Proceso de gesti��n de denuncias

El Manual de Procesos en Protecci��n de la Salud estableci�� cuales eran los procesos operativos o claves que deb��an ser dise��ados e implementados dentro del marco del II Plan de Calidad del Sistema Sanitario Publico de Andaluc��a. El fin ��ltimo de elaborar un proceso operativo relacionado con las denuncias, es dar respuesta a la demanda habitual de la ciudadan��a de poner en conocimiento de la Administraci��n P��blica los posibles incumplimientos o posibles riesgos en el ��mbito de la protecci��n de la salud.

Telemedicine influence on the follow-up of type 2 diabetes patients.

OBJECTIVE This study was designed to evaluate the impact of a teleassistance system on the metabolic control of type 2 diabetes patients. RESEARCH DESIGN AND METHODS We conducted a 1-year controlled parallel-group trial comparing patients randomized (1) to an intervention group, assigned to a teleassistance system using real-time transmission of blood glucose results, with immediate reply when necessary, and telephone consultations, or (2) to a control group, being regularly followed-up at their healthcare center. Study subjects were type 2 diabetes patients >30 years of age followed in the primary care setting. RESULTS A total of 328 type 2 diabetes patients were recruited from 35 family practices in the province of M��laga, Spain. There was a reduction in hemoglobin A1c after 12 months from 7.62 +/- 1.60% to 7.40 +/- 1.43% (P = 0.027) in the intervention group and from 7.44 +/- 1.31% to 7.35 +/- 1.38% (P = 0.303) in the control group. The difference in the change between groups was not statistically significant. There was also a significant decrease in systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, and body mass index in the intervention group. In the control group, the only significant decline was in low-density lipoprotein cholesterol. CONCLUSIONS A teleassistance system using real-time transmission of blood glucose results with an option to make telephone consultations is feasible in the primary care setting as a support tool for family physicians in their follow-up of type 2 diabetes patients.

Manual de procesos en protecci��n. 2�� ed.

En la port.: Secretar��a General de Salud P��blica, Inclusi��n Social y Calidad de Vida. 2�� EDICI��N (2013), revisada por Jos�� Antonio Conejo D��az, Catalina G��mez L��pez, Francisco Chavernas Garvi, Alonso Ortiz Dominguez, Jes��s Peinado ��lvarez, Jos�� P��rez-Rend��n Gonz��lez, Mar��a Fernanda Vallino Llabr��s y Jos�� Vela R��os.

Los retos de la Salud en el contexto de la Uni��n Europea

Bolet��n semanal para profesionales sanitarios de la Secretar��a General de Salud P��blica y Participaci��n Social de la Consejer��a de Salud

���La atenci��n integral a la infancia debe enfocarse hacia la salud y no hacia la enfermedad���

Bolet��n semanal para profesionales sanitarios de la Secretar��a General de Salud P��blica y Participaci��n Social de la Consejer��a de Salud

La gesti��n por procesos, una herramienta de calidad en la protecci��n de la salud

Bolet��n semanal para profesionales sanitarios de la Secretar��a General de Salud P��blica y Participaci��n Social de la Consejer��a de Salud

Fortalezas y amenazas en torno a la seguridad del paciente seg��n la opini��n de los profesionales de enfermer��a

The aim of this research is to know the barriers and opportunities that nursing professionals detect in their clinical practice in order to develop the culture of patient safety and to identify future research lines. This qualitative study is based on the DELPHI method, with a group of 19 nursing professionals from education and care practice, involving both primary and specialized care. Weaknesses and threats revolve around five categories: profession, organization and infrastructure; indicators; communication and safety culture; and safety training. Opportunities to improve safety cover six categories: organizational change; promotion of the safety culture, professional training and development; relationship with the patients; research; and strategic planning. Work is needed to improve safety and nursing should be ready to assume this leadership.

Listado de verificaci��n de procedimientos invasivos en nefrolog��a: cat��ter peritoneal, cat��ter venoso central temporal para hemodi��lisis y biopsia renal percut��nea

Secci��n "Buenas pr��cticas en gesti��n cl��nica"

Colorectal cancer survival in the USA and Europe: a CONCORD high-resolution study.

OBJECTIVES: To assess the extent to which stage at diagnosis and adherence to treatment guidelines may explain the persistent differences in colorectal cancer survival between the USA and Europe. DESIGN: A high-resolution study using detailed clinical data on Dukes' stage, diagnostic procedures, treatment and follow-up, collected directly from medical records by trained abstractors under a single protocol, with standardised quality control and central statistical analysis. SETTING AND PARTICIPANTS: 21 population-based registries in seven US states and nine European countries provided data for random samples comprising 12 523 adults (15-99 years) diagnosed with colorectal cancer during 1996-1998. OUTCOME MEASURES: Logistic regression models were used to compare adherence to 'standard care' in the USA and Europe. Net survival and excess risk of death were estimated with flexible parametric models. RESULTS: The proportion of Dukes' A and B tumours was similar in the USA and Europe, while that of Dukes' C was more frequent in the USA (38% vs 21%) and of Dukes' D more frequent in Europe (22% vs 10%). Resection with curative intent was more frequent in the USA (85% vs 75%). Elderly patients (75-99 years) were 70-90% less likely to receive radiotherapy and chemotherapy. Age-standardised 5-year net survival was similar in the USA (58%) and Northern and Western Europe (54-56%) and lowest in Eastern Europe (42%). The mean excess hazard up to 5 years after diagnosis was highest in Eastern Europe, especially among elderly patients and those with Dukes' D tumours. CONCLUSIONS: The wide differences in colorectal cancer survival between Europe and the USA in the late 1990s are probably attributable to earlier stage and more extensive use of surgery and adjuvant treatment in the USA. Elderly patients with colorectal cancer received surgery, chemotherapy or radiotherapy less often than younger patients, despite evidence that they could also have benefited.

Utilidad de la ecograf��a en rehabilitaci��n

Secci��n "Buenas pr��cticas en gesti��n cl��nica"

Organigrama de funciones de la Unidad de Gesti��n Cl��nica

Secci��n: Buenas pr��cticas en gesti��n cl��nica

Diferencias de g��nero en la percepci��n del logro profesional en especialistas de medicina familiar y comunitaria

BACKGROUND The concept of achievement is important to study the professional development. In medicine there are gender inequalities in career. The purpose was to know and compare the professional achievement's perceptions and attributions of female and male primary care physicians in Andalusia. METHOD Qualitative study with 12 focus groups (October 2009 to November 2010). POPULATION primary care physicians. SAMPLE intentionally segmented by age, sex and health care management. Were conducted by sex: two groups with young physicians, two groups with middle aged and two with health care management. TOTAL: 32 female physician and 33 male physicians. Qualitative content analysis with Nuddist Vivo. RESULTS Female and male physicians agree to perceive internal achievements and to consider aspects inherent to the profession as external achievements. The most important difference is that female physician related professional achievement with affective bond and male physician with institutional merit. Internal attributions are more important for female physician who also highlight the importance of family, the organization of working time and work-family balance. Patients, continuing education, institutional resources and computer system are the most important attributions for male physician. CONCLUSIONS There are similarities and differences between female and male physicians both in the understanding and the attributions of achievement. The differences are explained by the gender system. The perception of achievement of the female physicians questions the dominant professional culture and incorporates new values in defining achievement. The attributions reflect the unequal impact of family and organizational variables and suggest that the female physicians would be changing gender socialization.