Pub Date : 2025-12-11DOI: 10.1016/j.jhqr.2025.101180
A Cuerva Carvajal, I Osorio González, J L Fernández Ropero, A Quitián Martín
Objective: To describe the process of developing a risk map in a hospital emergency department.
Method: A risk map was developed for the observation area of the emergency department of a secondary-level hospital belonging to the Regional Health Service of Andalusia. The work involved the systematic identification of potential problems, their prioritization, and the proposal of improvement measures, following a structured risk analysis methodology applied to patient safety.
Results: A total of 25 main problems were identified. After prioritization, the following critical areas were highlighted: direct patient monitoring; medication safety during treatment administration; standardization of clinical procedures; continuity of care during night shifts; appropriate management of patient isolation; analysis of previous initiatives; and the implementation and auditing of new improvement proposals.
Conclusions: The use of structured tools aimed at patient safety, such as risk maps, is both feasible and useful for identifying improvement areas in emergency services. Their application allows problems to be prioritized, interventions to be targeted, and a systematic framework to be established for the continuous improvement of healthcare quality.
{"title":"Improving the quality of emergency care with a risk map.","authors":"A Cuerva Carvajal, I Osorio González, J L Fernández Ropero, A Quitián Martín","doi":"10.1016/j.jhqr.2025.101180","DOIUrl":"https://doi.org/10.1016/j.jhqr.2025.101180","url":null,"abstract":"<p><strong>Objective: </strong>To describe the process of developing a risk map in a hospital emergency department.</p><p><strong>Method: </strong>A risk map was developed for the observation area of the emergency department of a secondary-level hospital belonging to the Regional Health Service of Andalusia. The work involved the systematic identification of potential problems, their prioritization, and the proposal of improvement measures, following a structured risk analysis methodology applied to patient safety.</p><p><strong>Results: </strong>A total of 25 main problems were identified. After prioritization, the following critical areas were highlighted: direct patient monitoring; medication safety during treatment administration; standardization of clinical procedures; continuity of care during night shifts; appropriate management of patient isolation; analysis of previous initiatives; and the implementation and auditing of new improvement proposals.</p><p><strong>Conclusions: </strong>The use of structured tools aimed at patient safety, such as risk maps, is both feasible and useful for identifying improvement areas in emergency services. Their application allows problems to be prioritized, interventions to be targeted, and a systematic framework to be established for the continuous improvement of healthcare quality.</p>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"101180"},"PeriodicalIF":1.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/j.jhqr.2025.101181
M. López-Gobernado , J. Hernández Bartolomé , D. Villalba Gil
{"title":"30 años de la Ley de Prevención de Riesgos Laborales en España: avances y retos en las organizaciones sanitarias","authors":"M. López-Gobernado , J. Hernández Bartolomé , D. Villalba Gil","doi":"10.1016/j.jhqr.2025.101181","DOIUrl":"10.1016/j.jhqr.2025.101181","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101181"},"PeriodicalIF":1.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-13DOI: 10.1016/j.jhqr.2025.101179
F.M. Escandell Rico , L. Pérez Fernández
Objective
To analyze the relationship between public health expenditure and its possible association with health indicators, particularly life expectancy and infant mortality in Spain during the period 2002-2022.
Method
An ecological, longitudinal, and retrospective study that included the 17 autonomous communities, generating a panel of 340 observations (17 communities × 20 years). Official data from the Public Health Expenditure Statistics and health indicators from the Ministry of Health were used. Time trends in public health expenditure, life expectancy, and infant mortality were analyzed, and correlation analysis, multiple regression, and hierarchical cluster analysis were applied to evaluate patterns and associations.
Results
Public health expenditure per capita increased by 70.6% between 2002 and 2022, mainly concentrated in hospital services, while primary care showed limited growth, and public health only increased significantly after the COVID-19 pandemic. A positive, albeit weak, association was observed between total spending and life expectancy, and a negative correlation approaching significance between spending and infant mortality. Regional inequalities persisted, with regions such as Catalonia and Madrid presenting the highest spending levels and improved indicators, in contrast to regions such as Andalusia and the Valencian Community, which maintained lower and more unstable levels.
