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Objetivos. Describir el diseño, implantación y seguimiento del cuadro de mando integral de atención primaria (eSOAP) y su papel en el despliegue de los objetivos estratégicos y en la gestión clínica. Mostrar las lecciones aprendidas en los 6 años de seguimiento. Método. Estudio descriptivo en esferas: metodológica (marco conceptual, matriz estratégica, mapa estratégico y de procesos), tecnológica y de normalización. Resultados. En diciembre de 2014 9.046 (78%) profesionales estaban registrados en eSOAP. Se midieron 381 indicadores de 16 fuentes de datos, de los cuales, el 36% era de resultados (modelo EFQM), el 39,1% de gestión clínica y el 20% estaba incluido en el contrato programa de centro. El eSOAP ha permitido desplegar todas las líneas estratégicas de atención primaria, y ha hecho posible que los asistenciales evalúen la evolución de indicadores resultados a lo largo del tiempo y en el ámbito del paciente (por ejemplo incremento del 16% en el control de pacientes diabéticos). Se generaron 295.779 informes y se valoró por objetivos a 13.080 profesionales. Conclusiones. Se ha hecho un elevado uso de la aplicación eSOAP por parte de los profesionales. Fue clave el papel del cuadro de mando integral en el despliegue de las estrategias de atención primaria. Ha permitido la gestión clínica y la mejora de los indicadores relevantes (salud, experiencia del paciente y costes) tal y como promueven los modelos de gestión que hemos utilizado como referentes (EFQM y Kaplan y Norton) y los nuevos escenarios emergentes (triple meta) (AU)

Objectives. To describe the design, implementation, and monitoring of eSOAP (Primary Health Care Balanced Scorecard) and its role in the deployment of strategic objectives and clinical management, as well as to show the lessons learned during six years of follow-up. Method. Descriptive study areas: methodology (conceptual framework, strategic matrix, strategic map, and processes map), technology and standardisation. Results. As of December 2014, 9,046 (78%) professionals are registered in eSOAP. A total of 381 indicators were measured from 16 data sources, of which 36% were of results (EFQM model), 39.1% of clinical management, and 20% were included in the Program Centre Contract. The Balanced Scorecard has enabled to deploy all strategic lines of Primary Health Care, and has enabled the healthcare professionals to evaluate the evolution of results over time, and at patient level (e.g. 16% increase in control of diabetic patients). A total of 295,779 reports were generated and 13,080 professionals were evaluated by goals. Conclusions. There was an increased use of the eSOAP application by the professionals. The Balanced Scorecard was the key in deploying Primary Health Care strategies. It has helped clinical management and improved relevant indicators (health, patient experience, and costs), such as the management models that we used as references (EFQM Kaplan and Norton), and new emerging scenarios (Triple aim) (AU)

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OBJECTIVES: To describe the design, implementation, and monitoring of eSOAP (Primary Health Care Balanced Scorecard) and its role in the deployment of strategic objectives and clinical management, as well as to show the lessons learned during six years of follow-up. METHOD: Descriptive study areas: methodology (conceptual framework, strategic matrix, strategic map, and processes map), technology and standardisation. RESULTS: As of December 2014, 9,046 (78%) professionals are registered in eSOAP. A total of 381 indicators were measured from 16 data sources, of which 36% were of results (EFQM model), 39.1% of clinical management, and 20% were included in the Program Centre Contract. The Balanced Scorecard has enabled to deploy all strategic lines of Primary Health Care, and has enabled the healthcare professionals to evaluate the evolution of results over time, and at patient level (e.g. 16% increase in control of diabetic patients). A total of 295,779 reports were generated and 13,080 professionals were evaluated by goals. CONCLUSIONS: There was an increased use of the eSOAP application by the professionals. The Balanced Scorecard was the key in deploying Primary Health Care strategies. It has helped clinical management and improved relevant indicators (health, patient experience, and costs), such as the management models that we used as references (EFQM Kaplan and Norton), and new emerging scenarios (Triple aim).

