Pub Date : 2026-01-01DOI: 10.1016/j.jhqr.2025.101185
Aitziber Echevarria Echevarria
Introduction
The current health situation necessitates a paradigm shift in Patient Care Services to meet societal needs.
The general objective wasto improve the quality and effectiveness of the Patient Care Service and users of a public health system.
Material and methods
A systematic bibliographic review of aspects related to the Patient/User/Citizen Care Service was conducted, and a survey was developed on general and organizational aspects and the strategies followed by different hospitals in various Autonomous Communities.
Results
Significant differences in User Care Services exist between the Autonomous Communities in Spain due to the decentralization of the health system and outdated regulations. These differences include nomenclature, hierarchical dependence, organization and management, services offered, responsibilities, professional training, accessibility, implementation of user rights and duties, and citizen participation in health centers.
Conclusion
The results highlight the need for a comprehensive model that combines personalization, technology, and citizen participation. This approach enhances the efficiency of User Care Services, strengthens equity, and reinforces institutional trust. In the face of the sociodemographic and structural challenges of the healthcare system, it is essential to move towards person-centered models, where the patient's voice is integrated as a driver of quality and transformation.
{"title":"Estrategia para la mejora del Servicio de Atención a la persona Usuaria de un Sistema Público de Salud","authors":"Aitziber Echevarria Echevarria","doi":"10.1016/j.jhqr.2025.101185","DOIUrl":"10.1016/j.jhqr.2025.101185","url":null,"abstract":"<div><h3>Introduction</h3><div>The current health situation necessitates a paradigm shift in Patient Care Services to meet societal needs.</div><div>The general objective wasto improve the quality and effectiveness of the Patient Care Service and users of a public health system.</div></div><div><h3>Material and methods</h3><div>A systematic bibliographic review of aspects related to the Patient/User/Citizen Care Service was conducted, and a survey was developed on general and organizational aspects and the strategies followed by different hospitals in various Autonomous Communities.</div></div><div><h3>Results</h3><div>Significant differences in User Care Services exist between the Autonomous Communities in Spain due to the decentralization of the health system and outdated regulations. These differences include nomenclature, hierarchical dependence, organization and management, services offered, responsibilities, professional training, accessibility, implementation of user rights and duties, and citizen participation in health centers.</div></div><div><h3>Conclusion</h3><div>The results highlight the need for a comprehensive model that combines personalization, technology, and citizen participation. This approach enhances the efficiency of User Care Services, strengthens equity, and reinforces institutional trust. In the face of the sociodemographic and structural challenges of the healthcare system, it is essential to move towards person-centered models, where the patient's voice is integrated as a driver of quality and transformation.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101185"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965982","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 : 2025-12-24DOI: 10.1016/j.jhqr.2025.101182
D. Parés
{"title":"Surgical safety checklist in crisis: We do either it right or we do it right","authors":"D. Parés","doi":"10.1016/j.jhqr.2025.101182","DOIUrl":"10.1016/j.jhqr.2025.101182","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101182"},"PeriodicalIF":1.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834818","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 : 2025-12-24DOI: 10.1016/j.jhqr.2025.101175
P. Ballester , E. Gil-Hernández , C. Pérez-Esteve , M. Guilabert , I. Carrillo , A. Arroyo , A. Cobos , J.J. Mira
Objective
The aim of this study was to evaluate the potential association between medication-related safety incidents in home care settings reported by informal caregivers and their emotional burden levels.
Methods
A cross-sectional study was conducted among informal caregivers of senior patients aged over 65 years requiring daily care. Participants completed the 7-item Zarit Caregiver Burden Scale and self-reported medication safety incidents.
Results
In total, 176 participants responded. Medication safety incidents were reported by 25.6% of them. Caregiver burden was independently associated with a higher likelihood of self-reported medication safety incidents, with an odds ratio of 2.16 (95% CI: 1.03–4.50), after adjusting for caregiving hours. In addition, male sex was also independently associated with increased risk, with an odds ratio of 2.29 (95% CI: 1.06–4.98).