Conclusions
Increased public health spending in Spain is associated with improvements in key health indicators, but spending alone does not guarantee better outcomes. Efficiency improvements, strengthening of primary care, reduction of territorial inequalities, and results-oriented strategic planning are required to ensure the sustainability and effectiveness of the health system.
{"title":"Análisis de la relación entre gasto sanitario público y resultados en salud en España (2002-2022)","authors":"F.M. Escandell Rico , L. Pérez Fernández","doi":"10.1016/j.jhqr.2025.101179","DOIUrl":"10.1016/j.jhqr.2025.101179","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the relationship between public health expenditure and its possible association with health indicators, particularly life expectancy and infant mortality in Spain during the period 2002-2022.</div></div><div><h3>Method</h3><div>An ecological, longitudinal, and retrospective study that included the 17 autonomous communities, generating a panel of 340 observations (17 communities ×<!--> <!-->20<!--> <!-->years). Official data from the Public Health Expenditure Statistics and health indicators from the Ministry of Health were used. Time trends in public health expenditure, life expectancy, and infant mortality were analyzed, and correlation analysis, multiple regression, and hierarchical cluster analysis were applied to evaluate patterns and associations.</div></div><div><h3>Results</h3><div>Public health expenditure per capita increased by 70.6% between 2002 and 2022, mainly concentrated in hospital services, while primary care showed limited growth, and public health only increased significantly after the COVID-19 pandemic. A positive, albeit weak, association was observed between total spending and life expectancy, and a negative correlation approaching significance between spending and infant mortality. Regional inequalities persisted, with regions such as Catalonia and Madrid presenting the highest spending levels and improved indicators, in contrast to regions such as Andalusia and the Valencian Community, which maintained lower and more unstable levels.</div></div><div><h3>Conclusions</h3><div>Increased public health spending in Spain is associated with improvements in key health indicators, but spending alone does not guarantee better outcomes. Efficiency improvements, strengthening of primary care, reduction of territorial inequalities, and results-oriented strategic planning are required to ensure the sustainability and effectiveness of the health system.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101179"},"PeriodicalIF":1.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-04DOI: 10.1016/j.jhqr.2025.101173
M.C. Miguez-Navarro , G. Guerrero-Márquez , P. Storch De Gracia Calvo , S. Herranz López , M.A. de la Fuente de la Hoz , M.I. Sainz de la Maza Giménez , Grupo de Triaje Pediátrico-STPED
Introduction
This study was conducted to determine the indirect validity of the Sistema Centralizado de Triaje Pediátrico (STPED) –the computer version of the Sistema de Triaje Pediátrico del Hospital Gregorio Marañón (TRIPED-GM)– in eight pediatric emergency departments of the Community of Madrid.
Patients and methods
It is a retrospective observational multicenter study. A sample of patients (<18 years) attending triaje from October 2021 to October 2022, for any reason, was randomly selected. The validity of STPED was assessed by analyzing the association between priority level (1 [maximum]- 5 [minimum]) and use of resources utilization (number of complementary tests, procedures, or treatments; need for observation or admissions; mean length of stay [LOS]) with a regression model. A subgroup analysis of secondary and tertiary hospitals was performed. The R software version
4.3.3 was used.
Results
A total of 542 patients were analyzed. For each unit increase in priority, the probability of performing a complementary test, procedure or receiving treatment increased 1.83-fold (Incidence Rate Ratio: 1.83; 95% confidence interval (CI): 1.66-2.02; p < 0.001), the need for observation, 6 (Odds Ratio: 6.07; 95% CI: 4.10-9.22; p < 0.001) and the need for admission, almost 5 (Odds Ratio: 4.93; 95% CI: 2.97-8.43; p < 0.001). The LOS increased by 69 minutes (beta: 69; 95% CI: 44-95; p < 0.001). The relationship between resource use and priority was higher in tertiary hospitals.
