Description of the quality system programme in a group of practices in Catalonia. Key words: quality, EFQM, indicators. Language: English. Please look for my article published in Quality in Primary Care

1. IMPLEMENTATION OF A QUALITY SYSTEM LINKED TO
ECONOMIC INCENTIVES IN A HEALTH CONSORTIUM
IN CATALONIA: EVALUATION OF THE FIRST YEAR

2. The Consortium of Primary Health Care of l’Eixample
(CAPSE) is a public health provider located in a district
of Barcelona. CAPSE, founded in 2001, is owned by
the two main health providers in Catalonia.
There are 98 health workers in CAPSE delivering
healthcare to approximately 70,000 people.
The implementation of a total quality system began in
2004 with the aims of establishing tools for the
continuous quality improvement in various dimensions

3. The SWOT analysis showed that there was:
•variability among health care delivery
•low orientation to the needs of the patients
•gaps between the needs / demands of the population
and the Public Insurance objectives
•doctors’ and nurses’ economic incentives poorly linked
to objectives

4. These improvement opportunities were implemented:
•on time: 56%
•delayed: 18%
•unsuccessfully: 26%

5. Process management: difficulties encountered
•The use of indicators over time
•Opposing strategies between directive staff and quality improvement
team
•Imbalanced data register: management indicators differ from quality
indicators
•Low involvement of patients in decision-making

6. Two examples:
1.- Preventive medicine and Promotion of Health
Activities (PPHA)
•Routine activities, carried out mainly by nurses in all public PHC centres
in Catalonia
•Promoted by the MoH
•Goal: primary prevention of the more prevalent diseases
•Candidates: referrals to the nurse, who carries out prevention and
health promotion activities
•Improvement: appointment for all new patients who are to receive
prevention and health promotion activites, independently of their
demands

7. 2.- Chronic Prescriptions
•Computorised drug prescriptions delivered by clerks to the patients
registered as Chronic Patients
•There were mistakes in the issue of prescriptions due to the unreliability
of data
•Improvement: to review Chronic Prescriptions in order to improve the
reliability of data

8. Aquí van los créditos (Cuerpo 17)
Challenges for the near future
•To involve patients in decision–making
•To implement a community plan
•To promote disease management programmes
•To evaluate the effectiveness of improvement opportunities related to
patients

9. Aquí van los créditos (Cuerpo 17)
Thank you very much
vilaseca@clinic.ub.es