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This paper describes the implementation of a patient safety strategy in primary care within the new organizational and functional structure that was created in October 2010 to cover the single primary health care area of the Community of Madrid. The results obtained in Patient Safety after the implementation of this new model over the first two years of its development are also presented.

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En este trabajo se describe el despliegue de la estrategia de seguridad del paciente (SP) en atención primaria (AP) dentro de la nueva estructura organizativa y funcional que se crea en octubre de 2010, para dar cobertura al área única de salud de AP de la Comunidad de Madrid (CM). Así mismo, se detallan cuáles han sido los resultados obtenidos en SP tras la implantación de este nuevo modelo a lo largo de los 2 primeros años de su desarrollo (AU)

This paper describes the implementation of a patient safety strategy in primary care within the new organizational and functional structure that was created in October 2010 to cover the single primary health care area of the Community of Madrid. The results obtained in Patient Safety after the implementation of this new model over the first two years of its development are also presented (AU)

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Objetivo. Identificar y definir un conjunto mínimo y normalizado de objetivos de seguridad en el contrato programa de centro (CPC) de la Comunidad de Madrid, cuya implantación y seguimiento permita garantizar la mejora de la calidad asistencial y la seguridad del paciente en Atención Primaria. Material y métodos. El elemento clave es el CPC elaborado con el modelo EFQM como referente. Metodológicamente, se han seguido las etapas del ciclo de mejora. En la planificación, se ha incluido en el CPC objetivos normalizados de seguridad. El seguimiento de los indicadores se ha realizado con una aplicación informática. Resultados. En el CPC 2009 se han definido 12 objetivos de seguridad y 21 indicadores. En todos los criterios del modelo se ha contemplado la inclusión de algún objetivo de seguridad. Destacamos los siguientes resultados: en el criterio de procesos, la cobertura del programa del polimedicado es del 59,22%, en el 93% de las consultas se utiliza solución bioalcohólicas y el 89% de los Centros de Salud (CS) realizan control y mantenimiento de carros de parada. En comunicación, se han notificado 1.096 errores de medicación en toda la Comunidad de Madrid, 239 reacciones adversas a medicamentos y 1.945 incidentes de seguridad. En el criterio 6, clientes, el 66,22% de los INR están en rango. Se ha obtenido 19,46 DHD osteoporosis en mujeres de 45-65 años y 16,9 DHD neurolépticos en personas mayores. El indicador referente a BEERS es del 11,9%. Se han adoptado una 1,19 medidas de seguridad por CS. En resultados personas, el 14,44% de los profesionales se han formado en calidad y seguridad del paciente. Con la aplicación e-SOAP los CS conocen resultados para adoptar mejoras. Se han introducido mejoras en el CPC 2010. Conclusiones. Con el CPC elaborado con el modelo EFQM como referente, se han implantado y seguido indicadores de seguridad de forma sistematizada en los CS de la Comunidad de Madrid. Se han generalizado buenas prácticas que garantizan la seguridad del paciente, y se ha empezado a evaluar el impacto de la atención sanitaria prestada en Atención Primaria con la medición de indicadores que la evidencia científica revela que afectan a la seguridad del paciente(AU)