Conclusions
The results confirm the indirect validity of STPED, especially in tertiary hospitals. Studies in other regions are needed to ratify these findings.
本研究旨在确定马德里社区8个儿科急诊科的Sistema Centralizado de Triaje Pediátrico （STPED）——计算机版Sistema de Triaje Pediátrico del Hospital Gregorio Marañón （TRIPED-GM）的间接有效性。患者和方法：这是一项回顾性观察性多中心研究。结果：共分析542例患者。优先级每增加一个单位，执行补充检查、程序或接受治疗的概率增加1.83倍(发病率比：1.83；95%可信区间（CI）： 1.66-2.02；结论：结果证实了STPED的间接有效性，特别是在三级医院。需要在其他区域进行研究以批准这些发现。
{"title":"Estudio multicéntrico de validez del Sistema Centralizado de Triaje Pediátrico","authors":"M.C. Miguez-Navarro , G. Guerrero-Márquez , P. Storch De Gracia Calvo , S. Herranz López , M.A. de la Fuente de la Hoz , M.I. Sainz de la Maza Giménez , Grupo de Triaje Pediátrico-STPED","doi":"10.1016/j.jhqr.2025.101173","DOIUrl":"10.1016/j.jhqr.2025.101173","url":null,"abstract":"<div><h3>Introduction</h3><div>This study was conducted to determine the indirect validity of the Sistema Centralizado de Triaje Pediátrico (STPED) –the computer version of the Sistema de Triaje Pediátrico del Hospital Gregorio Marañón (TRIPED-GM)– in eight pediatric emergency departments of the Community of Madrid.</div></div><div><h3>Patients and methods</h3><div>It is a retrospective observational multicenter study. A sample of patients (<18 years) attending triaje from October 2021 to October 2022, for any reason, was randomly selected. The validity of STPED was assessed by analyzing the association between priority level (1 [maximum]- 5 [minimum]) and use of resources utilization (number of complementary tests, procedures, or treatments; need for observation or admissions; mean length of stay [LOS]) with a regression model. A subgroup analysis of secondary and tertiary hospitals was performed. The R software version</div><div>4.3.3 was used.</div></div><div><h3>Results</h3><div>A total of 542 patients were analyzed. For each unit increase in priority, the probability of performing a complementary test, procedure or receiving treatment increased 1.83-fold (Incidence Rate Ratio: 1.83; 95% confidence interval (CI): 1.66-2.02; <em>p</em> <!--><<!--> <!-->0.001), the need for observation, 6 (Odds Ratio: 6.07; 95% CI: 4.10-9.22; <em>p</em> <!--><<!--> <!-->0.001) and the need for admission, almost 5 (Odds Ratio: 4.93; 95% CI: 2.97-8.43; <em>p</em> <!--><<!--> <!-->0.001). The LOS increased by 69<!--> <!-->minutes (beta: 69; 95% CI: 44-95; <em>p</em> <!--><<!--> <!-->0.001). The relationship between resource use and priority was higher in tertiary hospitals.</div></div><div><h3>Conclusions</h3><div>The results confirm the indirect validity of STPED, especially in tertiary hospitals. Studies in other regions are needed to ratify these findings.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101173"},"PeriodicalIF":1.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.jhqr.2025.101172
R. Harsvardhan, A. Jain, S. Singh, M. Suhaib, S. Bose
Background
The Central Control Room (CCR) of hospital plays a pivotal role in the hospital operations by overseeing, coordinating and resolving real-time administrative and operational challenges. Trauma centres operate in high-pressure environment and frequently encounter inefficiently designed workflows that impacts service delivery. Pareto analysis and Gemba Walk, based on Lean Management and Total Quality Management approach, focuses on direct observation by identify high-priority issues and real-time problem solving.