Conclusions
This study shows that caregiver burden is associated with self-reported medication-related incidents in home care. Targeted interventions that promote informal caregiver well-being may reduce safety incidents and enhance the sustainability of informal care. This study suggests that training programs should address medication safety using gender-sensitive strategies and incorporate tools to alleviate caregiver burden.
{"title":"Medication incidents and informal caregiver burden: A cross-sectional study","authors":"P. Ballester , E. Gil-Hernández , C. Pérez-Esteve , M. Guilabert , I. Carrillo , A. Arroyo , A. Cobos , J.J. Mira","doi":"10.1016/j.jhqr.2025.101175","DOIUrl":"10.1016/j.jhqr.2025.101175","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to evaluate the potential association between medication-related safety incidents in home care settings reported by informal caregivers and their emotional burden levels.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among informal caregivers of senior patients aged over 65 years requiring daily care. Participants completed the 7-item Zarit Caregiver Burden Scale and self-reported medication safety incidents.</div></div><div><h3>Results</h3><div>In total, 176 participants responded. Medication safety incidents were reported by 25.6% of them. Caregiver burden was independently associated with a higher likelihood of self-reported medication safety incidents, with an odds ratio of 2.16 (95% CI: 1.03–4.50), after adjusting for caregiving hours. In addition, male sex was also independently associated with increased risk, with an odds ratio of 2.29 (95% CI: 1.06–4.98).</div></div><div><h3>Conclusions</h3><div>This study shows that caregiver burden is associated with self-reported medication-related incidents in home care. Targeted interventions that promote informal caregiver well-being may reduce safety incidents and enhance the sustainability of informal care. This study suggests that training programs should address medication safety using gender-sensitive strategies and incorporate tools to alleviate caregiver burden.</div><div>Trial registration <span><span>NCT05885334</span><svg><path></path></svg></span> (date 2023-06-01).</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101175"},"PeriodicalIF":1.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834806","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 : 2025-12-24DOI: 10.1016/j.jhqr.2025.101174
L. de la Sen de la Cruz, A. Palacios Bermejo, S. Amorós Villaverde, M. Escobar Castellanos, C. Ferrero García-Loygorri, A. Rivas García
Introduction and objectives
Overcrowding in Pediatric Emergency Departments(PED) have a negative impact in waiting times. External factors such as the SARS-CoV-2 pandemic can change the incoming volume of patients. The aim of this study is to quantify the extent to which the quality indicators are impacted by overcrowding and the extent to which the pandemic has impacted them.
Material and methods
Retrospective study in the PED of a high complexity hospital. Quality indicators from the PED dashboard are collected weekly for the period 2018-2022, excluding the pandemic year 2020. A univariate and multivariate analysis of the association between the variation of the indicators for every 100 additional emergencies was performed, expressing it using the regression coefficient B and its 95% CI.
Results
A median of 1105 emergencies were attended each week(876-1262). The adjusted multivariate analysis showed differences in the indicators for every 100 additional weekly emergencies of: triage delay time(B = 0.23; 95%CI:0.17-0.29.p< 0.001), delay time in care(B = 1.84; 95%CI:1.58- 2.10.p< 0.001); percentage of patients under observation(B = -0.13;95%CI:-0.24--0.02).p = 0.017), percentage of admissions(B = -0.13;95%CI:-0.23--0.03.p = 0.011), percentage of patients waiting ≥1 hour for admission(B = 0.89;95%CI:0.06-1.73.p = 0.036) and percentage of return visit(B = 0.22;95%CI:0.11-0.34.p< 0.001).
The analysis by pre-post pandemic periods showed differences: in the percentage of patients with priority≤3(B = -3.8;95%CI: -4.7- -2.9.p< 0.001), length of stay in the PED(B = 0,24;95%CI:0,12-0,36.p< 0,001), percentage of patients in observation(B = -2.6;95%CI:-3.2--1.9.p< 0.001), length of stay in observation(B = 0.68;95%CI:0.51-0.86.p< 0.001), percentage of admissions(B = 0.8;95%CI;-1.4--0.2.p = 0.006), percentage of patients waiting ≥ 1 hour for admission(B = 30.5;95%CI:26.9-34.p< 0.001) and percentage of voluntary discharges (B = 0,3;95%CI:0,1-0,6.p = 0,013).
