half of the countries (48.1%, N = 13) open disclosure depends on the initiative of HCPs. The tort liability system was common in most countries. No-fault compensation schemes and alternative forms of redress were less common. Support for HCPs involved in patient safety incidents was extremely limited, with just 11.1% (N = 3) of participating countries reporting that supports were available in all healthcare institutions. Despite progress in the patient safety movement worldwide, the findings suggest that there are considerable differences in the approach to the reporting and disclosure of patient safety incidents. Additionally, models of compensation vary limiting patients' access to redress. Finally, the results highlight the need for comprehensive support for HCPs involved in safety incidents.
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Affiliation(s)
- Eva Gil-Hernández
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Sant Joan d'Alacant, Spain
| | - Irene Carrillo
- Health Psychology Department, Miguel Hernández University, Elche, Spain
| | | | - Einav Srulovici
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
| | - Kris Vanhaecht
- Department of Public Health, Leuven Institute for Healthcare Policy, KU Leuven-University of Leuven, Leuven, Belgium
| | - Katharine Ann Wallis
- General Practice Clinical Unit, Medical School, The University of Queensland, Brisbane, Australia
| | - Priscila Giraldo
- Head Patient Advocacy, Hospital del Mar, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - María Pilar Astier-Peña
- Primary Care Quality Unit, Territorial Health Authority, Camp de Tarragona. Health Institut of Catalonia, Barcelona, Spain
- Patient Safety Group of SemFYC (Spanish Society of Family and Community Medicine) and Quality and Safety Group of Wonca World (Global Family Doctors), Barcelona, Spain
| | - Massimiliano Panella
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, Novara, Italy
| | - Sofia Guerra-Paiva
- Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Sandra Buttigieg
- Department of Health Services Management, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Deborah Seys
- Department of Public Health, Leuven Institute for Healthcare Policy, KU Leuven-University of Leuven, Leuven, Belgium
| | - Reinhard Strametz
- Wiesbaden Business School, RheinMain University of Applied Sciences, Wiesbaden, Germany
| | - Asier Urruela Mora
- Department of Criminal Law, Philosophy of Law and History of Law, University of Zaragoza, Zaragoza, Spain
| | - José Joaquín Mira
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Sant Joan d'Alacant, Spain
- Health Psychology Department, Miguel Hernández University, Elche, Spain
- Alicante-Sant Joan Health District, Alicante, Spain
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Guilabert M, Sánchez-García A, Asencio A, Marrades F, García M, Mira JJ. [Challenges and strategies to recover and dynamize primary care: SWOT-CAME analysis in a Health Department]. Aten Primaria 2024; 56:102809. [PMID: 38029655 PMCID: PMC10716492 DOI: 10.1016/j.aprim.2023.102809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE To identify strengths, obstacles, changes in the environment, and capabilities of primary care teams and support units, with the aim of providing high-quality care in an integrated healthcare area. DESIGN Mixed methods study based on the SWOT matrix and CAME analysis. LOCATION Primary care, Valencian community. PARTICIPANTS A total of 271 professionals from different collectives and patient association representatives participated. 99 in the idea generation phase, 154 in the SWOT matrix development phase, and 18 in the CAME analysis development phase. INTERVENTIONS A SWOT-CAME analysis was conducted, from which action lines were established. Information capture was carried out through nominal groups, and the consensus phase involved integrating all professionals through Delphi and consensus conference techniques. MAIN MEASUREMENTS Prioritization of proposals to maintain strengths, address threats, exploit opportunities, and correct weaknesses within the framework of an integrated healthcare area action plan. RESULTS A total of 82 different ideas were proposed (20 strengths; 40 weaknesses; 4 threats; 12 opportunities; 6 threats-opportunities), which, once prioritized, were translated into 7 lines and 33 prioritized actions/interventions (CAME analysis). CONCLUSIONS Integrated care, seeking collaborative approaches between care levels, redefining roles, digital solutions, staff training, and improvements in equipment and support processes, along with measures to address the aging population and the needs of socio-sanitary centers, constitute the challenges to be addressed.
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Affiliation(s)
- Mercedes Guilabert
- Departamento Psicología de la Salud, Universidad Miguel Hernández, Alicante, España.
| | | | - Alberto Asencio
- Departamento de Salud Alicante-Sant Joan d'Alacant, Alicante, España
| | - Fabiola Marrades
- Departamento de Salud Alicante-Sant Joan d'Alacant, Alicante, España
| | - Mónica García
- Departamento de Salud Alicante-Sant Joan d'Alacant, Alicante, España
| | - José Joaquín Mira
- Departamento Psicología de la Salud, Universidad Miguel Hernández, Alicante, España; Departamento de Salud Alicante-Sant Joan d'Alacant, Alicante, España; ATENEA investigación. FISABIO, Sant Joan d'Alacant, Alicante, España; Red de Investigación sobre Crónicidad, Atención Primaria y Promoción de la Salud (RICAPPS), España
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Brotons A, Mangas-Sanjuan C, Cubiella J, Cid-Gómez L, Díez-Redondo P, Seoane A, García-Mateo S, Suárez A, Nicolás-Pérez D, Lumbreras B, Mira JJ, Sola-Vera J, Jover R. Colonoscopy Satisfaction and Safety Questionnaire based on patient experience (CSSQP): A valuable quality tool for all colonoscopies. Gastroenterol Hepatol 2024; 47:1-13. [PMID: 36841528 DOI: 10.1016/j.gastrohep.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/06/2023] [Accepted: 02/11/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION The Colonoscopy Satisfaction and Safety Questionnaire based on Patient experience (CSSQP) was recently developed and validated within a Bowel Cancer Screening Program. We aimed to identify factor related to patient experience through the CSSQP, including all indications for colonoscopy. Indicators of satisfaction and perceived safety with colonoscopy were also assessed to compare the different centers. METHODS Multicenter study in nine Spanish hospitals. Consecutive patients who had undergone a colonoscopy completed the CSSQP adding a novel item on bowel preparation. Factors related to patient experiences and data from non-respondents were analyzed. RESULTS Of 2200 patients, 1753 filled out the questionnaire (response rate 79.7%, sample error 2%). Patients whose colonoscopy indication was a primary colorectal cancer screening (OR: 1.68, 95% CI: 1.15-2.44, p=0.007) or due to a +FIT (OR: 1.73, 95% CI: 1.18-2.53) reported higher satisfaction than patients with gastrointestinal symptoms. In addition, college-educated patients (OR: 2.11, 95% CI: 1.25-3.56) were more likely to report better overall satisfaction than patients with lower education level. Significant differences were observed in the majority of the CSSQP items between centers. Safety incidents were reported by 35 (2%) patients, and 176 (10%) patients reported that they received insufficient information. CONCLUSION The CSSQP identifies several significant factors on satisfaction and perceived safety in patients referred for colonoscopy for any reason. The CSSQP also allows comparison of patient-identified colonoscopy quality indicators between centers.
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Affiliation(s)
- Alicia Brotons
- Department of Gastroenterology, Hospital General Universitario de Elche, Elche, Spain; Department of Gastroenterology, Vega Baja Hospital of Orihuela, Spain.
| | - Carolina Mangas-Sanjuan
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain
| | - Joaquín Cubiella
- Department of Gastroenterology, Complexo Hospitalario de Ourense, Instituto de Investigación Sanitaria Galicia Sur, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Ourense, Spain
| | - Lucía Cid-Gómez
- Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica, Xerencia Integrada de Vigo, Vigo, Spain
| | | | - Agustín Seoane
- Department of Gastroenterology, Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
| | - Sandra García-Mateo
- Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Aragon Health Research Institute, Zaragoza, Spain
| | - Adolfo Suárez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - David Nicolás-Pérez
- Department of Gastroenterology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Blanca Lumbreras
- Department of Public Health, Miguel Hernández University, Elche, Spain; CIBERESP, CIBER in Epidemiology and Public Health, Spain
| | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
| | - Javier Sola-Vera
- Department of Gastroenterology, Hospital General Universitario de Elche, Elche, Spain
| | - Rodrigo Jover
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain
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Guerra-Paiva S, Lobão MJ, Simões DG, Fernandes J, Donato H, Carrillo I, Mira JJ, Sousa P. Key factors for effective implementation of healthcare workers support interventions after patient safety incidents in health organisations: a scoping review. BMJ Open 2023; 13:e078118. [PMID: 38151271 PMCID: PMC10753749 DOI: 10.1136/bmjopen-2023-078118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023] Open
Abstract
OBJECTIVES This study aims to map and frame the main factors present in support interventions successfully implemented in health organisations in order to provide timely and adequate response to healthcare workers (HCWs) after patient safety incidents (PSIs). DESIGN Scoping review guided by the six-stage approach proposed by Arksey and O'Malley and by PRISMA-ScR. DATA SOURCES CINAHL, Cochrane Library, Embase, Epistemonikos, PsycINFO, PubMed, SciELO Citation Index, Scopus, Web of Science Core Collection, reference lists of the eligible articles, websites and a consultation group. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Empirical studies (original articles) were prioritised. We used the Mixed Methods Appraisal Tool Version 2018 to conduct a quality assessment of the eligible studies. DATA EXTRACTION AND SYNTHESIS A total of 9766 records were retrieved (last update in November 2022). We assessed 156 articles for eligibility in the full-text screening. Of these, 29 earticles met the eligibility criteria. The articles were independently screened by two authors. In the case of disagreement, a third author was involved. The collected data were organised according to the Organisational factors, People, Environment, Recommendations from other Audies, Attributes of the support interventions. We used EndNote to import articles from the databases and Rayyan to support the screening of titles and abstracts. RESULTS The existence of an organisational culture based on principles of trust and non-judgement, multidisciplinary action, leadership engagement and strong dissemination of the support programmes' were crucial factors for their effective implementation. Training should be provided for peer supporters and leaders to facilitate the response to HCWs' needs. Regular communication among the implementation team, allocation of protected time, funding and continuous monitoring are useful elements to the sustainability of the programmes. CONCLUSION HCWs' well-being depends on an adequate implementation of a complex group of interrelated factors to support them after PSIs.
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Affiliation(s)
- Sofia Guerra-Paiva
- Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA National School of Public Health, NOVA University Lisbon, Lisboa, Portugal
| | - Maria João Lobão
- Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA National School of Public Health, NOVA University Lisbon, Lisboa, Portugal
- Internal Medicine Department, Hospital de Cascais Dr Jose de Almeida, Alcabideche, Portugal
| | - Diogo Godinho Simões
- Public Health Unit of ACES Almada-Seixal, Almada, Portugal
- NOVA National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Joana Fernandes
- NOVA National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Helena Donato
- Documentation and Scientific Information Service, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Irene Carrillo
- Health Psychology, Miguel Hernandez University, Elche, Spain
- Health Psychology, FISABIO, Miguel Hernandez University, Elche, Spain
| | - José Joaquín Mira
- Health Psychology, Miguel Hernandez University, Elche, Spain
- Salud Alicante-Sant Joan Health District, Elche, Spain
| | - Paulo Sousa
- Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA National School of Public Health, NOVA University Lisbon, Lisboa, Portugal
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Lorenzo S, Carrasco G, Parés D, Mira JJ, Natal MC, Lledó R, Vazquez F, Orrego C, Santiñà M, Izquierdo S, March JC, Zurita B, Põlluste K. Journal of Healthcare Quality Research and its first impact factor. J Healthc Qual Res 2023; 38:325-326. [PMID: 37758603 DOI: 10.1016/j.jhqr.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Affiliation(s)
- S Lorenzo
- Editorial Committee, Journal of Healthcare Quality Research, Spain.
| | - G Carrasco
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - D Parés
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - J J Mira
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - M C Natal
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - R Lledó
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - F Vazquez
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - C Orrego
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - M Santiñà
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - S Izquierdo
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - J C March
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - B Zurita
- Editorial Committee, Journal of Healthcare Quality Research, Spain
| | - K Põlluste
- Editorial Committee, Journal of Healthcare Quality Research, Spain
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Pola-Garcia M, Carrera Noguero AM, Astier-Peña MP, Mira JJ, Guilabert-Mora M, Cassetti V, Melús-Palazón E, Gasch-Gallén A, Benedé Azagra CB. Social Prescribing Schemes in Primary Care in Spain (EvalRA Project): a mixed-method study protocol to build an evaluation model. BMC Prim Care 2023; 24:220. [PMID: 37880601 PMCID: PMC10598937 DOI: 10.1186/s12875-023-02164-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/28/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Social Prescribing is a Primary Health Care service that provides people with non-clinical care alternatives that may have an impact on their health. Social Prescribing can be more or less formal and structured. Social Prescribing Schemes are formal Social Prescribing of health assets by Primary Health Care teams in coordination and follow-up of patients with providers. The emerging evidence suggests that this service can improve people's health and well-being, create value and provide sustainability for the healthcare system. However, some evaluations note that the current evidence regarding social prescribing is insufficient and needs further investigation. The EvaLRA project aims to elaborate an evaluation model of Social Prescribing Schemes in Primary Health Care based on a set of structure, process, and outcomes indicators. METHODS In the region of Aragon, the Community Health Care Strategy aims to promote the development of social prescription schemes in Primary Health Care teams. This study is divided into two stages. Stage 1: identification of primary health care teams that implement social prescribing schemes and establish a first set of indicators to evaluate social prescribing using qualitative consensus techniques with experts. Stage 2 evaluation of the relevance, feasibility and sensitivity of selected indicators after 6 and 12 months in primary health care teams. The results will provide a set of indicators considering structure, process and outcomes for social prescribing schemes. DISCUSSION Current evaluations of the application of social prescribing schemes use different criteria and indicators. A set of agreed indicators and its piloting in primary health care teams will provide a tool to evaluate the implementation of social prescription schemes. In addition, the scorecard created could be of interest to other health systems in order to assess the service and improve its information system, deployment and safety.
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Affiliation(s)
- M Pola-Garcia
- Servicio Aragonés de Salud, Zaragoza, Spain.
