Analysis of adverse events in general surgery. Multicenter study.

Introduction: Knowledge of adverse events (AE) in acute care hospitals is a particularly relevant aspect of patient safety. Its incidence ranges from 3% to 17%, and surgery is related to the occurrence of 46%-65% of all AE.

Material And Methods: An observational, descriptive, retrospective, multicenter study was conducted with the participation of 31 Spanish acute-care hospitals to determine and analyze AE in general surgery services.

Value-Based Healthcare Project Implementation in a Hierarchical Tertiary Hospital: Lessons Learned.

An important innovation in healthcare is the value-based healthcare (VBHC) framework, a way to solve health services' sustainability problems and ensure continuous improvement of healthcare quality. The Quality and Safety Unit at the Hospital Universitario 12 de Octubre has been since May 2018 coordinating the implementation of several healthcare innovation projects within the paradigm of VBHC. Implementing innovations in a complex institution, such as a tertiary hospital, is a challenge; we present here the lessons learned in the last 4 years of work.

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study.

Background: In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new "Trigger Tool" represents a sensitive predictor of adverse events in general surgery.

Methods: An observational multicenter validation study was performed among 31 hospitals in Spain.

Estimation of the Overuse of Preoperative Chest X-rays According to "Choosing Wisely", "No Hacer", and "Essencial" Initiatives: Are They Equally Applicable and Comparable?

Background: Overuse reduces the efficiency of healthcare systems and compromises patient safety. Different institutions have issued recommendations on the indication of preoperative chest X-rays, but the degree of compliance with these recommendations is unknown. This study investigates the frequency and characteristics of the inappropriateness of this practice.

Impact of the implementation of electronic health records on the quality of discharge summaries and on the coding of hospitalization episodes.

Objective: To determine whether the implementation and use of the electronic health records (EHR) modifies the quality, readability and/or the length of the discharge summaries (DS) and the average number of coded diagnosis and procedures per hospitalization episode.

Design: A pre-post-intervention descriptive study conducted between 2010 and 2014.

Setting: The 'Hospital Universitario 12 de Octubre' (H12O) of Madrid (Spain).

[Performance and optimisation of a trigger tool for the detection of adverse events in hospitalised adult patients].

Objective: To characterise the performance of the triggers used in the detection of adverse events (AE) of hospitalised adult patients and to define a simplified panel of triggers to facilitate the detection of AE.

Method: Cross-sectional study of charts of patients from a service of internal medicine to detect EA through systematic review of the charts and identification of triggers (clinical event often related to AE), determining if there was AE as the context in which it appeared the trigger. Once the EA was detected, we proceeded to the characterization of the triggers that detected it.

Detection of adverse events in general surgery using the " Trigger Tool" methodology.

Introduction: Surgery is one of the high-risk areas for the occurrence of adverse events (AE). The purpose of this study is to know the percentage of hospitalisation-related AE that are detected by the «Global Trigger Tool» methodology in surgical patients, their characteristics and the tool validity.

Material And Methods: Retrospective, observational study on patients admitted to a general surgery department, who underwent a surgical operation in a third level hospital during the year 2012.

Analysis of the quality of care in surgical treatment of colorectal cancer: national study. Follow-up results.

Objectives: Using the cases included in the Study on the quality of care in colorectal cancer conducted by the Spanish Association of Surgeons in 2008, we present follow-up data.

Method: Multicenter, descriptive, longitudinal and prospective study of patients operated on a scheduled basis of colorectal cancer. 35 hospitals have contributed data on 334 patients.

Assessment of a rapid referral pathway for suspected colorectal cancer in Madrid.

Objective: To assess the results achieved with a rapid referral pathway for suspected colorectal cancer (CRC), comparing with the standard referral pathway.

Methods: Three-year audit of patients suspected of having CRC routed via a rapid referral pathway, and patients with CRC routed via the standard referral pathway of a health care district serving a population of 498,000 in Madrid (Spain). Outcomes included referral criteria met, waiting times, cancer diagnosed and stage of disease.

[Analysis of the quality of surgical treatment of colorectal cancer, in 2008. A national study].

Objective: A national study conducted for the Spanish Association of Surgeons with the aim of analysing the surgical treatment of colorectal cancer (CRC) in Spain and to compare it with scientific literature.

Material And Methods: A multicentre, descriptive, prospective and longitudinal study of patients with CRC who were treated by elective surgery. A total of 50 hospitals in 15 Autonomous Regions took part, with 496 treated cases in 2008.

[Guidelines and clinical pathways. Is there really a difference?].

Quality Design Activities of Good Clinical Practice guidelines or protocols and clinical pathways (CP) include those clinical plans intended for the patients with a particular disease. They must be based on the clinical evidence, the analysis of the process, and the consensus of the professionals involved in the care of the patient. When these are introduced to surgical professionals, they usually say that they do not understand the the difference between CP and protocols or guidelines.

[Adverse events in general and digestive surgery departments in Spanish hospitals].

Objective: To determine the incidence of patients with adverse events (AE) in Spanish general surgery units, describe the immediate causes of AE, identify avoidable AE, and determine the impact of these events.

Material And Method: We performed a retrospective cohort study of a randomized stratified sample of 24 hospitals. Six of the hospitals were small (fewer than 200 beds), 13 were medium-sized (between 200 and 499 beds) and five were large (500 or more beds).

[National project for the clinical management of healthcare processes. The surgical treatment of cholelithiasis. Development of a clinical pathway].

Introduction: Because surgical treatment of gallstones is highly prevalent, this topic is particularly suitable for a national study aimed at determining the most important indicators and developing a clinical pathway.

Objectives: To analyze the results obtained during the hospital phase of the process. To define the key indicators of the process.