Methods
An interventional study was conducted over seven months (April–October 2024) at a trauma centre. In Phase I (April–June), all complaints reported in CCR were registered, categorized and analysed using Pareto analysis to identify the most frequent and high-impact issues. In Phase II (July), Gemba Walk by multidisciplinary team was introduced. During Phase III (August–October 2024), complaints were re-evaluated using Pareto analysis to measure the impact of the intervention.
Interventions
Introduction of structured complaint tracking using Pareto charts, followed by Gemba Walks involving operations, nursing, engineering, and housekeeping teams to address issues at the point of occurrence.
Results
Pareto analysis done in pre-intervention phase revealed that 69.88% of issues stemmed from 28.6% of the complaints. After targeted Gemba Walk introduction, the post-intervention analysis showed that while 67.77% of issues were still from 28.6% of complaints, however, nature of the problems was different.
Conclusion
Integration of Pareto analysis and Gemba Walk proved to be an effective approach for identifying and resolving key operational challenges in trauma centre. Findings highlight the importance of structured quality improvement approach in enhancing hospital efficiency.
{"title":"Improving Administrative Processes in a Trauma Centre: Lean and Pareto Approach","authors":"R. Harsvardhan, A. Jain, S. Singh, M. Suhaib, S. Bose","doi":"10.1016/j.jhqr.2025.101172","DOIUrl":"10.1016/j.jhqr.2025.101172","url":null,"abstract":"<div><h3>Background</h3><div>The Central Control Room (CCR) of hospital plays a pivotal role in the hospital operations by overseeing, coordinating and resolving real-time administrative and operational challenges. Trauma centres operate in high-pressure environment and frequently encounter inefficiently designed workflows that impacts service delivery. Pareto analysis and Gemba Walk, based on Lean Management and Total Quality Management approach, focuses on direct observation by identify high-priority issues and real-time problem solving.</div></div><div><h3>Methods</h3><div>An interventional study was conducted over seven months (April–October 2024) at a trauma centre. In Phase I (April–June), all complaints reported in CCR were registered, categorized and analysed using Pareto analysis to identify the most frequent and high-impact issues. In Phase II (July), Gemba Walk by multidisciplinary team was introduced. During Phase III (August–October 2024), complaints were re-evaluated using Pareto analysis to measure the impact of the intervention.</div></div><div><h3>Interventions</h3><div>Introduction of structured complaint tracking using Pareto charts, followed by Gemba Walks involving operations, nursing, engineering, and housekeeping teams to address issues at the point of occurrence.</div></div><div><h3>Results</h3><div>Pareto analysis done in pre-intervention phase revealed that 69.88% of issues stemmed from 28.6% of the complaints. After targeted Gemba Walk introduction, the post-intervention analysis showed that while 67.77% of issues were still from 28.6% of complaints, however, nature of the problems was different.</div></div><div><h3>Conclusion</h3><div>Integration of Pareto analysis and Gemba Walk proved to be an effective approach for identifying and resolving key operational challenges in trauma centre. Findings highlight the importance of structured quality improvement approach in enhancing hospital efficiency.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101172"},"PeriodicalIF":1.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-31DOI: 10.1016/j.jhqr.2025.101170
S. Postigo-Morales , B. Ugarte-Sierra , M. San-Juan-González , J.M. Ramírez-Rodríguez
Background and objective
The Enhanced Recovery After Surgery (ERAS) clinical pathway has been shown to improve postoperative outcomes in elective surgery but its implementation in emergency settings remains limited and understudied. The aim of the study is to assess the degree of adherence to selected perioperative ERAS items in frequent emergency surgeries (appendectomy, cholecystectomy and non-neoplastic perforated peptic ulcer), as well as to identify barriers and facilitators for its implementation.