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
| | - A M Carrera Noguero
- Servicio Aragonés de Salud, Zaragoza, Spain
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Programa Actividades Comunitarias en Atención Primaria (PACAP), Sociedad Española de Medicina Familiar y Comunitaria (SEMFYC), Barcelona, Spain
| | - M P Astier-Peña
- Servicio Aragonés de Salud, Zaragoza, Spain
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Unidad Territorial de Calidad, Dirección Territorial del Camp de Tarragona, Institut Català De La Salut, Tarragona, Spain
- FEPS, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Wonca World Executive Board, Brussels, Belgium
- Grupo de trabajo de Seguridad del Paciente, Sociedad Española de Medicina Familiar y Comunitaria (SEMFYC), Barcelona, Spain
| | - J J Mira
- Departmento Psicología de la Salud, Universidad Miguel Hernandez, Alicante, Spain
- Grupo de Investigación Atenea, Fundación para la Investigación Biomédica de la Comunidad Valenciana (FISABIO), Alicante, Spain
- Calité Investigación, Universidad Miguel Hernandez, Alicante, Spain
- Departamento de Salud Alicante-San Juan de Alicante, Alicante, Spain
| | - M Guilabert-Mora
- Departmento Psicología de la Salud, Universidad Miguel Hernandez, Alicante, Spain
- Calité Investigación, Universidad Miguel Hernandez, Alicante, Spain
| | - V Cassetti
- Universidad Internacional de Valencia (VIU), Valencia, Spain
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Indepent research, Affiliated researcher to the Unesco Chair in Global Health and Education, London, UK
| | - E Melús-Palazón
- Servicio Aragonés de Salud, Zaragoza, Spain
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Grupo Aragonés de Investigación en Atención Primaria B21_23R, Gobierno de Aragón, Zaragoza, Spain
- Departamento de Medicina, Psiquiatría y Dermatología, Universidad de Zaragoza, Zaragoza, Spain
| | - A Gasch-Gallén
- Grupo Aragonés de Investigación en Atención Primaria B21_23R, Gobierno de Aragón, Zaragoza, Spain
- Departamento de Fisiatria y Enfermería, Universidad de Zaragoza, Zaragoza, Spain
- Grupo GIIS094, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - C B Benedé Azagra
- Servicio Aragonés de Salud, Zaragoza, Spain
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Programa Actividades Comunitarias en Atención Primaria (PACAP), Sociedad Española de Medicina Familiar y Comunitaria (SEMFYC), Barcelona, Spain
- Grupo Aragonés de Investigación en Atención Primaria B21_23R, Gobierno de Aragón, Zaragoza, Spain
- Estrategia de Atencion Comunitaria en el Sistema de Salud de Aragon Atencion Primaria. Servicio Aragones de Salud, Departamento de Sanidad, Gobierno de Aragon, Zaragoza, Spain
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Carrillo I, Poblete R, Serpa P, Martin-Delgado J, Giménez A, Mira JJ. Social support for overcoming fear of contagion at the start of the COVID-19 pandemic. Cross-sectional study in Latin America. Front Psychol 2023; 14:1215693. [PMID: 37780156 PMCID: PMC10536181 DOI: 10.3389/fpsyg.2023.1215693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/30/2023] [Indexed: 10/03/2023] Open
Abstract
Background The psychological impact of the COVID-19 pandemic on healthcare professionals has been widely studied, along with different strategies to minimize it. However, professionals' assessment of the social support received and the factors that mitigated their fear of contagion have not been described. This study aimed to assess healthcare professionals' satisfaction with the social support and information received and their efforts to self-isolate to avoid infecting loved ones in Chile, Colombia, and Ecuador. Methods A cross-sectional online survey, conducted from July to September 2020 in three Latin American countries, elicited healthcare professionals' satisfaction with social support from colleagues, their community, the media, and scientific societies; as well as the information received about the evolution of the pandemic and measures to avoid contagion. The EASE scale was used to measure acute stress. Results Survey responses were received from 700 professionals. The response rate per country exceeded the estimated sample size except in the case of Colombia, which was 81.4%. In general, peer support was highly valued, though satisfaction was lower in high-risk units (p < 0.001). Those who directly assisted COVID-19 patients perceived the least community support (p = 0.023). Professionals from high-risk units (p = 0.013) and those who experienced greater acute stress (p = 0.05) assigned the lowest rating to the information offered by the centre on the pandemic. Men perceived more support from colleagues and better information from the centre than women (p < 0.05). Just 10.7% of professionals changed their residence during the pandemic, but those who worked in high-risk areas self-isolated more frequently (p = 0.026). Conclusion In the early stages of the COVID-19 pandemic, healthcare professionals in Chile, Colombia, and Ecuador greatly valued the support received from their peers. Being infected with COVID-19, working in high-risk areas, experiencing higher self-reported acute stress, and having an infected co-worker were predictors for self-isolation to protect their relatives. These results point to the appropriateness of putting in place institutional resources based on peer support and specific communication strategies and action protocols to build resilience and responsiveness to future health crises.
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Affiliation(s)
- Irene Carrillo
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
| | - Rodrigo Poblete
- Pontificia Universidad Católica de Chile, Facultad de Medicina, Departamento de Medicina Interna, Dirección de Calidad y Gestión Clínica Red de Salud UC CHRISTUS, Santiago, Chile
| | - Piedad Serpa
- Department of Clinical Management and Patient Safety, School of Medicine, Universidad de Santander, Bucaramanga, Colombia
| | - Jimmy Martin-Delgado
- Hospital Luis Vernaza, Junta de Beneficencia de Guayaquil, Guayaquil, Ecuador
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Alejandro Giménez
- ATENEA Research Group, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Sant Joan d’Alacant, Spain
| | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain
- ATENEA Research Group, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Sant Joan d’Alacant, Spain
- Hospital Provincial-Pla Health District, Health Department of Alicante-Sant Joan, Alicante, Spain
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Vicente MA, Gil Hernández E, Carrillo I, Fernández C, López-Pineda A, Guilabert M, Martín-Delgado J, Solis C, Camba K, Cañizares Fuentes WR, Mira JJ. Coping Strategies Used by Health Care Workers in Ecuador During the COVID-19 Pandemic: Observational Study to Enhance Resilience and Develop Training Tools. JMIR Hum Factors 2023; 10:e47702. [PMID: 37672317 PMCID: PMC10512111 DOI: 10.2196/47702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/21/2023] [Accepted: 07/28/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has generated immense health care pressure, forcing critical decisions to be made in a socially alarmed environment. Adverse conditions have led to acute stress reactions, affective pathologies, and psychosomatic reactions among health personnel, which have been exacerbated by the successive waves of the pandemic. The recovery of the entire health system and its professionals has been hindered, making it essential to increase their resilience. OBJECTIVE This study aimed to achieve 2 primary objectives. First, it sought to identify coping strategies, both individual and organizational, used by health care workers in Ecuador to navigate the acute stress during the early waves of the pandemic. Second, it aimed to develop training materials to enhance team leaders' capabilities in effectively managing high-stress situations. METHODS The study used qualitative research techniques to collect information on institutional and personal coping strategies, as well as consensus-building techniques to develop a multimedia psychological tool that reinforces the resilience of professionals and teams in facing future crises. RESULTS The findings from the actions taken by health care workers in Ecuador were categorized into 4 types of coping strategies based on Lazarus' theories on coping strategies. As a result of this study, a new audiovisual tool was created, comprising a series of podcasts, designed to disseminate these strategies globally within the Spanish-speaking world. The tool features testimonials from health care professionals in Ecuador, narrating their experiences under the pressures of providing care during the pandemic, with a particular emphasis on the coping strategies used. CONCLUSIONS Ensuring the preparedness of health professionals for potential future outbreaks is imperative to maintain quality and patient safety. Interventions such as this one offer valuable insights and generate new tools for health professionals, serving as a case study approach to train leaders and improve the resilience capacity and skills of their teams.
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Affiliation(s)
| | - Eva Gil Hernández
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Sant Joan d'Alacant, Spain
| | - Irene Carrillo
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| | - César Fernández
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| | - Adriana López-Pineda
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Sant Joan d'Alacant, Spain
| | | | - Jimmy Martín-Delgado
- Hospital Luis Vernaza, Junta de Beneficencia de Guayaquil, Guayaquil, Ecuador
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Carlos Solis
- Endocrinology Service, Hospital IEES Norte Los Ceibos, Guayaquil, Ecuador
- Facultad de Medicina, Universidad de Guayaquil, Guayaquil, Ecuador
| | - Karla Camba
- Facultad de Ciencias de la Salud, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador
| | - Wilson Ricardo Cañizares Fuentes
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - José Joaquín Mira
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Sant Joan d'Alacant, Spain
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Mira JJ. [Errores Honestos y Segundas Víctimas: Hacia una Cultura Justa para la Seguridad del Paciente]. J Healthc Qual Res 2023; 38:259-261. [PMID: 37657855 DOI: 10.1016/j.jhqr.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 09/03/2023]
Affiliation(s)
- José Joaquín Mira
- Chair ERNST Consortium (funded by European Cooperation in Science and Technology, COST Action 19113). ATENEA Research Group Director, FISABIO. Professor at Miguel Hernández University of Elche.
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Sánchez-García A, Saurín-Morán PJ, Carrillo I, Tella S, Põlluste K, Srulovici E, Buttigieg SC, Mira JJ. Patient safety topics, especially the second victim phenomenon, are neglected in undergraduate medical and nursing curricula in Europe: an online observational study. BMC Nurs 2023; 22:283. [PMID: 37620803 PMCID: PMC10464449 DOI: 10.1186/s12912-023-01448-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 08/14/2023] [Indexed: 08/26/2023] Open
Abstract
This study aims to assess the inclusion of second victims and other patient safety issues in the curricula of undergraduate medical and nursing degrees in the countries participating in the European Researchers' Network Working on Second Victims (The ERSNT Consortium, COST Action 19,113). A review of medical and nursing school curricula in 206 universities was carried out, using their websites to search for subjects addressing "patient safety", "quality of care", "risk management", "safe practices", "interprofessional communication", "adverse events", and "second victims". There was substantial variability in the extent of training for patient safety. Forty-four out of 88 nursing schools and 74 of 118 medical schools did not include any of the patient safety topics studied. The most frequent in both nursing and medicine was "interprofessional communication", followed by "quality of care" and basic aspects on "patient safety". The second victim phenomenon was present in only one curriculum of the total sample. Our study showed that patient safety, especially the second victim phenomenon, is still neglected in medical and nursing curricula in European universities, although positive initiatives were also found. Given the frequency with which adverse events occur in health centres and the need to prepare students to deal with them adequately, additional efforts are needed to introduce patient safety elements into medical and nursing education.
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Affiliation(s)
- Alicia Sánchez-García
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region, FISABIO, Alicante, Spain
| | - Pedro José Saurín-Morán
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region, FISABIO, Alicante, Spain
| | - Irene Carrillo
- Health Psychology Department, Miguel Hernandez University, Elche, 03202, Spain.
| | - Susanna Tella
- Faculty of Social Services and Health Care, LAB University of Applied Sciences, Lappeenranta, 53850, Finland
| | - Kaja Põlluste
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Einav Srulovici
- Cheryl Spencer Department of Nursing, University of Haifa, Haifa, 3498838, Israel
| | - Sandra C Buttigieg
- Department of Health Systems Management and Leadership, Faculty of Health Sciences, University of Malta, Msida, 2080, MSD, Malta
| | - José Joaquín Mira
- Foundation for the Promotion of Health and Biomedical Research of the Valencia Region, FISABIO, Alicante, Spain
- Health Psychology Department, Miguel Hernandez University, Elche, 03202, Spain
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13
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Gil-Hernández E, Falaschi A, Carrillo I, Rodríguez V, Peralta Roca MB, García-Elorrio E, Mira JJ. Clinical leadership and coping strategies in times of COVID-19: observational study with health managers in Mendoza. BMC Health Serv Res 2023; 23:869. [PMID: 37587446 PMCID: PMC10433632 DOI: 10.1186/s12913-023-09792-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 07/06/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND The outbreak of the COVID-19 pandemic required an immediate response to the healthcare challenges it posed. This study was conducted to identify actions that helped healthcare professionals to overcome the initial impact in Mendoza (Argentina). METHODS A cross-sectional study was carried out in a non-random sample of managers and staff of the public health system of Mendoza (Argentina) (n = 134). An ad-hoc and voluntary survey was carried out with 5 multi-response questions that combined questions referring to the management of the pandemic at the organizational level with others referring to coping at the individual level. The survey questions were formulated based on the results of six focus groups that were conducted previously. Descriptive frequency analysis was performed. RESULTS 60 people agreed to participate and 45 answered the full questionnaire. At both the organizational and individual level, there was consensus with at least 50% of votes. The most outstanding at the organizational level was "Prioritize the need according to risk" and at the individual level it was "Support from family or friends", being also the most voted option in the whole questionnaire. CONCLUSIONS The responses that emerged for coping with COVID-19 must be seen as an opportunity to identify strategies that could be effective in addressing future crisis situations that jeopardize the system's response capacity. Moreover, it is essential to retain both changes at the organizational level (e.g., new protocols, multidisciplinary work, shift restructuring, etc.) and coping strategies at the individual level (e.g., social support, leisure activities, etc.) that have proven positive outcomes.
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Affiliation(s)
- Eva Gil-Hernández
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (Fisabio), Sant Joan d'Alacant, Spain
| | - Andrea Falaschi
- Ministry of Health, Social Development and Sport, Government of Mendoza, Mendoza, Argentina
| | - Irene Carrillo
- Health Psychology Department, Miguel Hernández University, Avenida de la Universidad s/n, Elche, 03202, Spain.
| | - Viviana Rodríguez
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | | | | | - José Joaquín Mira
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (Fisabio), Sant Joan d'Alacant, Spain
- Health Psychology Department, Miguel Hernández University, Avenida de la Universidad s/n, Elche, 03202, Spain
- Alicante-Sant Joan d'Alacant Health District, Alicante, Spain
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14
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Mira JJ, Ballester P, Gil-Hernández E, Sambrano Valeriano L, Álvarez Gómez E, Olier Garate C, Márquez Ruiz Á, Acedo Torrecilla M, Arroyo Rodríguez A, Hidalgo Galache E, Navas Gutiérrez P, Pérez-Jover V, Lorenzo Martínez S, Carrillo Murcia I, Fernández Peris C, Sánchez-García A, Vicente Ripoll MA, Cobos Vargas Á, Pérez-Pérez P, Guilabert Mora M. Safe Care and Medication Intake Provided by Caregivers at Home: Reality Care Study Protocol. Healthcare (Basel) 2023; 11:2190. [PMID: 37570430 PMCID: PMC10419200 DOI: 10.3390/healthcare11152190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
JUSTIFICATION Providing care to patients with several conditions and simultaneously taking several medications at home is inexorably growing in developed countries. This trend increases the chances of home caregivers experiencing diverse errors related with medication or care. OBJECTIVE To determine the effectiveness of four different educational solutions compared to the natural intervention (absence of intervention) to provide a safer care at home by caregivers. METHOD Prospective, parallel, and mixed research study with two phases. Candidates: Home-based caregivers caring a person with multiple comorbid conditions or polymedication who falls into one of the three profiles of patients defined for the study (oncology, cardiovascular, or pluripathological patients). First phase: Experts first answered an online survey, and then joined together to discuss the design and plan the content of educational solutions directed to caregivers including the identification of medication and home care errors, their causes, consequences, and risk factors. Second phase: The true experiment was performed using an inter- and intrasubject single-factor experimental design (five groups: four experimental groups against the natural intervention (control), with pre- and post-intervention and follow-up measures) with a simple random assignment, to determine the most effective educational solution (n = 350 participants). The participants will be trained on the educational solutions through 360 V, VR, web-based information, or psychoeducation. A group of professionals called the "Gold Standard" will be used to set a performance threshold for the caring or medication activities. The study will be carried out in primary care centers, hospitals, and caregivers' associations in the Valencian Community, Andalusia, Madrid, and Murcia. EXPECTED RESULTS We expect to identify critical elements of risk management at home for caregivers and to find the most effective and optimal educational solution to reduce errors at home, increasing caregivers' motivation and self-efficacy whilst the impact of gender bias in this activity is reduced. TRIAL REGISTRATION Clinical Trial NCT05885334.