Objective. To identify and define a minimum and standard set of safety objectives in the Centre Agreement Program (CAP) of the Community of Madrid, the introduction of which has led to improved follow-up and an improvement in quality of care and patient safety in Primary Care. Material and Methods. The key element is the Centre Agreement Program developed with the EFQM model as a reference. Methodologically, this project has followed the steps set out in the PDCA cycle., Standardised safety objectives were included in the CAP during the planning phase. Indicators have been monitored by the e-SOAP application. Results. We have identified 12 safety goals and 21 indicators. All the criteria of the model included some safety objectives. We highlight the following results: in the criteria relating to processes, the program cover of patients who were on several medications was 59.22%, a bio-alcohol solution was used in 93% of health facilities, 89% of Health Centres had performed a control and maintenance of vital emergency equipment. As regards communication, 1096 medication errors were notified throughout the Community of Madrid. There were 239 adverse reactions to medication and 1945 safety incidents were reported. In criterion 6, 66.22% of INR determinations were within range. There were 19.46 defined daily doses (DDD) for women of 45-65 years, and 16.9 DDD of neuroleptics in the elderly population. The indicator related to minimising drugs considered inappropriate in the elderly (Beers) was 11.9%. An average of 1.19 safety measures were adopted per Centre. For Criterion 7, 14.44% of professionals had been trained in quality and patient safety. By implementing e-SOAP, Health Centres can know their results in order to implement improvements. In addition, improvements have been set up in the 2010 CAP. Conclusions. With the development of the CAP using the EFQM model as a benchmark, safety indicators have been implemented and monitored systematically in the Health Centres of the Community of Madrid. Best practices that ensure patient safety have been extended and we have begun to evaluate the impact of the health care provided in Primary Care with the measurement of indicators that the scientific evidence reveals affect patient safety(AU)

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OBJECTIVE: To identify and define a minimum and standard set of safety objectives in the Centre Agreement Program (CAP) of the Community of Madrid, the introduction of which has led to improved follow-up and an improvement in quality of care and patient safety in Primary Care. MATERIAL AND METHODS: The key element is the Centre Agreement Program developed with the EFQM model as a reference. Methodologically, this project has followed the steps set out in the PDCA cycle., Standardised safety objectives were included in the CAP during the planning phase. Indicators have been monitored by the e-SOAP application. RESULTS: We have identified 12 safety goals and 21 indicators. All the criteria of the model included some safety objectives. We highlight the following results: in the criteria relating to processes, the program cover of patients who were on several medications was 59.22%, a bio-alcohol solution was used in 93% of health facilities, 89% of Health Centres had performed a control and maintenance of vital emergency equipment. As regards communication, 1096 medication errors were notified throughout the Community of Madrid. There were 239 adverse reactions to medication and 1945 safety incidents were reported. In criterion 6, 66.22% of INR determinations were within range. There were 19.46 defined daily doses (DDD) for women of 45-65 years, and 16.9 DDD of neuroleptics in the elderly population. The indicator related to minimising drugs considered inappropriate in the elderly (Beers) was 11.9%. An average of 1.19 safety measures were adopted per Centre. For Criterion 7, 14.44% of professionals had been trained in quality and patient safety. By implementing e-SOAP, Health Centres can know their results in order to implement improvements. In addition, improvements have been set up in the 2010 CAP. CONCLUSIONS: With the development of the CAP using the EFQM model as a benchmark, safety indicators have been implemented and monitored systematically in the Health Centres of the Community of Madrid. Best practices that ensure patient safety have been extended and we have begun to evaluate the impact of the health care provided in Primary Care with the measurement of indicators that the scientific evidence reveals affect patient safety.

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OBJECTIVE: To find the vaccination coverage of children seen at a Health Centre. To complete the vaccination, assess the validity of the clinical notes as a record and to verify the tendency for the number of those properly vaccinated to decrease with age. DESIGN: Crossover and descriptive. SETTING: Chopera I Primary Care team. PARTICIPANTS: The 877 children between 4 months and 7 years old at a Paediatrics clinic and between 12 and 16 years at a general medical clinic. MEASUREMENTS AND RESULTS: The percentage of those properly vaccinated were, for the first five appointments of the official vaccination calendar, 85.29%, 89.24%, 83.98%, 81.90% and 81.95%, respectively; at 6 years, 65.51%; for German Measles, 44.30%; and in the last one, 40.80%. The percentage of the 2 to 5-year old cohort fully vaccinated was 91.10%; and of the 15 to 16-year old cohort, 37%. CONCLUSIONS: The importance of vaccination surveys as against other measures. Limitations of surveys at the Health Centre. First vaccination percentages close to W.H.O. objectives. Decrease with age of those properly vaccinated. Need for universal recording systems and that the Primary Care teams assume the prime responsibility in vaccination monitoring.

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