Materials and methods
Descriptive, prospective and exploratory observational study including 206 consecutive patients undergoing one of the selected emergency surgeries between November 2021 and July 2022. Adherence to ERAS items was assessed in the preoperative, intraoperative and immediate postoperative phases. Barriers and facilitators were also analysed through literature review, standardised matrix development, unstructured interviews and direct observation.
Results
Overall adherence was over 70% for most items, with greater variability, as expected, in those measures dependent on the complexity of the case, such as the use of drains or tubes. The main barrier was organisational and the previous experience of ERAS in elective surgery acted as a facilitator.
Conclusions
The implementation of certain perioperative ERAS items in emergency surgery is feasible, presenting high adherence in settings with previous experience in elective surgery. The main barrier detected was organisational, while the consolidated institutional culture was a key facilitator. Studies with methodologically robust designs, including evaluation of clinical outcomes, are needed to support its implementation as a standard of care.
{"title":"Implementación de la vía RICA en cirugía urgente: adherencia, barreras y facilitadores","authors":"S. Postigo-Morales , B. Ugarte-Sierra , M. San-Juan-González , J.M. Ramírez-Rodríguez","doi":"10.1016/j.jhqr.2025.101170","DOIUrl":"10.1016/j.jhqr.2025.101170","url":null,"abstract":"<div><h3>Background and objective</h3><div>The Enhanced Recovery After Surgery (ERAS) clinical pathway has been shown to improve postoperative outcomes in elective surgery but its implementation in emergency settings remains limited and understudied. The aim of the study is to assess the degree of adherence to selected perioperative ERAS items in frequent emergency surgeries (appendectomy, cholecystectomy and non-neoplastic perforated peptic ulcer), as well as to identify barriers and facilitators for its implementation.</div></div><div><h3>Materials and methods</h3><div>Descriptive, prospective and exploratory observational study including 206 consecutive patients undergoing one of the selected emergency surgeries between November 2021 and July 2022. Adherence to ERAS items was assessed in the preoperative, intraoperative and immediate postoperative phases. Barriers and facilitators were also analysed through literature review, standardised matrix development, unstructured interviews and direct observation.</div></div><div><h3>Results</h3><div>Overall adherence was over 70% for most items, with greater variability, as expected, in those measures dependent on the complexity of the case, such as the use of drains or tubes. The main barrier was organisational and the previous experience of ERAS in elective surgery acted as a facilitator.</div></div><div><h3>Conclusions</h3><div>The implementation of certain perioperative ERAS items in emergency surgery is feasible, presenting high adherence in settings with previous experience in elective surgery. The main barrier detected was organisational, while the consolidated institutional culture was a key facilitator. Studies with methodologically robust designs, including evaluation of clinical outcomes, are needed to support its implementation as a standard of care.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101170"},"PeriodicalIF":1.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.jhqr.2025.101171
R. Allande-Cussó , J. Gómez-Salgado
{"title":"Float nurses, patient safety and humanised care: A global challenge","authors":"R. Allande-Cussó , J. Gómez-Salgado","doi":"10.1016/j.jhqr.2025.101171","DOIUrl":"10.1016/j.jhqr.2025.101171","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101171"},"PeriodicalIF":1.0,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-07DOI: 10.1016/j.jhqr.2025.101169
I. de Lecuona , R.F. Estévez
AI-powered neurotechnologies pose significant challenges due to the sensitive nature of the personal data they process and their potential impact on human behaviour and health. This work adopts an ethical framework that, drawing on scientific evidence, advocates for the promotion and protection of individual rights in the deployment of AI. First, it explores the exponential adoption and diversification of AI systems in healthcare delivery. Second, it explores translational neuroethics to demonstrate its value in enhancing the quality of care. Ultimately, ensuring high-quality healthcare requires rethinking the human–technology relationship.