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Affiliation(s)
- José Joaquín Mira
- Departamento Psicología de la Salud, Universidad Miguel Hernández, 03202 Elche, Spain; (V.P.-J.); (I.C.M.); (C.F.P.); (M.A.V.R.); (M.G.M.)
- Health District Alicante-Sant Joan, 03013 Alicante, Spain
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, 03550 Sant Joan d’Alacant, Spain; (P.B.); (E.G.-H.); (A.S.-G.)
| | - Pura Ballester
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, 03550 Sant Joan d’Alacant, Spain; (P.B.); (E.G.-H.); (A.S.-G.)
- Departamento Farmacología, Universidad Católica de San Antonio de Murcia, 30107 Murcia, Spain
| | - Eva Gil-Hernández
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, 03550 Sant Joan d’Alacant, Spain; (P.B.); (E.G.-H.); (A.S.-G.)
| | | | | | - Clara Olier Garate
- Hospital Universitario Fundación Alcorcón, 28922 Alcorcón, Spain; (C.O.G.); (S.L.M.)
| | | | | | | | | | | | - Virtudes Pérez-Jover
- Departamento Psicología de la Salud, Universidad Miguel Hernández, 03202 Elche, Spain; (V.P.-J.); (I.C.M.); (C.F.P.); (M.A.V.R.); (M.G.M.)
- Health District Alicante-Sant Joan, 03013 Alicante, Spain
| | | | - Irene Carrillo Murcia
- Departamento Psicología de la Salud, Universidad Miguel Hernández, 03202 Elche, Spain; (V.P.-J.); (I.C.M.); (C.F.P.); (M.A.V.R.); (M.G.M.)
- Health District Alicante-Sant Joan, 03013 Alicante, Spain
| | - César Fernández Peris
- Departamento Psicología de la Salud, Universidad Miguel Hernández, 03202 Elche, Spain; (V.P.-J.); (I.C.M.); (C.F.P.); (M.A.V.R.); (M.G.M.)
- Health District Alicante-Sant Joan, 03013 Alicante, Spain
| | - Alicia Sánchez-García
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, 03550 Sant Joan d’Alacant, Spain; (P.B.); (E.G.-H.); (A.S.-G.)
| | - María Asunción Vicente Ripoll
- Departamento Psicología de la Salud, Universidad Miguel Hernández, 03202 Elche, Spain; (V.P.-J.); (I.C.M.); (C.F.P.); (M.A.V.R.); (M.G.M.)
- Health District Alicante-Sant Joan, 03013 Alicante, Spain
| | | | - Pastora Pérez-Pérez
- Unidad Territorial II. Provincia San Juan de Dios de España, 41005 Sevilla, Spain;
| | - Mercedes Guilabert Mora
- Departamento Psicología de la Salud, Universidad Miguel Hernández, 03202 Elche, Spain; (V.P.-J.); (I.C.M.); (C.F.P.); (M.A.V.R.); (M.G.M.)
- Health District Alicante-Sant Joan, 03013 Alicante, Spain
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Seys D, Panella M, Russotto S, Strametz R, Joaquín Mira J, Van Wilder A, Godderis L, Vanhaecht K. In search of an international multidimensional action plan for second victim support: a narrative review. BMC Health Serv Res 2023; 23:816. [PMID: 37525127 PMCID: PMC10391912 DOI: 10.1186/s12913-023-09637-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/03/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Insights around second victims (SV) and patient safety has been growing over time. An overview of the available evidence is lacking. This review aims to describe (i) the impact a patient safety incident can have and (ii) how healthcare professionals can be supported in the aftermath of a patient safety incident. METHODS A literature search in Medline, EMBASE and CINAHL was performed between 1 and 2010 and 26 November 2020 with studies on SV as inclusion criteria. To be included in this review the studies must include healthcare professionals involved in the aftermath of a patient safety incident. RESULTS In total 104 studies were included. SVs can suffer from both psychosocial (negative and positive), professional and physical reactions. Support can be provided at five levels. The first level is prevention (on individual and organizational level) referring to measures taken before a patient safety incident happens. The other four levels focus on providing support in the aftermath of a patient safety incident, such as self-care of individuals and/or team, support by peers and triage, structured support by an expert in the field (professional support) and structured clinical support. CONCLUSION The impact of a patient safety incident on healthcare professionals is broad and diverse. Support programs should be organized at five levels, starting with preventive actions followed by self-care, support by peers, structured professional support and clinical support. This multilevel approach can now be translated in different countries, networks and organizations based on their own culture, support history, structure and legal context. Next to this, they should also include the stage of recovery in which the healthcare professional is located in.
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Affiliation(s)
- Deborah Seys
- Department Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, Leuven, Belgium.
- Department Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Massimiliano Panella
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Sophia Russotto
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - José Joaquín Mira
- The Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Alicante, Spain
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| | - Astrid Van Wilder
- Department Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Lode Godderis
- Department Public Health and Primary Care, KU Leuven, Leuven, Belgium
- External Service for Prevention and Protection at Work, IDEWE, Heverlee, Belgium
| | - Kris Vanhaecht
- Department Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Quality, University Hospitals Leuven, 3000, Leuven, Belgium
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de Dios JG, López-Pineda A, Juan GMP, Minagorre PJA, Guilabert M, Pérez-Jover V, Carrillo I, Mira JJ. Perceptions and attitudes of pediatricians and families with regard to pediatric medication errors at home. BMC Pediatr 2023; 23:380. [PMID: 37525101 PMCID: PMC10391897 DOI: 10.1186/s12887-023-04106-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 06/02/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE This study aimed to identify the perceptions and attitudes of pediatricians and parents/caregivers regarding medication errors at home, and to compare the findings from the two populations. METHODS This was a cross-sectional survey study. We designed a survey for working pediatricians and another one for parents or caregivers of children aged 14 years and younger. The survey's questions were designed to assess provider and parental opinions about the difficulty faced by parents providing medical treatment, specific questions on medication errors, and on a possible intervention program aimed at preventing pediatric medication errors. Pediatrician and parent responses to matching questions in both surveys were compared. RESULTS The surveys were administered in Spain from 2019 to 2021. In total, 182 pediatricians and 194 families took part. Most pediatricians (62.6%) and families (79.3%) considered that managing medical treatment was not among the main difficulties faced by parents in caring for their children. While 79.1% of pediatricians thought that parents consulted the internet to resolve doubts regarding the health of their children, most families (81.1%) said they consulted healthcare professionals. Lack of knowledge among parents and caregivers was one of the causes of medication errors most frequently mentioned by both pediatricians and parents. Most pediatricians (95.1%) said they would recommend a program designed to prevent errors at home. CONCLUSIONS Pediatricians and families think that medical treatment is not among the main difficulties faced by parents in caring for their children. Most pediatricians said they would recommend a medication error reporting and learning system designed for families of their patients to prevent medication errors that might occur in the home environment.
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Grants
- GV/2019/040 Ministry of innovation, universities, science and society of Valencia Region
- GV/2019/040 Ministry of innovation, universities, science and society of Valencia Region
- GV/2019/040 Ministry of innovation, universities, science and society of Valencia Region
- GV/2019/040 Ministry of innovation, universities, science and society of Valencia Region
- GV/2019/040 Ministry of innovation, universities, science and society of Valencia Region
- GV/2019/040 Ministry of innovation, universities, science and society of Valencia Region
- GV/2019/040 Ministry of innovation, universities, science and society of Valencia Region
- GV/2019/040 Ministry of innovation, universities, science and society of Valencia Region
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Affiliation(s)
- Javier González de Dios
- Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernandez University, San Juan de Alicante, Spain
- Paediatrics Department, General University Hospital of Alicante, Alicante, Spain
- Institute of Health and Biomedical Research of Alicante, Alicante Spain General University Hospital of Alicante, Alicante, Spain
| | - Adriana López-Pineda
- Clinical Medicine Department, Miguel Hernández University, San Juan de Alicante, Spain
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, San Juan de Alicante, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), San Juan de Alicante, Spain
| | | | - Pedro J Alcalá Minagorre
- Paediatrics Department, General University Hospital of Alicante, Alicante, Spain
- Institute of Health and Biomedical Research of Alicante, Alicante Spain General University Hospital of Alicante, Alicante, Spain
| | - Mercedes Guilabert
- Health Psychology Department, Miguel Hernandez University, Elche, Spain.
| | - Virtudes Pérez-Jover
- Institute of Health and Biomedical Research of Alicante, Alicante Spain General University Hospital of Alicante, Alicante, Spain
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| | - Irene Carrillo
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| | - José Joaquín Mira
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, San Juan de Alicante, Spain
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
- Alicante-Sant Joan d'Alacant Health Department, San Juan de Alicante, Spain
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Härkänen M, Pineda AL, Tella S, Mahat S, Panella M, Ratti M, Vanhaecht K, Strametz R, Carrillo I, Rafferty AM, Wu AW, Anttila VJ, Mira JJ. The impact of emotional support on healthcare workers and students coping with COVID-19, and other SARS-CoV pandemics - a mixed-methods systematic review. BMC Health Serv Res 2023; 23:751. [PMID: 37443003 DOI: 10.1186/s12913-023-09744-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Pandemics such as COVID-19 pose threats to the physical safety of healthcare workers and students. They can have traumatic experiences affecting their personal and professional life. Increasing rates of burnout, substance abuse, depression, and suicide among healthcare workers have already been identified, thus making mental health and psychological wellbeing of the healthcare workers a major issue. The aim of this systematic review is to synthesize the characteristics of emotional support programs and interventions targeted to healthcare workers and students since the onset of COVID-19 and other SARS-CoV pandemics and to describe the effectiveness and experiences of these programs. METHOD This was a mixed method systematic review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the review was registered on PROSPERO [CRD42021262837]. Searches were conducted using Medline, CINAHL, PsycINFO, Cochrane Library, and Scopus databases. The COVIDENCE systematic review management system was used for data selection and extraction by two independent reviewers. The JBI (Joanna Briggs Institute) critical appraisal tools were used to assess the quality of selected studies by two additional reviewers. Finally, data extraction and narrative analysis were conducted. RESULTS The search retrieved 3161 results including 1061 duplicates. After screening, a total of 19 articles were included in this review. Participants in studies were nurses, physicians, other hospital staff, and undergraduate medical students mostly working on the front-line with COVID-19 patients. Publications included RCTs (n = 4), quasi-experimental studies (n = 2), cross-sectional studies (n = 6), qualitative interview studies (n = 3), and systematic reviews (n = 4). Most (63.4%) of the interventions used online or digital solutions. Interventions mostly showed good effectiveness (support-seeking, positive emotions, reduction of distress symptoms etc.) and acceptance and were experienced as helpful, but there were some conflicting results. CONCLUSION Healthcare organizations have developed support strategies focusing on providing emotional support for these healthcare workers and students, but it is difficult to conclude whether one program offers distinct benefit compared to the others. More research is needed to evaluate the comparative effectiveness of emotional support interventions for health workers.
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Affiliation(s)
- Marja Härkänen
- Department of Nursing Science, University of Eastern Finland, Yliopistoranta 1c, Kuopio, Finland
| | - Adriana López Pineda
- Department of Clinical Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
- The Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Alicante, Spain
| | - Susanna Tella
- LAB University of Applied Sciences, Lappeenranta, Finland
| | - Sanu Mahat
- Department of Nursing Science, University of Eastern Finland, Yliopistoranta 1c, Kuopio, Finland
| | - Massimiliano Panella
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, Novara, Italy
| | - Matteo Ratti
- Department of Translational Medicine (DIMET), Università del Piemonte Orientale, Novara, Italy
| | - Kris Vanhaecht
- Leuven Institute for Healthcare Policy, Department of Public Health & Primary Care, University of Leuven, Leuven, Belgium
- Department of Quality Management, University Hospitals Leuven, Leuven, Belgium
| | - Reinhard Strametz
- Wiesbaden Business School of RheinMain University of Applied Sciences, Wiesbaden, Germany
| | - Irene Carrillo
- Health Psychology Department, Miguel Hernández University, Elche, Spain
| | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College, London, UK
| | - Albert W Wu
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - José Joaquín Mira
- The Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Alicante, Spain.
- Health Psychology Department, Miguel Hernández University, Elche, Spain.
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Carrillo I, Lopez-Pineda A, Pérez-Jover V, Guilabert M, Vicente MA, Fernández C, Gil-Guillen VF, Orozco-Bletrán D, Chilet-Rosell E, Luzon Oliver L, Astier-Peña MP, Tella S, Carratalá-Munuera C, Mira JJ. Epidemiological study on gender bias and low-value practices in primary care: a study protocol. BMJ Open 2023; 13:e070311. [PMID: 37160394 PMCID: PMC10174026 DOI: 10.1136/bmjopen-2022-070311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
INTRODUCTION Evidence shows that gender has a substantial impact on health behaviours, access to and use of health systems and health system responses. This study aims to assess gender bias in patients subjected to low-value practices in the primary care setting and to develop recommendations for reducing adverse events that women experience for this reason. METHODS AND ANALYSIS A Delphi study will be performed to reach a consensus on the 'Do Not Do' recommendations with a possible gender bias. A retrospective cohort study in a random selection of medical records will then be carried out to identify the frequency of adverse events that occur when the selected 'Do Not Do' recommendations are ignored. Qualitative research techniques (consensus conference and nominal group) will be carried out to develop recommendations to address any gender bias detected, considering barriers and facilitators in clinical practice. ETHICS AND DISSEMINATION The study was approved by the ethics committee of San Juan de Alicante Hospital (San Juan de Alicante, Spain) Reference N. 21/061. We will disseminate the research findings via peer-reviewed articles, presentations at national and international scientific forums and webinars. TRIAL REGISTRATION NUMBER The study was registered at ClinicalTrials.gov (NCT05233852) on 10 February 2022.
