Experiencia del plan de mejora de la calidad del Centro de Salud La Mina (1989-2004)

Abstract

Objectives. To describe how well the problems detected by a quality improvement plan (QIP) for a health care team (HCT) were solved; and to analyse the identification methods, the quality causes and dimensions affected by the problems detected, and the participation of professionals. Design. Descriptive study. Evaluation of the situation in December 2004 of the problems identified since 1989. Setting. Urban HCT, with 58 professionals caring for a population of 18 897 inhabitants in the La Mina District, Barcelona, Spain. Participants. Five-hundred and thirty problems identified. Main measurements. Number and kind of detections and problems; identification methods; quality dimensions; causes; degree of solution, by method and cause; degree of solution of the QIP (of "internal" problems, excluding the problems caused externally or by patients); professional participation. Results. In 312 meetings, there were 963 detections (annual average, 60.1; SD, 18.8), corresponding to 530 problems (annual average, 33.1; SD, 12.4). Of these 530 problems, 411 improved (77.5%). Of the 258 "internal" problems, 225 improved. The degree of solution of the QIP was 87.2%. The identification method that detected most problems (53.02% of the total) was the active listening of the quality improvement group. The quality dimensions most affected by the problems were effectiveness (31.7%) and accessibility (20.4%). The most frequent cause of problems and, at the same time, the category with the highest improvement rate (81.6%) was internal organization; 83.9% of professionals took part in the QIP. Conclusions. Having a QIP at our centre facilitated the management of the quality of care delivery.