{"title":"AI and neurotechnology: Ethical challenges, human rights, and quality of healthcare","authors":"I. de Lecuona , R.F. Estévez","doi":"10.1016/j.jhqr.2025.101169","DOIUrl":"10.1016/j.jhqr.2025.101169","url":null,"abstract":"<div><div>AI-powered neurotechnologies pose significant challenges due to the sensitive nature of the personal data they process and their potential impact on human behaviour and health. This work adopts an ethical framework that, drawing on scientific evidence, advocates for the promotion and protection of individual rights in the deployment of AI. First, it explores the exponential adoption and diversification of AI systems in healthcare delivery. Second, it explores translational neuroethics to demonstrate its value in enhancing the quality of care. Ultimately, ensuring high-quality healthcare requires rethinking the human–technology relationship.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101169"},"PeriodicalIF":1.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jhqr.2025.101166
M Corominas Iglesias, M Blasco Afonso, J Piqué-Buisan
Introduction: Surgery is a fundamental component of healthcare, with over 300 million procedures performed annually. At least half of adverse events are considered preventable through tools such as the Surgical Safety Checklist (SSC). However, adherence to the SSC is often incomplete. Simulation-based training offers a meaningful learning methodology that can effectively improve compliance. This study aims to evaluate the use of simulation as a strategy to increase SSC adherence at our hospital.
Methods: We conducted a retrospective, quasi-experimental quantitative intervention study, analyzing pre- and post-simulation data collected between the second half of 2021 and the second half of 2023. The target population included operating room healthcare professionals, and the SSC endorsed by the WHO was used. Clinical simulations were carried out that had been previously designed to imitate real situations in operating rooms with natural equipment and their respective post-debriefings as guided reflection for learning.
Results: Simulation participation rates by department were as follows: 40% for Anesthesiology, 55.5% for Surgery, 75% for Orthopedics, and 76.5% for surgical nurses. The impact of the intervention was assessed by retrospectively reviewing SSC compliance before and after the simulation training. The results showed a significant increase in SSC compliance at the entry phase and during the surgical pause (P=.000), while no significant change was observed at the surgical exit phase.
Conclusion: The findings suggest that implementing simulation-based interventions in the operating room can enhance compliance with the Surgical Safety Checklist, thereby contributing to improved patient safety.
{"title":"[Impact of clinical simulation on improving compliance with the surgical safety checklist].","authors":"M Corominas Iglesias, M Blasco Afonso, J Piqué-Buisan","doi":"10.1016/j.jhqr.2025.101166","DOIUrl":"https://doi.org/10.1016/j.jhqr.2025.101166","url":null,"abstract":"<p><strong>Introduction: </strong>Surgery is a fundamental component of healthcare, with over 300 million procedures performed annually. At least half of adverse events are considered preventable through tools such as the Surgical Safety Checklist (SSC). However, adherence to the SSC is often incomplete. Simulation-based training offers a meaningful learning methodology that can effectively improve compliance. This study aims to evaluate the use of simulation as a strategy to increase SSC adherence at our hospital.</p><p><strong>Methods: </strong>We conducted a retrospective, quasi-experimental quantitative intervention study, analyzing pre- and post-simulation data collected between the second half of 2021 and the second half of 2023. The target population included operating room healthcare professionals, and the SSC endorsed by the WHO was used. Clinical simulations were carried out that had been previously designed to imitate real situations in operating rooms with natural equipment and their respective post-debriefings as guided reflection for learning.</p><p><strong>Results: </strong>Simulation participation rates by department were as follows: 40% for Anesthesiology, 55.5% for Surgery, 75% for Orthopedics, and 76.5% for surgical nurses. The impact of the intervention was assessed by retrospectively reviewing SSC compliance before and after the simulation training. The results showed a significant increase in SSC compliance at the entry phase and during the surgical pause (P=.000), while no significant change was observed at the surgical exit phase.</p><p><strong>Conclusion: </strong>The findings suggest that implementing simulation-based interventions in the operating room can enhance compliance with the Surgical Safety Checklist, thereby contributing to improved patient safety.</p>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":" ","pages":"101166"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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