La seguridad del paciente en atención primaria en salud ¿una actividad que podría quedar en el olvido?

Los eventos adversos (EA) están presentes en todos los niveles de atención en salud y deben ser evaluados de manera integral, tanto en los servicios hospitalarios como en el entorno de la Atención Primaria en Salud (APS). Los EA que se presentan en los servicios hospitalarios, son diferentes a los que se presentan en los servicios de Atención Primaria en Salud (APS) y por ello se debe dar un abordaje diferenciado. La seguridad del paciente debe ser una prioridad para todos los sistemas de salud. Desde esta perspectiva se deben identificar cuáles son las herramientas más adecuadas para el reporte, análisis, intervenciones y acciones de mejora, con las que deben contar los programas de seguridad del paciente y la apropiación de conceptos de gestión de riesgo, facilita la identificación y el manejo institucional de situaciones que ponen en peligro la integridad y la vida de los pacientes.

Paradoxes of resilience: lessons learnt from a comparison between Columbia and France

This paper investigates a discrepancy concerning resilience. International institutions such as ISDR try to promote resilience as a notion useful for preventing disasters. And some searchers, mainly coming from ecology, such as Resilience Alliance group, found the notion relevant enough to promote it as a brand for their studies on disaster prevention. Yet, the second part of the paper will verify how other searchers are still not convinced by the relevance of the notion. Territorial managers are reluctant as well, in line with the poor number of policies trying to bring resilience to reality, be it in Columbia or in France. How can we make sense of this discrepancy? The paper will stress on various political, institutional and cultural conditionings hidden behind the notion. It will also enlighten the contradictions embedded within the notion, because resilience, as disaster, depends on the scales and the actors the analysis relies on first. Which resilience to whom and at what scale? These are critical questions that should be addressed in order to give sense to these contradictions. Resilience has no absolute meaning. However, it helps identifying trends towards future disasters. This is one of the main reasons why it may be found useful.