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Affiliation(s)
- Irene Carrillo
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Adriana Lopez-Pineda
- Department of Clinical Medicine, Miguel Hernandez University of Elche, San Juan de Alicante, Spain
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, San Juan de Alicante, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), San Juan de Alicante, Spain
| | - Virtudes Pérez-Jover
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Mercedes Guilabert
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | | | - César Fernández
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
| | - Vicente F Gil-Guillen
- Department of Clinical Medicine, Miguel Hernandez University of Elche, San Juan de Alicante, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), San Juan de Alicante, Spain
| | - Domingo Orozco-Bletrán
- Department of Clinical Medicine, Miguel Hernandez University of Elche, San Juan de Alicante, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), San Juan de Alicante, Spain
| | - Elisa Chilet-Rosell
- Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Madrid, Spain
- Department of Public Health, Miguel Hernandez University of Elche, San Juan de Alicante, Spain
| | | | - Maria Pilar Astier-Peña
- Grupo de investigación IIS-Aragón H36_23D Feminización, Ética y Profesionalidad de las ciencias de la salud (FEPS), Tarragona, Spain
- Territorial Quality Unit. Management of Camp de Tarragona, Catalan Health Institute, Tarragona, Spain
| | - Susanna Tella
- Health & Wellbeing, LAB University of Applied Sciences-Lappeenrannan kampus, Lappeenranta, Finland
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Concepción Carratalá-Munuera
- Department of Clinical Medicine, Miguel Hernandez University of Elche, San Juan de Alicante, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), San Juan de Alicante, Spain
| | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, San Juan de Alicante, Spain
- Alicante-Sant Joan d'Alacant Health Department, San Juan de Alicante, Spain
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19
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Moya D, Guilabert M, Manzanera R, Gálvez G, Torres M, López-Pineda A, Jiménez ML, Mira JJ. Differences in Perception of Healthcare Management between Patients and Professionals. Int J Environ Res Public Health 2023; 20:3842. [PMID: 36900854 PMCID: PMC10001773 DOI: 10.3390/ijerph20053842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/12/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Patient perception and the organizational and safety culture of health professionals are an indirect indicator of the quality of care. Both patient and health professional perceptions were evaluated, and their degree of coincidence was measured in the context of a mutual insurance company (MC Mutual). This study was based on the secondary analysis of routine data available in databases of patients' perceptions and professionals' evaluations of the quality of care provided by MC Mutual during the period 2017-2019, prior to the COVID-19 pandemic. Eight dimensions were considered: the results of care, coordination of professionals, trust-based care, clinical and administrative information, facilities and technical means, confidence in diagnosis, and confidence in treatment. The patients and professionals agreed on the dimension of confidence in treatment (good), and the dimensions of coordination and confidence in diagnosis (poor). They diverged on confidence in treatment, which was rated worse by patients than by professionals, and on results, information and infrastructure, which were rated worse by professionals only. This implies that care managers have to reinforce the training and supervision activities of the positive coincident aspects (therapy) for their maintenance, as well as the negative coincident ones (coordination and diagnostic) for the improvement of both perceptions. Reviewing patient and professional surveys is very useful for the supervision of health quality in the context of an occupational mutual insurance company.
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Affiliation(s)
- Diego Moya
- Healthcare and Prevention Services Area, MC Mutual, 08037 Barcelona, Spain
| | - Mercedes Guilabert
- Health Psychology Department, Miguel Hernández University, 03202 Elche, Spain
| | - Rafael Manzanera
- Healthcare and Prevention Services Area, MC Mutual, 08037 Barcelona, Spain
| | | | - Marta Torres
- Healthcare and Prevention Services Area, MC Mutual, 08037 Barcelona, Spain
| | - Adriana López-Pineda
- Clinical Medicine Department, Miguel Hernandez University, 03550 Sant Joan d'Alacant, Spain
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, 03550 Sant Joan d'Alacant, Spain
| | - María Lourdes Jiménez
- Department of Emergency Medicine, College of Medicine, University of the Philippines, Manila 1500, Philippines
| | - José Joaquín Mira
- Health Psychology Department, Miguel Hernández University, 03202 Elche, Spain
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, 03550 Sant Joan d'Alacant, Spain
- Alicante-Sant Joan d'Alacant Health Department, 03013 Alicante, Spain
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20
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Fernández C, Vicente MA, Guilabert M, Carrillo I, Mira JJ. Developing a mobile health app for chronic illness management: Insights from focus groups. Digit Health 2023; 9:20552076231210662. [PMID: 37928329 PMCID: PMC10621305 DOI: 10.1177/20552076231210662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
Background Mobile applications have the potential to assist patients and caregivers in managing chronic diseases, but current offerings are typically limited to a single disease or only focused on patients. A multifaceted app could expand the user base and provide more comprehensive support for patients who usually suffer from diverse chronic conditions at the same time and their caregivers. Objectives This study aimed to design, develop, and evaluate a mobile application that could aid chronic patients and their caregivers in managing the range of chronic conditions. Methods Focus group meetings were conducted with patients and caregivers to identify their needs, which were translated into app functionalities. The final version of the app was evaluated through a survey and analysis of the most used features. Results Five focus group (FG) meetings were held, involving 39 patients and 22 caregivers. The app included medication aids, self-monitoring aids, activation reminders, messages for caregiver shifts, remote monitoring, medicine management, and informative videos. Testing by 65 patients revealed that medication reminders (96.8% positive responses), medicine information (96.8%), messages for caregiver shifts (90.3%), and ease of use (80.6%) were the most valued aspects. The most frequently used feature was the health data record check. Conclusions A multifaceted mobile application can address the needs of a variety of chronic patients and their caregivers, while still being easy to use. The app's most used functionalities were aligned with the needs expressed in the FG, which reflects the success of this study and suggests that future research could benefit from incorporating similar user-centered design methodologies.
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Affiliation(s)
- César Fernández
- Telematics Engineering, Miguel Hernandez University, Elche, Spain
| | | | | | - Irene Carrillo
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| | - José Joaquín Mira
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
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21
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Carrillo I, López-Pineda A, García-Díaz S, López A, Valencia Muntalà L, Juanola X, Zarco P, Ignacio E, Mira JJ. Proposals for the incorporation of the nursing role in the certification of axial spondyloarthritis units. Literature review and expert consensus. Reumatol Clin (Engl Ed) 2022; 18:580-586. [PMID: 35469782 DOI: 10.1016/j.reumae.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/30/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To analyse the role of nursing in the approach to axial spondyloarthritis (axSpA) and to make proposals to include the role of rheumatology nursing consultations (RECs) in the quality certification of these specialized units. METHODS A systematic review of the nursing role in quality certification systems in the management of axSpA was conducted. Subsequently a consensus conference was held with the participation of three rheumatology nurses to determine elements that should be considered in future revisions of certification standards. RESULTS The systematic review yielded five papers as relevant. None of the publications reviewed explicitly proposed standards applicable to nursing care in the management of patients with axSpA, although they contemplated the activities of this professional group. The proposals agreed upon to incorporate the role of RECs in the certification standards for axSpA monographic units included the following: basic equipment and resources, organization, administration of pharmacological treatments and promotion of adherence, standardized programmes for axSpA, telematic consultation for monitoring the stable patient, registry of patient-reported outcome measures and e-consultation. CONCLUSIONS The literature on quality standards and certification standards for axSpA monographic units is scarce and hardly reflects the role of RECs in providing quality care. The consensus proposals in this study would incorporate RECs into quality certification standards. In the future, the increased presence of RECs in Spain should be accompanied by a review of the indicators regarding their role.
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Affiliation(s)
- Irene Carrillo
- Departamento de Psicología de la Salud, Universidad Miguel Hernández de Elche, Elche, Spain.
| | - Adriana López-Pineda
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan (Alicante), Spain; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), San Juan (Alicante), Spain
| | - Silvia García-Díaz
- Departamento de Reumatología, Complex Hospitalari Moisès Broggi, CSI, Sant Joan Despí (Barcelona), Spain
| | - Amparo López
- Departamento de Enfermería de Práctica Avanzada, CEIMI, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Lídia Valencia Muntalà
- Servicio de Reumatología, Hospital Universitario de Bellvitge, Hospitalet de Llobregat (Barcelona), Spain
| | - Xavier Juanola
- Servicio de Reumatología, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat (Barcelona), Spain
| | - Pedro Zarco
- Unidad de Reumatología, Hospital Universitario Fundación de Alcorcón, Madrid, Spain
| | - Emilio Ignacio
- Gestión Sanitaria y Calidad Asistencial, Universidad de Cádiz, Cádiz, Spain
| | - José Joaquín Mira
- Departamento de Psicología de la Salud, Universidad Miguel Hernández de Elche, Elche, Spain; Departamento de Salud Alicante-Sant Joan d'Alacant, San Juan (Alicante), Spain
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22
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Vicente MA, Fernández C, Guilabert M, Carrillo I, Martín-Delgado J, Mira JJ. Patient Engagement Using Telemedicine in Primary Care during COVID-19 Pandemic: A Trial Study. Int J Environ Res Public Health 2022; 19:14682. [PMID: 36429402 PMCID: PMC9690471 DOI: 10.3390/ijerph192214682] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
The correct treatment of most non-transmissible diseases requires, in addition to adequate medication, adherence to physical activity and diet guidelines, as well as health data monitoring and patient motivation. The restrictions caused by the COVID-19 pandemic made telemedicine tools and mobile apps the best choice for monitoring patient compliance. The objective of this study was to analyze the benefits of an m-Health solution designed specifically for chronic patients during the COVID-19 pandemic. A pragmatic clinical trial with pre-post measurements of a single group was carried out with 70 patients (aged 40+) with one or more chronic conditions. Patients were provided with an ad hoc mobile app and health data measuring devices according to their diseases. The health status of the patients was monitored remotely by health professionals who could also modify the patient's objectives according to their evolution. The results obtained show an average fulfillment of objectives of 77%. Higher fulfillment values: medication adherence (98%) and oxygen saturation (82%); lower fulfillment values: weight (48%), glucose (57%), and distance walked (57%). Globally, the ad hoc app was rated 8.72 points out of 10 (standard deviation 1.10). Concerning the pre-post analysis, there were significant improvements vs. prior apps used by the participants in the following items: improved physical activation and better control of blood pressure, diet, weight, glucose, and oxygen saturation. In conclusion, the telemedicine tool developed was useful in increasing patient engagement and adherence to treatment.
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Affiliation(s)
| | - César Fernández
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain
| | - Mercedes Guilabert
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain
| | - Irene Carrillo
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain
| | - Jimmy Martín-Delgado
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 0313 Alicante, Spain
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil 090603, Ecuador
| | - José Joaquín Mira
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), 0313 Alicante, Spain
- Alicante-Sant Joan d’Alacant Health Department, 03013 Alicante, Spain
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23
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Martin‐Delgado J, Tovar C, Pazmiño I, Briones A, Carrillo I, Guilabert M, Mira JJ. Indicators for adequate diabetes care for the indigenous communities of Ecuador. Health Expect 2022; 25:3315-3325. [DOI: 10.1111/hex.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 10/09/2022] [Accepted: 10/19/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jimmy Martin‐Delgado
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas Universidad Católica de Santiago de Guayaquil Guayaquil Ecuador
- Hospital Luis Vernaza Junta de Beneficencia de Guayaquil Guayaquil Ecuador
| | - Carla Tovar
- 14D06 District of Health Ministry of Health Macas Ecuador
| | - Israel Pazmiño
- Health Zone Coordination #3 Ministry of Health Riobamba Ecuador
| | - Amelia Briones
- Facultad de Medicina Pontificia Universidad Católica del Ecuador Quito Ecuador
- Coordinación de Calidad Secretaria Metropolitana de Salud Municipio de Quito Ecuador
| | - Irene Carrillo
- Health Psychology Department Miguel Hernández University Elche Spain
| | | | - José Joaquín Mira
- Health Psychology Department Miguel Hernández University Elche Spain
- Health District Alicante‐Sant Joan Alicante Spain
- Atenea Research Group Foundation for the Promotion of Health and Biomedical Research Sant Joan d'Alacant Spain
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24
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Guerra-Paiva S, Lobão MJ, Simões JD, Donato H, Carrillo I, Mira JJ, Sousa P. Key factors for effective implementation of healthcare worker support interventions after patient safety incidents in health organisations: a protocol for a scoping review. BMJ Open 2022; 12:e061543. [PMID: 35926988 PMCID: PMC9358946 DOI: 10.1136/bmjopen-2022-061543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Health organisations should support healthcare workers who are physically and psychologically affected by patient safety incidents (second victims). There is a growing body of evidence which focuses on second victim support interventions. However, there is still limited research on the elements necessary to effectively implement and ensure the sustainability of these types of interventions. In this study, we propose to map and frame the key factors which underlie an effective implementation of healthcare worker support interventions in healthcare organisations when healthcare workers are physically and/or emotionally affected by patient safety incidents. METHODS AND ANALYSIS This scoping review will be guided by the established methodological Arksey and O'Malley framework, Levac and Joanna Briggs Institute (JBI) recommendations. We will follow the JBI three-step process: (1) a preliminary search conducted on two databases; (2) the definition of clear inclusion criteria and the creation of a list of search terms to be used in the subsequent running of the search on a larger number of databases; and (3) additional searches (cross-checking/cross-referencing of reference lists of eligible studies, hand-searching in target journals relevant to the topic, conference proceedings, institutional/organisational websites and networks repositories). We will undertake a comprehensive search strategy in relevant bibliographic databases (PubMed/MEDLINE, Embase, CINHAL, Web of Science, Scopus, PsycInfo, Epistemonikos, Scielo, Cochrane Library and Open Grey). We will use the Mixed Methods Appraisal Tool V.2018 for quality assessment of the eligible studies. Our scoping review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. ETHICS AND DISSEMINATION This study will not require ethical approval. Results of the scoping review will be published in a peer-review journal, and findings will be presented in scientific conferences as well as in international forums and other relevant dissemination channels. TRIAL REGISTRATION NUMBER 10.17605/OSF.IO/RQAT6.Preprint from medRxiv available: doi: https://doi.org/10.1101/2022.01.25.22269846.