Conclusion
Overcrowding impacts the quality of care in our center, increasing the waiting times for triage, care and admission, and increasing the proportion of visit return.
{"title":"Impacto de la frecuentación en la calidad asistencial en un Servicio de Urgencias Pediátricas","authors":"L. de la Sen de la Cruz, A. Palacios Bermejo, S. Amorós Villaverde, M. Escobar Castellanos, C. Ferrero García-Loygorri, A. Rivas García","doi":"10.1016/j.jhqr.2025.101174","DOIUrl":"10.1016/j.jhqr.2025.101174","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Overcrowding in Pediatric Emergency Departments(PED) have a negative impact in waiting times. External factors such as the SARS-CoV-2 pandemic can change the incoming volume of patients. The aim of this study is to quantify the extent to which the quality indicators are impacted by overcrowding and the extent to which the pandemic has impacted them.</div></div><div><h3>Material and methods</h3><div>Retrospective study in the PED of a high complexity hospital. Quality indicators from the PED dashboard are collected weekly for the period 2018-2022, excluding the pandemic year 2020. A univariate and multivariate analysis of the association between the variation of the indicators for every 100 additional emergencies was performed, expressing it using the regression coefficient B and its 95% CI.</div></div><div><h3>Results</h3><div>A median of 1105 emergencies were attended each week(876-1262). The adjusted multivariate analysis showed differences in the indicators for every 100 additional weekly emergencies of: triage delay time(B<!--> <!-->=<!--> <!-->0.23; 95%CI:0.17-0.29.p<<!--> <!-->0.001), delay time in care(B<!--> <!-->=<!--> <!-->1.84; 95%CI:1.58- 2.10.p<<!--> <!-->0.001); percentage of patients under observation(B<!--> <!-->=<!--> <!-->-0.13;95%CI:-0.24--0.02).p<!--> <!-->=<!--> <!-->0.017), percentage of admissions(B<!--> <!-->=<!--> <!-->-0.13;95%CI:-0.23--0.03.p<!--> <!-->=<!--> <!-->0.011), percentage of patients waiting ≥1 hour for admission(B<!--> <!-->=<!--> <!-->0.89;95%CI:0.06-1.73.p<!--> <!-->=<!--> <!-->0.036) and percentage of return visit(B<!--> <!-->=<!--> <!-->0.22;95%CI:0.11-0.34.p<<!--> <!-->0.001).</div><div>The analysis by pre-post pandemic periods showed differences: in the percentage of patients with priority≤3(B<!--> <!-->=<!--> <!-->-3.8;95%CI: -4.7- -2.9.p<<!--> <!-->0.001), length of stay in the PED(B<!--> <!-->=<!--> <!-->0,24;95%CI:0,12-0,36.p<<!--> <!-->0,001), percentage of patients in observation(B<!--> <!-->=<!--> <!-->-2.6;95%CI:-3.2--1.9.p<<!--> <!-->0.001), length of stay in observation(B<!--> <!-->=<!--> <!-->0.68;95%CI:0.51-0.86.p<<!--> <!-->0.001), percentage of admissions(B<!--> <!-->=<!--> <!-->0.8;95%CI;-1.4--0.2.p<!--> <!-->=<!--> <!-->0.006), percentage of patients waiting ≥ 1 hour for admission(B<!--> <!-->=<!--> <!-->30.5;95%CI:26.9-34.p<<!--> <!-->0.001) and percentage of voluntary discharges (B<!--> <!-->=<!--> <!-->0,3;95%CI:0,1-0,6.p<!--> <!-->=<!--> <!-->0,013).</div></div><div><h3>Conclusion</h3><div>Overcrowding impacts the quality of care in our center, increasing the waiting times for triage, care and admission, and increasing the proportion of visit return.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101174"},"PeriodicalIF":1.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834844","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 : 2025-12-11DOI: 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":"10.1016/j.jhqr.2025.101180","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the process of developing a risk map in a hospital emergency department.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 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}
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