Development and Pilot Test of a New Set of Good Practice Indicators for Chronic Nonmalignant Pain Management.

Objectives: This study was designed to address the current relative void of valid measures by developing evidence-based quality indicators for pain management of chronic nonmalignant pain.

Methods: We performed a 10-year literature search to identify guidelines and review articles on chronic pain management to identify evidence-based recommendations for the different conditions associated to chronic pain. A complementary search of indicators and indicator-related articles was also performed.

Understanding WHO surgical checklist implementation: tricks and pitfalls. An observational study.

Background: The purpose of the present study was to assess the reliability of implementation data regarding the surgical safety checklist (SSC) and to identify which factors influence actual implementation.

Methods: The study was a retrospective record-based evaluation in a regional network of nine Spanish hospitals, combined with a complementary direct-observation study that included a survey of the surgical teams' attitudes. SSC compliance and associated factors were assessed and compared in a retrospective sample of 280 operations and a concurrent sample of another 85 surgical interventions.

[Difficulties in implementing a surgical check list in operating theatres].

Objective: To assess the level of implementation and the factors associated with the compliance to the surgical check list (SCL) proposed by the WHO, in surgery departments in public hospitals in the Murcia Region of Spain.

Methodology: A retrospective cross-sectional study was conducted using a random, non-proportional, and stratified sample in each hospital. The sample size was established as 10 cases per centre, with a total of 90 surgical operations.

Ensuring evidence-based practices for falls prevention in a nursing home setting.

Objective: To evaluate the effectiveness of an ad hoc multifaceted program to improve structure, professional behavior, and outcomes related to falls prevention.

Design: Internal quality improvement cycle.

Setting: Nursing home in Spain.

Prevention of venous thromboembolism and safe use of heparin in Spanish hospitals.

Objective: To assess compliance with basic and actionable indicators in relation to prevention of venous thromboembolism (VTE) and safe use of heparin.

Design: We built, pilot tested and measured a set of evidence-based structure (existence of guidelines) and process (risk assessment for VTE, and dose adjustment to patient weight and renal function when prescribing heparin) indicators in a nation-wide random sample of 22 hospitals. Compliance with process indicators is estimated at national level and by groups of hospitals (stratified by size).

[Analysis of the patient safety culture in hospitals of the Spanish National Health System].

Background And Objectives: A safety culture is essential to minimize errors and adverse events. Its measurement is needed to design activities in order to improve it. This paper describes the methods and main results of a study on safety climate in a nation-wide representative sample of public hospitals of the Spanish NHS.

[Strategies for patient participation in continuing improvement of clinical safety].

Strategies for patient participation in quality improvement, as an active part of processes or providing relevant information when asked, have progressed to a great extent for the last few years, influenced by the emphasis on patient-focused care as a key dimension for quality and, lately, by the emphasis on patient safety -a dimension for which the patient contribution can not be ignored. However, these strategies have not been fully implemented and used in most quality management systems. This article aims to make it easier to select the appropriate strategies for a given context, by describing them, grouped in three main themes (mobilising patients for patient safety; promoting active participation of patients in the prevention of safety incidents; requesting and using the relevant information for quality improvement that patients can provide), illustrating them with examples, and pointing out some of the obstacles for implementing them.

Why hypertensive patients do not comply with the treatment: results from a qualitative study.

Background: Medical non-compliance has been identified as a major public health problem in the treatment of hypertension. There is a large research record focusing on the understanding of this phenomenon. However, to date, the majority of studies in this field have been focused from the medical care perspective, but few studies have focused on the patients' point of view.

Validity and reliability of guidelines for neck pain treatment in primary health care. A nationwide empirical analysis in Spain.

Objectives: To assess the reliability and validity of existing clinical guidelines on neck-pain physiotherapy treatment and follow-up in Spain.

Design: We identified existing guidelines through a nationwide census and listed their recommendations, grouped according to the main steps of the process flow-chart. To assess reliability we analysed the variability of statements.