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Affiliation(s)
- Sofia Guerra-Paiva
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Centre, CHRC, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Maria João Lobão
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Centre, CHRC, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - João Diogo Simões
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Public Health Unit of ACES USP Almada-Seixal, Almada, Portugal
| | - Helena Donato
- Documentation and Scientific Information Service, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Irene Carrillo
- Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
- Research Institute FISABIO, Alicante, Spain
| | - José Joaquín Mira
- Health Psychology, Miguel Hernandez University of Elche, Elche, Spain
- Research Institute FISABIO, Alicante, Spain
- Salud Alicante-Sant Joan Health District, Alicante, Spain
| | - Paulo Sousa
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Centre, CHRC, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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25
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Cheikh-Moussa K, Caro Mendivelso J, Carrillo I, Astier-Peña MP, Olivera G, Silvestre C, Nuín M, Mira JJ. Frequency and estimated costs of ten low-value practices in the Spanish Primary Care: a retrospective study. Expert Opin Drug Saf 2022; 21:995-1003. [PMID: 35020555 DOI: 10.1080/14740338.2022.2026924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The frequency of low-value practices (LVPs) in the healthcare system is a worldwide challenge. Far less is known about the related extra cost. This study aimed to evaluate the LVPs trend in Spanish primary care (PC), its frequency in both sexes, and estimate its related extra cost. METHODS A multicentric, retrospective, and national research project was conducted. Ten LVPs highly frequent and potentially harmful for patients were analyzed. Algorithms were applied to collect the data from 28,872,851 episodes registered into national databases (2015-2017). Cost estimation was made. RESULTS LVPs registered a total of 7,160,952 (26.5%) episodes plus a total of 259,326 avoidable PSA screening tests. In adults, a high frequency was found for prescription of 1g paracetamol >3 days, antibiotics for acute bronchitis (unconfirmed comorbidity), and benzodiazepines in patients >65 years with insomnia. Women received more jeopardizing practices (p≤0.001). Pediatrics presented a downward of antibiotic and paracetamol-ibuprofen prescription combination. The estimated extra cost was close to €292 million (2.8% of the total cost in PC). CONCLUSION LVPs reduction during the analyzed period was moderate compared to studies following 'Choosing Wisely list' of LVPs and must improve to reduce patient risk and the extra related costs.
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Affiliation(s)
- Kamila Cheikh-Moussa
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Sant Joan d'Alacant, Spain
| | - Johanna Caro Mendivelso
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Irene Carrillo
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
| | - María Pilar Astier-Peña
- Family and Community Medicine, Universitas Health Centre, Zaragoza I Sector, Aragonese Health Service (SALUD), Zaragoza, Spain.,University of Zaragoza, Aragon Health Research Institute (IISA), Zaragoza, Spain
| | | | - Carmen Silvestre
- Healthcare Effectiveness and Safety Service, Navarre Health Service-Osasunbidea, Pamplona, Spain
| | - Marian Nuín
- Healthcare Effectiveness and Safety Service, Navarre Health Service-Osasunbidea, Pamplona, Spain
| | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernández University, Elche, Spain.,Health District Alicante-Sant Joan, Alicante, Spain.,REDISSEC, Spain
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Mira JJ, Carrillo I, Pérez-Pérez P, Astier-Peña MP, Caro-Mendivelso J, Olivera G, Silvestre C, Nuín MA, Aranaz-Andrés JM. Avoidable Adverse Events Related to Ignoring the Do-Not-Do Recommendations: A Retrospective Cohort Study Conducted in the Spanish Primary Care Setting. J Patient Saf 2021; 17:e858-e865. [PMID: 34009877 PMCID: PMC8612910 DOI: 10.1097/pts.0000000000000830] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to measure the frequency and severity of avoidable adverse events (AAEs) related to ignoring do-not-do recommendations (DNDs) in primary care. METHODS A retrospective cohort study analyzing the frequency and severity of AAEs related to ignoring DNDs (7 from family medicine and 3 from pediatrics) was conducted in Spain. Data were randomly extracted from computerized electronic medical records by a total of 20 general practitioners and 5 pediatricians acting as reviewers; data between February 2018 and September 2019 were analyzed. RESULTS A total of 2557 records of adult and pediatric patients were reviewed. There were 1859 (72.7%) of 2557 (95% confidence interval [CI], 71.0%-74.4%) DNDs actions in 1307 patients (1507 were performed by general practitioners and 352 by pediatricians). Do-not-do recommendations were ignored more often in female patients (P < 0.0001). Sixty-nine AAEs were linked to ignoring DNDs (69/1307 [5.3%]; 95% CI, 4.1%-6.5%). Of those, 54 (5.1%) of 1062 were in adult patients (95% CI, 3.8%-6.4%) and 15 (6.1%) of 245 in pediatric patients (95% CI, 3.1%-9.1%). In adult patients, the majority of AAEs (51/901 [5.7%]; 95% CI, 4.2%-7.2%) occurred in patients 65 years or older. Most AAEs were characterized by temporary minor harm both in adult patients (28/54 [51.9%]; 95% CI, 38.5%-65.2%) and pediatric patients (15/15 [100%]). CONCLUSIONS These findings provide a new perspective about the consequences of low-value practices for the patients and the health care systems. Ignoring DNDs could place patients at risk, and their safety might be unnecessarily compromised. TRIAL REGISTRATION NUMBER NCT03482232.
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Affiliation(s)
- José Joaquín Mira
- From the Health District Alicante-Sant Joan, Alicante
- Miguel Hernández University, Elche
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Sant Joan d’Alacant
| | - Irene Carrillo
- Miguel Hernández University, Elche
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Sant Joan d’Alacant
| | - Pastora Pérez-Pérez
- Patient Safety Observatory, Andalusian Agency for Health Care Quality, Seville
| | - Maria Pilar Astier-Peña
- Family and Community Medicine, “La Jota” Health Centre, Zaragoza I Sector, Aragonese Health Service (SALUD)
- University of Zaragoza, Aragon Health Research Institute (IISA), Zaragoza
| | | | | | - Carmen Silvestre
- Healthcare Effectiveness and Safety Service, Navarre Health Service-Osasunbidea
| | | | - Jesús M. Aranaz-Andrés
- Preventive Medicine Service, Hospital Universitario Ramón y Cajal
- Institute Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
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Mira JJ, Cobos-Vargas Á, Astier-Peña MP, Pérez-Pérez P, Carrillo I, Guilabert M, Pérez-Jover V, Fernández-Peris C, Vicente-Ripoll MA, Silvestre-Busto C, Lorenzo-Martínez S, Martin-Delgado J, Aibar C, Aranaz J. Addressing Acute Stress among Professionals Caring for COVID-19 Patients: Lessons Learned during the First Outbreak in Spain (March-April 2020). Int J Environ Res Public Health 2021; 18:12010. [PMID: 34831767 PMCID: PMC8624221 DOI: 10.3390/ijerph182212010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/06/2021] [Accepted: 11/12/2021] [Indexed: 12/01/2022]
Abstract
Objectives: To describe lessons learned during the first COVID-19 outbreak in developing urgent interventions to strengthen healthcare workers' capacity to cope with acute stress caused by health care pressure, concern about becoming infected, despair of witnessing patients' suffering, and critical decision-making requirements of the SARS-CoV-2 pandemic during the first outbreak in Spain. Methods: A task force integrated by healthcare professionals and academics was activated following the first observations of acute stress reactions starting to compromise the professionals' capacity for caring COVID-19 patients. Literature review and qualitative approach (consensus techniques) were applied. The target population included health professionals in primary care, hospitals, emergencies, and nursing homes. Interventions designed for addressing acute stress were agreed and disseminated. Findings: There are similarities in stressors to previous outbreaks, and the solutions devised then may work now. A set of issues, interventions to cope with, and their levels of evidence were defined. Issues and interventions were classified as: adequate communication initiative to strengthen work morale (avoiding information blackouts, uniformity of criteria, access to updated information, mentoring new professionals); resilience and recovery from physical and mental fatigue (briefings, protecting the family, regulated recovery time during the day, psychological first aid, humanizing care); reinforce leadership of intermediate commands (informative leadership, transparency, realism, and positive messages, the current state of emergency has not allowed for an empirical analysis of the effectiveness of proposed interventions. Sharing information to gauge expectations, listening to what professionals need, feeling protected from threats, organizational flexibility, encouraging teamwork, and leadership that promotes psychological safety have led to more positive responses. Attention to the needs of individuals must be combined with caring for the teams responsible for patient care. Conclusions: Although the COVID-19 pandemic has a more devastating effect than other recent outbreaks, there are common stressors and lessons learned in all of them that we must draw on to increase our capacity to respond to future healthcare crises.
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Affiliation(s)
- José Joaquín Mira
- Alicante-Sant Joan Health Department, 03013 Alacant, Spain
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain; (I.C.); (M.G.); (V.P.-J.); (C.F.-P.); (M.A.V.-R.)
| | - Ángel Cobos-Vargas
- Quality and Patient Management, San Cecilio Clinical University Hospital, 18016 Granada, Spain;
| | | | | | - Irene Carrillo
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain; (I.C.); (M.G.); (V.P.-J.); (C.F.-P.); (M.A.V.-R.)
| | - Mercedes Guilabert
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain; (I.C.); (M.G.); (V.P.-J.); (C.F.-P.); (M.A.V.-R.)
| | - Virtudes Pérez-Jover
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain; (I.C.); (M.G.); (V.P.-J.); (C.F.-P.); (M.A.V.-R.)
| | - Cesar Fernández-Peris
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain; (I.C.); (M.G.); (V.P.-J.); (C.F.-P.); (M.A.V.-R.)
| | - María Asunción Vicente-Ripoll
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain; (I.C.); (M.G.); (V.P.-J.); (C.F.-P.); (M.A.V.-R.)
| | | | - Susana Lorenzo-Martínez
- Quality and Patient Management Department, Alcorcon Foundation University Hospital, 28922 Alcorcon, Spain;
| | - Jimmy Martin-Delgado
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, 03550 Sant Joan D’ Alacant, Spain;
| | - Carlos Aibar
- Preventive Medicine Department, Lozano Blesa Clinical University Hospital, 50009 Zaragoza, Spain;
| | - Jesús Aranaz
- Preventive Medicine Department, Ramón y Cajal University Hospital, 28034 Madrid, Spain;
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Pablo L, Beckford CA, Martin-Delgado J, Ferro Osuna M, Fernández-Ferreiro A, Fernández Rodriguez MI, Rodriguez Cid MJ, Méndez S, Torres A, Ignacio E, Mira JJ. «Do Not Do» recommendations for retinopathies: A mixed consensus study. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:578-586. [PMID: 34756279 DOI: 10.1016/j.oftale.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/08/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Among the main causes of blindness and severe vision loss are age-related macular degeneration, diabetic macular oedema, and retinal vein occlusion. The «Do Not Do» recommendations are strategies to improve quality of care and optimise healthcare costs. The aim of this study was to establish, by consensus, practices of low value in the above-mentioned pathologies, in addition to estimating their occurrence. MATERIALS AND METHODS Mixed methods study including a first phase of consensus of a multidisciplinary panel of experts using the Nominal Group technique. In the second phase, a retrospective observational study was conducted, by conducting a review of medical records. RESULTS A total of 7 recommendations were established for age-related macular degeneration, 4 for diabetic macular oedema, and 5 for retinal vein occlusion. A total of 1,012 medical records were reviewed by the 4 participating hospitals. The review of medical records revealed that agreed «Do Not Do's» occurred in a range between 0.6% and 31.4% of the cases included in the study. CONCLUSIONS This study identified «Do Not Do» recommendations in these pathologies that occur relatively often in clinical practice. It is necessary to review the healthcare processes that will enable these practices to be eradicated, and the quality of care to be improved.
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Affiliation(s)
- L Pablo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Spain; OFTARED, Universidad de Zaragoza, Zaragoza, Spain
| | - C A Beckford
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares (Madrid), Spain
| | - J Martin-Delgado
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante, Spain.
| | - M Ferro Osuna
- Servicio de Oftalmología, Hospital 12 de Octubre, Madrid, Spain
| | - A Fernández-Ferreiro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - M I Fernández Rodriguez
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, Spain; Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, Spain
| | - M J Rodriguez Cid
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - S Méndez
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Spain; OFTARED, Universidad de Zaragoza, Zaragoza, Spain
| | - A Torres
- Sociedad Española de Calidad Asistencial, Oviedo, Spain
| | | | - J J Mira
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante, Spain; Departamento de Salud Alicante-Sant Joan, Alicante, Spain; Universidad Miguel Hernández, Elche (Alicante), Spain
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García EI, Martin-Delgado J, Queiro R, Pérez Venegas JJ, Gratacos J, Sanz J, Torrés A, Mira JJ. Quality certification standard proposal "SpACE" for axial spondyloarthritis treatment units. ACTA ACUST UNITED AC 2021; 18:299-303. [PMID: 34736873 DOI: 10.1016/j.reumae.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Axial spondyloarthritis is an immune-mediated disease with a high cost, diagnostic delay and associated complications that makes it a particularly important condition. This work aims to establish a certification standard (SpACE Project) for monographic consultations in its diagnosis and treatment. MATERIALS AND METHODS Qualitative study of consensus, through the technique of the nominal group. First, a pragmatic review of the literature was carried out. Second, professionals involved throughout the care process (rheumatology, ophthalmology, gastroenterology, traumatology, family medicine, physical therapy, and nursing) were included. RESULTS Thirty-seven possible standards were extracted from the pragmatic review of the literature. During the consensus phase only those standards with high feasibility and importance in the care process were prioritized. Finally, the group of 26 experts agreed on the inclusion of 14 standards. DISCUSSION AND CONCLUSIONS SpACE is a consensus-based certification standard that seeks to improve health outcomes and more integrated care.
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Affiliation(s)
| | - Jimmy Martin-Delgado
- Grupo de Investigación Atenea, Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Sant Joan d'Alacant, Alicante, Spain.
| | - Ruben Queiro
- Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | | | - Jordi Gratacos
- Consorci Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain
| | - Jesús Sanz
- Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - José Joaquín Mira
- Departamento de Salud Alicante-Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, Spain; Universidad Miguel Hernández, Elche, Alicante, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Alicante, Spain
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Ortner J, Vives A, Moya D, Torres M, Grau N, Farrús X, Manzanera R, Mira JJ. [Use of the Trigger Tool to detect security incidents in an occupational mutual insurance company in Spain]. J Healthc Qual Res 2021; 37:125-126. [PMID: 34598905 DOI: 10.1016/j.jhqr.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 07/22/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Affiliation(s)
| | - A Vives
- MC Mutual, Barcelona, España
| | - D Moya
- MC Mutual, Barcelona, España
| | | | - N Grau
- MC Mutual, Barcelona, España
| | | | | | - J J Mira
- Universidad Miguel Hernández, Elche, Alicante, España; Departamento de Salud de Alicante-Sant Joan, Alicante, España
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Abstract
OBJECTIVE The aim of the study was to analyze the relationships between factors that contribute to healthcare professionals informing and apologizing to a patient after an avoidable adverse event (AAE). METHODS A secondary study based on the analysis of data collected in a cross-sectional study conducted in 2014 in Spain was performed. Health professionals from hospitals and primary care completed an online survey. RESULTS The responses from 1087 front-line healthcare professionals were analyzed. The willingness of the professionals to fully disclose an AAE was greater among those who were backed by their institution (odds ratio [OR] = 72.6, 95% confidence interval [CI] = 37.5-140.3) and who had experience with that type of communication (OR = 2.4, 95% CI = 1.3-4.5). An apology for the patient was more likely when there was institutional support (OR = 31.3, 95% CI = 14.4-68.2), the professional was not aware of lawsuits (OR = 2.7, 95% CI = 1.2-6.1), and attributed most AAE to human error (OR = 2.2, 95% CI = 1.1-4.2). The fear of lawsuits was determined by the lack of support from the center in disclosing AAE (OR = 5.5, 95% CI = 2.8-10.6) and the belief that being open would result in negative consequences (OR = 2.0, 95% CI = 1.1-3.6). CONCLUSIONS The culture of safety, the experience of blame, and the expectations about the outcome from communicating an AAE to patients affect the frequency of open disclosure. Nurses are more willing than physicians to participate in open disclosure. Health care organizations must act to establish a framework of legal certainty for professionals.
