Martin J S, Ruiz Ferrándiz U
Instituto Universitario de Evaluación Sanitaria, Universidad Complutense, Madrid.
Rev Esp Salud Publica. 1995 May-Aug;69(3-4):341-8.
The increasing interest for quality in hospital care brought the need to evaluate the effect of quality control and quality assurance strategies that are being or could be implemented in spanish hospitals.
This article describes the results of the pre-assessment phase of a study carried out as a european concerted action in a total of 262 hospitals in 15 european countries. Spain contributed with 88 hospitals divided in two groups of 62 and 16 hospitals. The study herein reported refers to the group of 62 hospitals belonging to the spanish National Health System in which the characteristics of the hospital and the baseline situation in respect to quality assurance structures and activities have been assessed through the answers to the standard questionnaire used the study.
Sixty-two hospitals filled out the preassessment questionnaire. Twenty three (37%) have a quality assurance programme and eighteen have personnel assigned to it. Clinical or quality control committees exist in 56 hospitals (90.3%). Fifty six hospitals (88.7%) know their autopsy rate, and 27 (43.5%) know their nosocomial infection rate as well as the adverse reactions due to blood transfusions. Complaints are registered in 56 hospitals (90.3%) and patients surveys are carried out in 54 (87.1%). Only 33 hospitals (53.2%) actually use this data for quality assurance purposes.
Most of the quality activities in hospitals are carried out by physicians or nurses in the different clinical committees considered as quality committees. The patients surveys results and the data from patients complains are not used in those committees as inputs for quality actions. The committement of the top hospital management is needed to achieve an integrated approach to quality activities in hospitals.
对医院医疗质量的关注度日益提高，这使得有必要评估西班牙医院正在实施或可能实施的质量控制和质量保证策略的效果。
本文描述了一项作为欧洲协调行动在15个欧洲国家的262家医院开展的研究的预评估阶段结果。西班牙有88家医院参与，分为两组，分别为62家和16家。本文报告的研究涉及西班牙国家卫生系统中的62家医院，通过对该研究使用的标准问卷的回答，评估了这些医院的特征以及质量保证结构和活动的基线情况。
62家医院填写了预评估问卷。其中23家（37%）有质量保证计划，18家有专人负责。56家医院（90.3%）设有临床或质量控制委员会。56家医院（88.7%）知道其尸检率，27家（43.5%）知道其医院感染率以及输血不良反应率。56家医院（90.3%）记录投诉，54家（87.1%）开展患者调查。只有33家医院（53.2%）实际将这些数据用于质量保证目的。
医院的大多数质量活动由医生或护士在被视为质量委员会的不同临床委员会中开展。患者调查结果和患者投诉数据在这些委员会中未被用作质量改进行动的依据。需要医院高层管理人员的支持，以实现医院质量活动的综合方法。
