Evaluación y mejora de la calidad en relación a los tiempos de espera de los pacientes en el servicio de urgencias

Patient satisfaction is a good indicator of quality, since it provides information on possible safety defects, one of the main reasons for dissatisfaction are the waiting times that patients suffer in an emergency service, from arrival to completion of the assistance process. These times can be reduced by applying the appropriate measures through good quality management practices in the Emergency Department. The main objective of the study was to evaluate and try to improve the waiting times of patients who come to the Emergency Service of the Virgen del Castillo Hospital (Yecla), from their arrival to admission until the end of their care process. Before-after evaluation through an improvement cycle, ¨Improving the waiting times of the HVC Emergency Service¨. The selected problem was the waiting time from the admission of the patient in the service to the first interview by the health personnel, after the identification of improvement opportunities and the prioritization of the same, the analysis of the causes was elaborated 9 valid criteria and reliable. After 5 months, a reassessment was performed on another 30 clinical histories using the same criteria. In a first evaluation, the total number of non-compliances was 28. After implementing some improvement interventions, the number of non-compliances was 26. The highest percentage of non-compliance is found in indicator 1: The patient / user will be assessed with a first interview in less than 10 minutes from arrival to admission, regardless of the time slot. An improvement was observed in indicator 3: The time from admission of the patient to hospital admission or transfer of the patient will be less than 12 hours. The rest of the indicators continue to be fulfilled in their entirety from the beginning. The criteria that account for 80% of the quality defects are:
• Criterion 1: The patient / user will be assessed with a first interview in less than 10 minutes from arrival to admission, regardless of the time slot.
• Criterion 3: The time from admission of the patient to hospital admission or transfer of the patient will be less than 12 hours.
The interventions implemented from the defects observed in the first evaluation were effective to improve the quality in the waiting time of the patients from the admission of them until their hospital admission or transfer of the patient, having to maintain the actions that have been put underway and design a monitoring plan in order to maintain the improvement. On the contrary, the waiting time from admission to its assessment with a first interview by health personnel, have not been sufficient, so we will have to continue studying and analyzing the possible causes.

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