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Affiliation(s)
- Irene Carrillo
- From the Universidad Miguel Hernández de Elche, Elche, Alicante
| | | | | | - Susana Lorenzo
- Hospital Universitario Fundación Alcorcón, Madrid, Spain
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Ortner J, Vives A, Moya D, Torres M, Grau N, Farrús X, Manzanera R, Mira JJ. Frequency of outpatient care adverse events in an occupational mutual insurance company in Spain. J Healthc Qual Res 2021; 36:340-344. [PMID: 34246648 DOI: 10.1016/j.jhqr.2021.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/15/2021] [Accepted: 05/23/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Occupational mutual insurance companies (OMICs), in collaboration with the Spanish Social Security System, provide healthcare and manage the economic benefits for the workers in Spain. They have ambulatory care centers that attend outpatient trauma pathology, although most of the studies published have focused on surgical and hospital activity. The aim of this study was to detect adverse events (AEs) in outpatient trauma care in the context of an OMIC. METHODS A cohort study designed to identify harmful safety incidents (adverse events, AEs) in 2017 was conducted. A random sample of 313 medical records among patients who were visited more than 3 medical and nursing attendances during their outpatient process. The AEs detected were classified according to category, severity and preventability. RESULTS We identified 48 AEs (15.3% of medical records, 95% CI 11.3-19.3), most of them procedure-related, while 27 (56.2%) were preventable and 46 mild (95.8%). CONCLUSIONS The AEs identified are double than those found in primary care general consultations in Spain and are close to the lower range of studies on surgical AEs in traumatology and orthopedics. Preventable AEs were within expected limits. Over half of AEs are preventable, within that group, the mild AEs have an increased rate of preventability. These results highlight the relevance of research of patient safety in the outpatient care of trauma and orthopaedic procedures in an OMIC for patient safety and contribute to introduce improvements in outpatient care.
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Affiliation(s)
- J Ortner
- MC Mutual, C/ Provença, 321, 08037 Barcelona, Spain.
| | - A Vives
- MC Mutual, C/ Provença, 321, 08037 Barcelona, Spain
| | - D Moya
- MC Mutual, C/ Provença, 321, 08037 Barcelona, Spain
| | - M Torres
- MC Mutual, C/ Provença, 321, 08037 Barcelona, Spain
| | - N Grau
- MC Mutual, C/ Provença, 321, 08037 Barcelona, Spain
| | - X Farrús
- MC Mutual, C/ Provença, 321, 08037 Barcelona, Spain
| | - R Manzanera
- MC Mutual, C/ Provença, 321, 08037 Barcelona, Spain
| | - J J Mira
- Universidad Miguel Hernández, Avinguda de la Universitat d'Elx, s/n, 03202 Elche, Alicante, Spain; Departamento de Salud de Alicante-Sant Joan, Alicante, Spain
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Mira JJ. How to reduce medication errors in patients over the age of 65? Expert Opin Pharmacother 2021; 22:2417-2421. [PMID: 34187264 DOI: 10.1080/14656566.2021.1947241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- José Joaquín Mira
- Health Psychology Department, Universidad Miguel Hernandez de Elche, Elche, Spain.,Alicante-Sant Joan Health District, Alicante, Spain
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García EI, Martin-Delgado J, Queiro R, Pérez Venegas JJ, Gratacos J, Sanz J, Torrés A, Mira JJ. Quality Certification Standard Proposal "SpACE" for Axial Spondyloarthritis Treatment Units. Reumatol Clin (Engl Ed) 2021; 18:S1699-258X(21)00126-1. [PMID: 34148827 DOI: 10.1016/j.reuma.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/15/2021] [Accepted: 04/05/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Axial spondyloarthritis is an immune-mediated disease with a high cost, diagnostic delay and associated complications that makes it a particularly important condition. This work aims to establish a certification standard (SpACE Project) for monographic consultations in its diagnosis and treatment. MATERIALS AND METHODS Qualitative study of consensus, through the technique of the nominal group. First, a pragmatic review of the literature was carried out. Second, professionals involved throughout the care process (rheumatology, ophthalmology, gastroenterology, traumatology, family medicine, physical therapy, and nursing) were included. RESULTS Thirty-seven possible standards were extracted from the pragmatic review of the literature. During the consensus phase only those standards with high feasibility and importance in the care process were prioritized. Finally, the group of 26 experts agreed on the inclusion of 14 standards. DISCUSSION AND CONCLUSIONS SpaCE is a consensus-based certification standard that seeks to improve health outcomes and more integrated care.
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Affiliation(s)
| | - Jimmy Martin-Delgado
- Grupo de Investigación Atenea, Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Sant Joan d'Alacant, Alicante, España.
| | - Ruben Queiro
- Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | | | - Jordi Gratacos
- Consorci Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España
| | - Jesús Sanz
- Hospital Puerta de Hierro, Majadahonda, Madrid, España
| | - Antonio Torrés
- Sociedad Española de Calidad Asistencial, Oviedo, España
| | - José Joaquín Mira
- Departamento de Salud Alicante-Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España; Universidad Miguel Hernández, Elche, Alicante, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Alicante, España
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Affiliation(s)
- J J Mira
- Universidad Miguel Hernández, Elche, Spain; Departamento de Salud Alicante-Sant Joan, Alicante, Spain; ATENEA Investigación (Prometeo 2017/173), FISABIO, Alicante, Spain.
| | - S Lorenzo
- Hospital Universitario Fundación Hospital Alcorcón, Madrid, Spain
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Abstract
OBJECTIVES The aim of the study was to assess the safety culture in a mutual insurance sector, searching for improvement opportunities. This sector offers health insurance for work-related injuries and occupational illnesses and represents an annual volume of patients corresponding to approximately 10% of the working population in Europe. METHODS A cross-sectional study was conducted to assess the safety culture in the mutual insurance sector in Spain. All physicians, nurses, and physiotherapists (N = 816) working in the organization in hospitals, outpatient clinics, and managerial settings were invited to reply to an online survey. RESULTS A total of 499 professionals completed the questionnaire (response rate, 61%). Two dimensions were assessed: attitudinal (5 items) and instrumental (5 items). There were no differences between professional profiles or centers in the attitudinal (7.8; standard deviation, 1.3; 95% confidence interval, 7.6-7.9) or instrumental (8.5; standard deviation, 1.0; 95% confidence interval, 8.5-8.6) factors. The lowest level of implementation (<9 points) was related to the following: open disclosure after an adverse event (73%), having a quality and safety plan (75%), prioritizing the improvement of patient care (75%), and involving patients when making decisions on potential treatments (63%). Managers showed lower scores than the rest of professionals' groups (P < 0.05). CONCLUSIONS This intent is to introduce a patient safety culture assessment in the mutual insurance companies. These results may encourage the implementation of quality and safety plans in this sector by paying more attention to attitudinal aspects.
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Pablo L, Beckford CA, Martin-Delgado J, Ferro Osuna M, Fernández-Ferreiro A, Fernández Rodriguez MI, Rodríguez Cid MJ, Méndez S, Torres A, Ignacio E, Mira JJ. «Do Not Do» recommendations for retinopathies: A mixed consensus study. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:S0365-6691(21)00034-4. [PMID: 33612365 DOI: 10.1016/j.oftal.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/31/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Among the main causes of blindness and severe vision loss are age-related macular degeneration, diabetic macular oedema, and retinal vein occlusion. The «Do Not Do» recommendations are strategies to improve quality of care and optimise healthcare costs. The aim of this study was to establish, by consensus, practices of low value in the above-mentioned pathologies, in addition to estimating their occurrence. MATERIALS AND METHODS Mixed methods study including a first phase of consensus of a multidisciplinary panel of experts using the Nominal Group technique. In the second phase, a retrospective observational study was conducted, by conducting a review of medical records. RESULTS A total of 7 recommendations were established for age-related macular degeneration, 4 for diabetic macular oedema, and 5 for retinal vein occlusion. A total of 1,012 medical records were reviewed by the 4 participating hospitals. The review of medical records revealed that agreed «Do Not Do's» occurred in a range between 0.6% and 31.4% of the cases included in the study. CONCLUSIONS This study identified «Do Not Do» recommendations in these pathologies that occur relatively often in clinical practice. It is necessary to review the healthcare processes that will enable these practices to be eradicated, and the quality of care to be improved.
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Affiliation(s)
- L Pablo
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; OFTARED, Universidad de Zaragoza, Zaragoza, España
| | - C A Beckford
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares (Madrid), España
| | - J Martin-Delgado
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante , España.
| | - M Ferro Osuna
- Servicio de Oftalmología, Hospital 12 de Octubre, Madrid, España
| | - A Fernández-Ferreiro
- Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS) , Santiago de Compostela, España; Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, España
| | - M I Fernández Rodriguez
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, España; Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, España
| | - M J Rodríguez Cid
- Servicio de Oftalmología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Ophthalmology and Visual Sciences Research Group, Universidad de Santiago de Compostela, Santiago de Compostela, España
| | - S Méndez
- Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España; OFTARED, Universidad de Zaragoza, Zaragoza, España
| | - A Torres
- Sociedad Española de Calidad Asistencial, Oviedo, España
| | - E Ignacio
- Universidad de Cádiz, Cádiz, Espa0ña
| | - J J Mira
- Grupo de Investigación ATENEA, Fundación para el Fomento de la Investigación Biomédica y Sanitaria, San Juan, Alicante , España; Departamento de Salud Alicante-Sant Joan, Alicante, España; Universidad Miguel Hernández, Elche (Alicante), España
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Guilabert M, Martínez-García A, Sala-González M, Solas O, Mira JJ. Results of a Patient Reported Experience Measure (PREM) to measure the rare disease patients and caregivers experience: a Spanish cross-sectional study. Orphanet J Rare Dis 2021; 16:67. [PMID: 33546736 PMCID: PMC7866674 DOI: 10.1186/s13023-021-01700-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 01/20/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To measure the experience of the person having a rare disease in order to identify objectives for optimal care in the health care received by these patients. Methods. A cross-sectional study was conducted in Spain involving patients associated with the Spanish Rare Diseases Federation [Federación Española de Enfermedades Raras] (FEDER). A modified version of the PREM IEXPAC [Instrumento para evaluar la Experiencia del Paciente Crónico] instrument was used (IEXPAC-rare-diseases). Scores ranged between 0 (worst experience) and 10 (best experience). Results A total of 261 caregivers (in the case of paediatric population) and patients with rare diseases (response rate 54.4%) replied. 232 (88.9%) were adult patients and 29 (11.1%) caregivers of minor patients. Most males, 227 (87%), with an average age of 38 (SD 13.6) years. The mean time since confirmation of diagnosis was 7.8 (SD 8.0) years. The score in this PREM was 3.5 points out to 10 (95%CI 3.2–3.8, SD 2.0). Caregivers of paediatric patients scored higher, except for coordination of social and healthcare services. Conclusions There are wide and important areas for improvement in the care of patients with rare diseases. This study involves a first assesment of the experience of patients with rare diseases in Spain.
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Affiliation(s)
- Mercedes Guilabert
- Health Psychology Department, Calitè Research Group, Miguel Hernández University, Elche, Spain.
| | | | | | | | - José Joaquín Mira
- Health Psychology Department, Calitè Research Group, Miguel Hernández University, Elche, Spain.,Alicante-Sant Joan Health District, Alicante, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas, REDISSEC, Alicante, Spain
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Abstract
OBJECTIVES Identify what occurs among health-care providers (HCPs) after an adverse event (AE) and what colleagues could do to help them. METHOD A qualitative study with participation by physicians and nurses from hospitals and primary care facilities. RESULTS Fifteen HCPs and 12 health professionals with quality management responsibilities with between 8 and 30 years of experience participated; 15 (56%) were physicians (9 general practitioners, 3 surgeons, 2 intensivists, and 1 from an emergency unit), and 12 (44%) were nurses (5 worked in primary care and 7 in hospitals). There was consensus that second victims require support from colleagues and management; however, instead, many times they perceive rejection. They experience repetitive thoughts, fear, and loneliness. Formal channels of information favor the implementation of improvements. Health-care providers reported that information about measures for preventing a new adverse event is inaccessible, whereas management said that a change in behavior was necessary to promote a culture of safety. Common informal channels were the hallways and cafeteria. Reactions by colleagues of second victims were of surprise and to avoid involvement. CONCLUSIONS Organized plans and protocols about what to do to help HCPs after an AE are uncommon. Formal channels of information mitigate rumors and misinformation. Informal channels hinder learning from the experience and strengthening the culture of safety, and they encourage incidents to be hidden. Approaches that permit HCPs involved in an AE to speak about what has happened offer a positive response to their emotional needs.
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Affiliation(s)
- Lena Ferrús
- From the Consorci Sanitari Integral, L'Hospitalet de Llobregat, Barcelona
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Mira JJ, Carrillo I, Guilabert M, Mula A, Martin-Delgado J, Pérez-Jover MV, Vicente MA, Fernández C. Acute stress of the healthcare workforce during the COVID-19 pandemic evolution: a cross-sectional study in Spain. BMJ Open 2020; 10:e042555. [PMID: 33158839 PMCID: PMC7650075 DOI: 10.1136/bmjopen-2020-042555] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To determine the volume of health professionals who suffered distress due to their care of patients with COVID-19 and to analyse the direction in which the response capacity of the professionals to face future waves of COVID-19 is evolving. DESIGN A cross-sectional study. SETTING Primary care and hospitals in Spain. PARTICIPANTS A non-randomised sample of 685 professionals (physicians, nurses and other health staff). PRIMARY AND SECONDARY OUTCOME MEASURES Frequency and intensity of stress responses measured by the Acute Stress of Health Professionals Caring COVID-19 Scale (EASE). Variation of stress responses according to the number of deaths per day per territory and the evolutionary stage of the COVID-19 outbreak measured by the Kruskal-Wallis and the Mann-Whitney U tests. RESULTS The average score on the EASE Scale was 11.1 (SD 6.7) out of 30. Among the participants, 44.2% presented a good emotional adjustment, 27.4% a tolerable level of distress, 23.9% medium-high emotional load and 4.5% extreme acute stress. The stress responses were more intense in the most affected territories (12.1 vs 9.3, p=0.003) and during the disillusionment phase (12.7 vs 8.5 impact, 10.2 heroic and 9.8 honeymoon, p=0.000). CONCLUSIONS The pandemic has affected the mental health of a significant proportion of health professionals which may reduce their resilience in the face of future waves of COVID-19. The institutional approaches to support the psychological needs of health professionals are essential to ensure optimal care considering these results.
