[Interlevel incident management: The experience of a primary care district].

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  • Additional Information
    • Transliterated Title:
      Gestión de incidencias interniveles. La experiencia de un distrito de atención primaria.
    • Source:
      Publisher: Saned, S.A Country of Publication: Spain NLM ID: 9610769 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1578-8865 (Electronic) Linking ISSN: 11383593 NLM ISO Abbreviation: Semergen Subsets: MEDLINE
    • Publication Information:
      Publication: <2000->: Madrid : Elsever España, : Saned, S.A.
      Original Publication: Madrid : Saned, S.A., [1996-
    • Subject Terms:
      Primary Health Care*/organization & administration ; Primary Health Care*/statistics & numerical data ; Referral and Consultation*/statistics & numerical data ; Referral and Consultation*/organization & administration; Humans ; Cross-Sectional Studies ; Risk Management/organization & administration ; Risk Management/methods ; Communication ; Hospitals/statistics & numerical data ; Incidence ; Medical Errors/statistics & numerical data ; Medical Errors/prevention & control
    • Abstract:
      Aim: Determine the prevalence and define the profile of interlevel incidences (ININ) between primary care (PC) and hospital (HC).
      Design: Multicenter cross-sectional descriptive study. SITE: Primary care.
      Participants: Professionals from a Health District and its reference hospitals.
      Interventions: ININ are errors in communication between PC and HC professionals derived from administrative, pharmaceutical or clinical procedures not resolved during the formal interlevel communication processes, which requires a coordinated and validated response from the health care directions to not overload the family physician.
      Main Measurements: ININ by category, hospital services and health centers, total and validated, relative to the total number of referrals, and the reason for the ININ.
      Results: We detected 2011 ININs (3.36%) among the 59.859 referrals, although only 1684 were validated (83.7%). Most were administrative (59.5%), followed by pharmaceutical (24.2%), clinical (10.2%) and reverse (6.1%). 41.3% of the clinical ININs were grouped around 5 hospital specialties, and 45.9% in 5 health centers. The main reasons for clinical ININ were non-prescription of the recommended pharmacological treatment in outpatient clinics or on hospital discharge (27.3%), request for referral to another hospital specialist (27.9%), or request to referral in person to patients who had already been referred by teleconsultation (17.8%).
      Conclusions: 3.36% of interlevel referrals are accompanied by incidents and 83.7% are validated and processed. It is necessary to develop ININ management tools to guarantee safe healthcare and debureaucratize PC.
      (Copyright © 2023 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)
    • Contributed Indexing:
      Keywords: Bureaucratization; Burocratización; Care continuity; Care coordination; Communication; Comunicación; Continuidad asistencial; Coordinación de cuidados
    • Publication Date:
      Date Created: 20240201 Date Completed: 20240630 Latest Revision: 20240726
    • Publication Date:
      20240726
    • Accession Number:
      10.1016/j.semerg.2023.102179
    • Accession Number:
      38301400