Effectiveness Of An Integration Program In Urgent Care In The Health Area Of Lanzarote (Spain)
1. The organizational and functional integration of health care must be translate into clinical results. There is nothing more ineffective than improper use of a clinical service. The frequency of emergencies in our health area was one of the highest in the environment2. The hypothesis can be formul...
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| Published in: | International journal of integrated care Vol. 22; no. S1; p. 98 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Paterna
Ubiquity Press
08-04-2022
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | 1. The organizational and functional integration of health care must be translate into clinical results. There is nothing more ineffective than improper use of a clinical service. The frequency of emergencies in our health area was one of the highest in the environment2. The hypothesis can be formulate in the terms that an audit intervention followed by feedback and accompaniment to professionals in the emergency area will improve the clinical indicators.3. Feedback to professionals have been show as great potential intervention to change the outcomes of health care.4. The hospital Dr. Jose Molina Orosa, with about 300 beds, located on the island of Lanzarote, belongs to the public Canary Islands Health Service. Primary Care and Hospital provides service to 147,000 h. In addition, every year grow up to 50.000 h. The activity in emergencies exceeds 260,000 per year, with 23% in hospital and more than 200,000 in the 4 urgent Primary Care with more than 50 professionals. The aim of this intervention was to evaluate the effectiveness of a feedback-based intervention to improve the adequacy of urgent care in a health area.5. The intervention took place from March 2019 to March 20206. The transfer of urgent patients from Primary Care to Hospital decreased by 33%. However, the, % of inadequate referral is still 19%. In relation to internal changes, the intervention in patient triage improved 22%, although the volume of level 3 cases remains at 18%. Regarding the relationship with in-hospital care services, clinical consultations have decreased by 6%. In addition, admission to the Internal Medicine Service was doing directly from Emergency. In general, the evaluation for professionals of the intervention was 8 out of 10.7. An intervention was carry out with educational and feedback components. First (1) an initial meeting with the urgent care team, with the participation of an external expert in which the main data obtained were explain. Then (2) a session was develop where an improvement plan was show, with prospective results of the intervention: the data of the pre-intervention period were show again. 3) In addition, coaching techniques (by having a referent) gives opportunity to talk about changes8. An intervention based on feedback is useful to improve any care problem in integrated areas9. The change was made from the bottom to up, relying on professionals improves the clinical effectiveness of urgent care.10 Transformation was establish by placing the patient at the center of the change model. Six pillars for change are identifie: transversal vision, unified criteria, homogeneous knowledge, operational management, threefold quality and alternatives to income11. Feedback could be more reasonably influence clinical practice, when information was presented closer at the time of decision-making and clinicians had previously agreed to review their practice. |
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| ISSN: | 1568-4156 1568-4156 |
| DOI: | 10.5334/ijic.ICIC21057 |