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Affiliation(s)
- José Joaquín Mira
- Health Psychology, Miguel Hernandez University of Elche, Elche, Valenciana, Spain
- Alicante-Sant Joan Health District, Alicante, Spain
| | - Irene Carrillo
- Health Psychology, Miguel Hernandez University of Elche, Elche, Valenciana, Spain
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), San Juan, Spain
| | - Mercedes Guilabert
- Health Psychology, Miguel Hernandez University of Elche, Elche, Valenciana, Spain
| | - Aurora Mula
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), San Juan, Spain
| | - Jimmy Martin-Delgado
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), San Juan, Spain
| | | | - Maria Asunción Vicente
- Department of Systems Engineering and Automation, Miguel Hernandez University of Elche, Elche, Valenciana, Spain
| | - César Fernández
- Department of Systems Engineering and Automation, Miguel Hernandez University of Elche, Elche, Valenciana, Spain
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Pascual J, Pozo-Rosich P, Carrillo I, Rodríguez-Justo S, Jiménez-Hernández D, Layos-Romero A, Bailón-Santamaría C, Torres A, Martínez-García A, Ignacio E, Mira JJ. Proposal of a clinical care pathway for quality and safe management of headache patients: a consensus study report. BMJ Open 2020; 10:e037190. [PMID: 33127628 PMCID: PMC7604819 DOI: 10.1136/bmjopen-2020-037190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Headache is one of the most prevalent and disabling conditions. Its optimal management requires a coordinated and comprehensive response by health systems, but there is still a wide variability that compromises the quality and safety of the care process. PURPOSE To establish the basis for designing a care pathway for headache patients through identifying key subpathways in the care process and setting out quality and clinical safety standards that contribute to providing comprehensive, adequate and safe healthcare. METHOD A qualitative research study based on the consensus conference technique. Eleven professionals from the Spanish National Health System participated, seven of them with clinical experience in headache and four specialists in healthcare management and quality. First, identification of the key subpathways in the care process for headache, barriers/limitations for optimal quality of care, and quality and safety standards applied in each subpathway. Second, two consecutive consensus rounds were carried out to assess the content of the subpathway level descriptors, until the expert agreement was reached. Third, findings were assessed by 17 external healthcare professionals to determine their understanding, adequacy and usefulness. RESULTS Seven key subpathways were identified: (1) primary care, (2) emergency department, (3) neurology department, (4) specialised headache unit, (5) hospitalisation, (6) outpatients and (7) governance and management. Sixty-seventh barriers were identified, the most frequent being related to diagnostic errors (36,1%), resource deficiency (25%), treatment errors (19,4%), lack of health literacy (13,9%) and inadequate communications with care transitions (5,6%). Fifty-nine quality and 31 safety standards were defined. They were related to evaluation (23.3%), patient safety (21.1%), comprehensive care (12.2%), treatment (12.2%), clinical practice guidelines (7.8%), counselling (6.7%), training (4.4%) and patient satisfaction (3.3%). CONCLUSIONS This proposal incorporates a set of indicators and standards, which can be used to define a pathway for headache patients and determine the levels of quality.
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Affiliation(s)
- Julio Pascual
- Service of Neurology, University Hospital Marqués de Valdecilla and Valdecilla Biomedical Research Institute, Santander, Cantabria, Spain
- Department of Medicine, University of Cantabria, Santander, Cantabria, Spain
| | - Patricia Pozo-Rosich
- Headache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain
- Headache Research Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Irene Carrillo
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Sant Joan d'Alacant, Valencia Region, Spain
- Department of Health Psychology, Miguel Hernández University, Elche, Valencia Region, Spain
| | | | - Dolores Jiménez-Hernández
- Neurology Department, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
- Faculty of Medicine, University of Seville, Seville, Andalusia, Spain
| | - Almudena Layos-Romero
- Headache Unit, Neurology Department, University Hospital of Albacete, Albacete, Castile-La Mancha, Spain
| | - Cristina Bailón-Santamaría
- Service of Neurology, University Hospital Marqués de Valdecilla and Valdecilla Biomedical Research Institute, Santander, Cantabria, Spain
| | - Antonio Torres
- Andalusian Agency for Healthcare Quality, Seville, Andalusia, Spain
| | - Alba Martínez-García
- Department of Health Psychology, Miguel Hernández University, Elche, Valencia Region, Spain
| | - Emilio Ignacio
- Department of Nursing and Physiotherapy, University of Cadiz, Cadiz, Andalusia, Spain
| | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernández University, Elche, Valencia Region, Spain
- Alicante-Sant Joan Health District, Alicante, Valencia Region, Spain
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Mira JJ, Vicente MA, Lopez-Pineda A, Carrillo I, Guilabert M, Fernández C, Pérez-Jover V, Martin Delgado J, Pérez-Pérez P, Cobos Vargas A, Astier-Peña MP, Martínez-García OB, Marco-Gómez B, Abad Bouzán C. Preventing and Addressing the Stress Reactions of Health Care Workers Caring for Patients With COVID-19: Development of a Digital Platform (Be + Against COVID). JMIR Mhealth Uhealth 2020; 8:e21692. [PMID: 32936769 PMCID: PMC7537725 DOI: 10.2196/21692] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/30/2020] [Accepted: 09/09/2020] [Indexed: 12/14/2022] Open
Abstract
Background COVID-19 became a major public health concern in March 2020. Due to the high rate of hospitalizations for COVID-19 in a short time, health care workers and other involved staff are subjected to a large workload and high emotional distress. Objective The objective of this study is to develop a digital tool to provide support resources that might prevent and consider acute stress reactions in health care workers and other support staff due to the COVID-19 pandemic. Methods The contents of the digital platform were created through an evidence-based review and consensus conference. The website was built using the Google Blogger tool. The Android version of the app was developed in the Java and XML languages using Android Studio version 3.6, and the iOS version was developed in the Swift language using Xcode version 11.5. The app was evaluated externally by the Andalusian Agency for Healthcare Quality. Results We detected the needs and pressing situations of frontline health care workers, and then, we proposed a serial of recommendations and support resources to address them. These resources were redesigned using the feedback received. A website in three different languages (Spanish, English, and Portuguese) and a mobile app were developed with these contents, and the AppSaludable Quality Seal was granted to the app. A specific self-report scale to measure acute stress and additional tools were included to support the health care workforce. This instrument has been used in several Latin American countries and has been adapted considering cultural differences. The resources section of the website was the most visited with 18,516 out of 68,913 (26.9%) visits, and the “Self-Report Acute Stress Scale” was the most visited resource with 6468 out of 18,516 (34.9%) visits. Conclusions The Be + against COVID platform (website and app) was developed and launched to offer a pool of recommendations and support resources, which were specifically designed to protect the psychological well-being and the work morale of health care workers. This is an original initiative different from the usual psychological assistance hotlines.
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Affiliation(s)
- José Joaquín Mira
- Health Psychology Department, Miguel Hernández University, Elche, Spain.,Alicante-Sant Joan Health District, Alicante, Spain.,The Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Alicante, Spain.,Prometeo/2017/173 Excellence Group, Generalitat Valenciana, Valencia, Spain
| | - María Asunción Vicente
- Prometeo/2017/173 Excellence Group, Generalitat Valenciana, Valencia, Spain.,Telematics Engineering Area, Miguel Hernández University, Elche, Spain
| | - Adriana Lopez-Pineda
- Health Psychology Department, Miguel Hernández University, Elche, Spain.,The Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Alicante, Spain
| | - Irene Carrillo
- Health Psychology Department, Miguel Hernández University, Elche, Spain.,The Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Alicante, Spain.,Prometeo/2017/173 Excellence Group, Generalitat Valenciana, Valencia, Spain
| | - Mercedes Guilabert
- Health Psychology Department, Miguel Hernández University, Elche, Spain.,Prometeo/2017/173 Excellence Group, Generalitat Valenciana, Valencia, Spain
| | - César Fernández
- Prometeo/2017/173 Excellence Group, Generalitat Valenciana, Valencia, Spain.,Telematics Engineering Area, Miguel Hernández University, Elche, Spain
| | - Virtudes Pérez-Jover
- Health Psychology Department, Miguel Hernández University, Elche, Spain.,Prometeo/2017/173 Excellence Group, Generalitat Valenciana, Valencia, Spain
| | - Jimmy Martin Delgado
- The Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Alicante, Spain
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Pozo-Rosich P, Martin-Delgado J, Layos-Romero A, Pascual J, Bailón C, Guerrero-Peral AL, Ignacio E, Torres A, Mira JJ. [Specialised headache units, a feasible alternative in Spain]. Rev Neurol 2020; 71:199-204. [PMID: 32895902 DOI: 10.33588/rn.7106.2020269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Visits due to headaches are the most frequent cause of demand for neurological treatment in primary care and neurology services. Headache units improve the quality of care, reduce waiting lists, facilitate access to new treatments of proven efficacy and optimise healthcare expenditure. However, these units have not been implemented on a widespread basis in Spain due to the relatively low importance attributed to the condition and also the assumption that such units have a high cost. AIM To define the structure and minimum requirements of a headache unit with the intention of contributing to their expansion in hospitals in Spain. SUBJECTS AND METHODS We conducted a consensus study among professionals after reviewing the literature on the structure, functions and resources required by a headache unit designed to serve an area with 350,000 inhabitants. RESULTS Eight publications were taken as a reference for identifying the minimum resources needed for a headache unit. The panel of experts was made up of 12 professionals from different specialties. The main resource required to be able to implement these units is the professional staff (both supervisory and technical), which can mean an additional cost for the first year of around 107,287.19 euros. CONCLUSIONS If we bear in mind the direct and indirect costs due to losses in labour productivity per patient and compare them with the estimated costs involved in implementing these units and their expected results, everything points to the need for headache units to become generalised in Spain.
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Affiliation(s)
- P Pozo-Rosich
- Hospitals Vall d'Hebron, 08035 Barcelona, España.,Universitat Autónoma de Barcelona. Facultat de Medicina, 08931 Bellaterra, España
| | - J Martin-Delgado
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica, San Juan de Alicante, España
| | - A Layos-Romero
- Hospital General Universitario de Albacete, 02006 Albacete, España
| | - J Pascual
- Universidad de Cantabria. Facultad de Medicina, 39011 Santander, España.,Hospital Universitario Marqués de Valdecilla, Santander, España
| | - C Bailón
- Hospital Universitario Marqués de Valdecilla, Santander, España
| | | | - E Ignacio
- Universidad de Cadiz. Facultad de Ciencias de la Salud, Cádiz, España
| | - A Torres
- Agencia de Calidad Sanitaria de Andalucía, Sevilla, España
| | - J J Mira
- Universidad Miguel Hernández, Elche, España.,Departamento de Salud Alicante- Sant Joan, Alicante, España.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Alicante, España
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Fernández C, Vicente MA, Carrillo I, Guilabert M, Mira JJ. Factors Influencing the Smartphone Usage Behavior of Pedestrians: Observational Study on "Spanish Smombies". J Med Internet Res 2020; 22:e19350. [PMID: 32667896 PMCID: PMC7455880 DOI: 10.2196/19350] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/19/2020] [Accepted: 06/25/2020] [Indexed: 11/29/2022] Open
Abstract
Background Smartphone addiction has become a reality accepted by all. Some previous studies have shown that the use of smartphones on public roads while walking is very common among the young population. The term “smombie” or smartphone zombie has been coined for this behavior. Such behavior causes a reduction in the attention given to other pedestrians and drivers and may result in accidents or collisions. However, there are no precise data about how many people use the phone while they are walking on the street. Smartphone usage habits are evolving rapidly, and more in-depth information is required, particularly about how users interact with their devices while walking: traditional phone conversations (phone close to the ear), voice chats (phone in front of the head), waiting for notifications (phone in hand), text chats (user touching the screen), etc. This in-depth information may be useful for carrying out specific preventive actions in both the education field (raising awareness about the risks) and in the infrastructure field (redesigning the cities to increase safety). Objective This study aimed to gather information about pedestrians’ smartphone usage and to identify population groups wherein interventions should be focused to prevent accidents. The main hypothesis was that gender, age, and city area can significantly influence the smartphone usage of the pedestrians while walking. Methods An observational study of pedestrians in the street was carried out in Elche, a medium-sized Spanish city of 230,000 inhabitants. The following data were gathered: gender, age group, location, and type of smartphone interaction. A specific smartphone app was developed to acquire data with high reliability. The statistical significance of each variable was evaluated using chi-squared tests, and Cramér’s V statistic was used to measure the effect sizes. Observer agreement was checked by the Cohen kappa analysis. Results The behavior of 3301 pedestrians was analyzed, of which 1770 (53.6%) were females. As expected, the effect of the main variables studied was statistically significant, although with a small effect size: gender (P<.001, V=0.12), age (P<.001, V=0.18), and city area (P<.001, V=0.16). The phone in hand or “holding” behavior was particularly dependent on gender for all age groups (P<.001, V=0.09) and to a greater extent in young people (P<.001, V=0.16). Approximately 39.7% (222/559) of the young women observed showed “holding” or “smombie” behavior, and they comprised the highest proportion among all age and gender groups. Conclusions An in-depth analysis of smartphone usage while walking revealed that certain population groups (especially young women) have a high risk of being involved in accidents due to smartphone usage. Interventions aimed at reducing the risk of falls and collisions should be focused in these groups.
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Affiliation(s)
- César Fernández
- Telematics Engineering Area, Miguel Hernández University, Elche, Spain
| | | | - Irene Carrillo
- Health Psychology Department, Miguel Hernández University, Elche, Spain.,Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Alicante, Spain
| | | | - José Joaquín Mira
- Health Psychology Department, Miguel Hernández University, Elche, Spain.,Alicante-Sant Joan Health District, Alicante, Spain
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García EI, Guilabert M, Queiro R, Carrillo I, Mira JJ. Evaluating standards of care in psoriatic arthritis of the QUANTUM project (qualitative initiative to improve outcomes): results of an accreditation project in Spain. Rheumatol Int 2020; 40:1817-1823. [PMID: 32588190 PMCID: PMC7519894 DOI: 10.1007/s00296-020-04632-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022]
Abstract
In Spain, the QUANTUM project has been promoted to reduce variability in clinical practice and improve the care and quality of life of people with psoriatic arthritis (PsA) by accrediting PsA units throughout the Spanish national health system. To present the results of this approach which sought to ensure an optimum level of quality for patients with PsA. Descriptive analysis of the self-assessments that the PsA units have carried out assessing their degree of compliance with the quality standards established in the QUANTUM project grouped into four blocks: shortening time to diagnosis; optimizing disease management; improving multidisciplinary collaboration; and improving patient monitoring. A total of 41 PsA units were self-evaluated. They met 64.1% of the defined quality standards. Optimize disease management obtained a higher level of standards compliance (72%) and improve multidisciplinary collaboration the lesser (63.9%). Accessibility to the treatments available for PsA in all hospitals was guaranteed (100%). Appropriate diagnostic equipment is available (97.6%). Compliance with specific quality standards leads to detect actions that should be implemented: quality of life assessment (9.8%), locomotor system assessment (12.2%), physical examination data record (14.6%), periodic cardiovascular risk assessment (17.1%). The QUANTUM project results make it possible to visualise how to care for patients with PsA is being developed in Spain. Problems identified in recent multinational reports are also identified in Spain.
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Affiliation(s)
| | - Mercedes Guilabert
- Calite Research Group, Universidad Miguel Hernández de Elche., Health Psychology Department, Altamira Building, Avenida de la Universidad, s/n, 03202, Elche, Spain.
| | - Rubén Queiro
- Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Irene Carrillo
- Calite Research Group, Universidad Miguel Hernández de Elche., Health Psychology Department, Altamira Building, Avenida de la Universidad, s/n, 03202, Elche, Spain.,The Foundation for the Promotion of Health and Biomedical Research of Valencia Region, FISABIO, Sant Joan d'Alacant, Spain
| | - José Joaquín Mira
- Calite Research Group, Universidad Miguel Hernández de Elche., Health Psychology Department, Altamira Building, Avenida de la Universidad, s/n, 03202, Elche, Spain.,Alicante-Sant Joan Health District, Alicante, Spain.,REDISSEC, Madrid, Spain
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Pozo-Rosich P, Layos-Romero A, Martin-Delgado J, Pascual J, Bailón C, Tentor A, Santiago A, Ignacio E, Torrés A, Mira JJ. Low-value care practice in headache: a Spanish mixed methods research study. J Headache Pain 2020; 21:74. [PMID: 32522142 PMCID: PMC7288523 DOI: 10.1186/s10194-020-01147-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Headache is one of the most prevalent diseases. The Global Burden of Disease Study ranks it as the seventh most common disease overall and the second largest neurological cause of disability in the world. The "Do Not Do" recommendations are a strategy for increasing the quality of care and reducing the cost of care for headache. This study aimed to identify specific low-value practices in headache care, determine their frequency, and estimate the cost overrun that they represent, in order to establish "Do not Do" recommendations specifically for headache by consensus and according to scientific evidence. METHODS This was a mixed methods research study that combined qualitative consensus-building techniques, involving a multidisciplinary panel of experts to define the "Do Not Do" recommendations in headache care, and a retrospective observational study with review of a randomized set of patient records from the past 6 months in four hospitals, to quantify the frequency of these "Do Not Do" practices. We calculated the sum of direct costs of medical consultations, medicines, and unnecessary diagnostic tests. RESULTS Seven "Do Not Do" recommendations were established for headache. In total, 3507 medical records were randomly reviewed. Low-value practices had a highly variable occurrence, depending on the hospital and type of headache. Overall, 34.1% of low-value practices were related to treatment, 21% were related to overuse of imaging in consultation, and 19% were related to emergency care. The estimated cost of low-value practices in the four hospitals was 203,520.47 euros per 1000 patients. CONCLUSIONS This study identified low-value headache practices that need to be eradicated and provided data on their frequency and cost overruns.
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Affiliation(s)
- Patricia Pozo-Rosich
- Headache Unit, Neurology Department, Vall d'Hebron Hospital, Barcelona, Spain
- Headache and Neurological Pain Research Group, VHIR, Universitat Autonoma of Barcelona, Barcelona, Spain
| | | | - Jimmy Martin-Delgado
- ATENEA research group, Foundation for the Promotion of Health and Biomedical Research, Sant Joan d'Alacant, Spain.
| | - Julio Pascual
- University Hospital Marqués de Valdecilla, Santander, Spain
- University of Cantabria and IDIVAL, Santander, Spain
| | | | - Ana Tentor
- Barrio del Pilar Health Center, Madrid, Spain
| | | | | | - Antonio Torrés
- Patient Safety Observatory, Andalusian Healthcare Quality Agency, Seville, Spain
| | - José Joaquín Mira
- Health Department Sant Joan d'Alicante, Alicante, Spain
- Miguel Hernández University of Elche, Elche, Spain
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Carrillo I, Mira JJ, Astier-Peña MP, Pérez-Pérez P, Caro-Mendivelso J, Olivera G, Silvestre C, Mula A, Nuin MÁ, Aranaz-Andrés JM. [Avoidable adverse events in primary care. Retrospective cohort study to determine their frequency and severity]. Aten Primaria 2020; 52:705-711. [PMID: 32527565 PMCID: PMC8054289 DOI: 10.1016/j.aprim.2020.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/28/2020] [Accepted: 02/04/2020] [Indexed: 11/24/2022] Open
Abstract
Puntos claveLas intervenciones en seguridad del paciente, como las prácticas seguras, buscan reducir el número de incidentes para la seguridad de los pacientes, particularmente el número de eventos adversos evitables. El número de eventos adversos evitables en atención primaria en España se ha duplicado con respecto a los datos aportados por el estudio APEAS (Estudio de la Seguridad de los Pacientes en atención primaria de Salud) realizado en 2008. Uno de cada 30 eventos adversos evitables supone un daño grave y permanente en el adulto.
Objetivo Determinar la frecuencia de eventos adversos evitables (EAE) en atención primaria (AP). Diseño Estudio retrospectivo de cohortes. Emplazamiento consultas de medicina de familia y pediatría de Andalucía, Aragón, Castilla La Mancha, Cataluña, Madrid, Navarra y Comunidad Valenciana. Participantes Se determinó revisar un mínimo de 2.397 historias clínicas (nivel de confianza del 95% y una precisión del 2%). La muestra se estratificó por grupos de edad de forma proporcional a su frecuentación y con revisión paritaria de historias de hombres y mujeres. Mediciones principales Número y gravedad de los EAE identificados entre febrero de 2018 y septiembre de 2019. Resultados Se revisaron un total de 2.557 historias clínicas (1.928, 75.4% de pacientes adultos y 629, 24.6% pediátricos). Se identificaron 182 EAE que afectaron a 168 pacientes (7,1%, IC 95% 6,1-8,1%); en adultos 7,6% (IC 95% 6,4-8,8%) y 5,7% (IC 95% 3,9-7,5%) en pacientes pediátricos. Las mujeres sufrieron más EAE que los hombres (p = 0,004). La incidencia de EAE en niños y niñas fue similar (p = 0,3). 6 (4.1%) de los EAE supusieron un daño permanente en pacientes adultos. Conclusiones Buscar fórmulas para incrementar la seguridad en AP, particularmente en pacientes mujeres, debe seguir siendo un objetivo prioritario incluso en pediatría. Uno de cada 24 EAE supone un daño grave y permanente en el adulto.
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Affiliation(s)
- Irene Carrillo
- Universidad Miguel Hernández de Elche, Elche, Alicante, España; Fundació per al Foment de la Investigació Sanitària i Biomèdica de la Comunitat Valenciana (FISABIO), Elche, Alicante, España
| | - José Joaquín Mira
- Universidad Miguel Hernández de Elche, Elche, Alicante, España; Centro de Salud Hospital Provincial-Pla, Departamento de Salud Alicante - Sant Joan D'Alacant, San Juan, Alicante, España.
| | | | - Pastora Pérez-Pérez
- Observatorio para la Seguridad del Paciente, Agencia de Calidad Sanitaria de Andalucía, Sevilla, España
| | | | - Guadalupe Olivera
- Hospital Clínico San Carlos, Servicio Madrileño de Salud, Madrid, España
| | - Carmen Silvestre
- Servicio de Efectividad y Seguridad Asistencial, Servicio Navarro de Salud-Osasunbidea, Pamplona, España
| | - Aurora Mula
- Fundació per al Foment de la Investigació Sanitària i Biomèdica de la Comunitat Valenciana (FISABIO), Elche, Alicante, España
| | | | - Jesús M Aranaz-Andrés
- Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, Madrid, España; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
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Affiliation(s)
- J J Mira
- Universidad Miguel Hernández, Departamento de Salud Alicante-Sant Joan D'Alacant, Editor de Journal of Healthcare Quality Research.
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Mira JJ, Martin-Delgado J, Aibar C, Gómez G, Ramos JM, Aranaz J, Gómez-Muzas F, Ruguero MJ, Cobos A, Colmenero M, Gorricho J, Silvestre C, Egea-Valera MA, Marqués-Espí JA, García-Montero JI, Carrillo I. Bed 13 is not worse than any other. A retrospective cohort study. J Healthc Qual Res 2020; 35:79-85. [PMID: 32273107 DOI: 10.1016/j.jhqr.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Risk management and patient safety are closely related, following this premise some industries have adopted measures to omit number 13. Healthcare is not left behind, in some hospital the day of surgery's or bed numbering avoid number 13. The objective was to assess whether it is necessary to redesign the safety policies implemented in hospitals based on avoiding 13 in the numbering of rooms/beds. METHODS A retrospective cohort study was conducted. Mortality and the number of adverse events suffered by patients admitted to rooms/beds numbering 13 (bad chance) or 7 (fair chance) over a two-year period to Intensive Care Unit, Medicine, Gastroenterology, Surgery, and Paediatric service were registered and compared. RESULTS A total of 8553 admissions were included. They had similar length-of-stay and Charlson Index scores (p-value=0.435). Mortality of bed 13 was 268 (6.2%, 95% CI 5.5-6.9) and 282 in bed 7 (6.7%, 95% CI 5.9-7.5) (p-value=0.3). A total of 422 adverse events from 4342 admissions (9.7%, 95% CI 8.9-10.6) occurred in bed 13, while in bed 7 the count of adverse events was 398 in 4211 admissions (9.4%, 95% CI 8.6-10.4) (p-value=0.6). Odds Ratio for mortality was equal to 0.9 (95% CI 0.8-1.1) and suffering adverse events when admitted to bed 13 versus bed 7 was 1.03 (95% CI 0.9-1.2). CONCLUSIONS Bed 13 is not a risk factor for patient safety. Hospitals should pay attention to causes and interventions to avoid adverse events based on evidence rather than beliefs or myths.
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Affiliation(s)
- J J Mira
- Health District Alicante-Sant Joan, Alicante, Spain; Miguel Hernández University, Elche, Spain
| | - J Martin-Delgado
- Foundation for the Promotion of Health and Biomedical Research, Sant Joan d'Alacant, Spain.
| | - C Aibar
- Aragon Health Service, Zaragoza, Spain
| | - G Gómez
- Madrid Health Service, Madrid, Spain
| | - J M Ramos
- Madrid Health Service, Madrid, Spain
| | - J Aranaz
- Preventive Medicine and Public Health Service, Ramon y Cajal University Hospital, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - F Gómez-Muzas
- Department of Universal and Public Health, Alicante, Spain
| | - M J Ruguero
- Department of Universal and Public Health, Alicante, Spain
| | - A Cobos
- Andalusian Health Service, Granada, Spain
| | | | - J Gorricho
- Navarre Health Service - Osasunbidea, Pamplona, Spain
| | - C Silvestre
- Navarre Health Service - Osasunbidea, Pamplona, Spain
| | | | | | | | - I Carrillo
- Miguel Hernández University, Elche, Spain; Foundation for the Promotion of Health and Biomedical Research, Sant Joan d'Alacant, Spain
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Mira JJ, Carrillo I, García-Elorrio E, Andrade-Lourenção DCDE, Pavan-Baptista PC, Franco-Herrera AL, Campos-Castolo EM, Poblete R, Limo J, Siu H, Sousa P. What Ibero-American hospitals do when things go wrong? A cross-sectional international study. Int J Qual Health Care 2020; 32:313-318. [DOI: 10.1093/intqhc/mzaa031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/05/2020] [Accepted: 03/02/2020] [Indexed: 12/12/2022] Open
Abstract
Abstract
Objective
To know what hospital managers and safety leaders in Ibero-American countries are doing to respond effectively to the occurrence of adverse events (AEs) with serious consequences for patients.
Design
Cross-sectional international study.
Setting
Public and private hospitals in Ibero-American countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru, Portugal and Spain).
Participants
A convenience sample of hospital managers and safety leaders from eight Ibero-American countries. A minimum of 25 managers/leaders from each country were surveyed.
Interventions
A selection of 37 actions for the effective management of AEs was explored. These were related to the safety culture, existence of a crisis plan, communication and transparency processes with the patients and their families, attention to second victims and institutional communication.
Main Outcome Measure
Degree of implementation of the actions studied.
Results
A total of 190 managers/leaders from 126 (66.3%) public hospitals and 64 (33.7%) private hospitals participated. Reporting systems, in-depth analysis of incidents and non-punitive approaches were the most implemented interventions, while patient information and care for second victims after an AE were the least frequent interventions.
Conclusions
The majority of these hospitals have not protocolized how to act after an AE. For this reason, it is urgent to develop and apply a strategic action plan to respond to this imperative safety challenge. This is the first study to identify areas of work and future research questions in Ibero-American countries.
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Affiliation(s)
- José Joaquín Mira
- Hospital Provincial-Pla Health District, Health Department of Alicante-Sant Joan, C/ Hermanos López de Osaba, s/n, 03013 Alicante, Spain
- Department of Health Psychology, Universidad Miguel Hernández, Avenida de la Universidad, s/n, 03202 Elche, Spain
| | - Irene Carrillo
- Department of Health Psychology, Universidad Miguel Hernández, Avenida de la Universidad, s/n, 03202 Elche, Spain
- The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Sant Joan, Spain
| | - Ezequiel García-Elorrio
- Department of Health Care Quality and Patient Safety Institute for Clinical Effectiveness and Health Policy, Dr. Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina
| | | | - Patricia Campos Pavan-Baptista
- Postgraduate Department Universidade de São Paulo, Rua Alfredo Rodrigues,130. Blumenau, SC. CEP 89045.180 São Paulo, Brazil
| | | | - Esther Mahuina Campos-Castolo
- Department of Biomedical Informatics, Faculty of Medicine, Universidad Nacional Autónoma de México, Interior Circuitry, University City, Avenida de la Universidad 3000, Basamento Edificio A, Mexico City, Mexico
| | - Rodrigo Poblete
- Medicine Department, Pontificia Universidad Católica de Chile, Lira 40, Santiago de Chile, Metropolitan Area Chile
| | - Juan Limo
- Quality and Patient Safety, New Medical Leaders, Avenida Emilio Cavenecia, 264, Piso 7, San Isidro District, Lima, Peru
| | - Hugo Siu
- Quality Department, Clínica Anglo Americana, Avenida Emilio Cavenecia 250, San Isidro District, Lima, Peru
| | - Paulo Sousa
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
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