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Implementation of an emergency department health care quality plan and its impact

Salvador Suárez FJ, Millán Soria J, Téllez Castillo CJ, Pérez García C, Oliver Martínez C

Servicio de Urgencias, Hospital LluĂ­s AlcanyĂ­s, XĂ tiva, Valencia, Spain.

Objective: To analyze the effect of a plan to improve case management in an
emergency department in terms of complaints received and patient level of satisfaction.
Methods: Longitudinal, descriptive, prospective observational study. Time frame:
January 2007 to December 2010. The health care quality plan involved the development
of a viable plan; a campaign to impart information on patient and staff safety; a
management system based on processes; and procedures for training and education,
including a balanced scorecard and a system for evaluating the results. Outcome
measures: emergencies attended monthly, number of claims and reasons for them,
mean stay in the emergency department, delay from admission to first physician visit,
and a user satisfaction survey.
Results: A total of 210 claims were studied; 81 were filed in 2007, 59 in 2008, 48 in
2009, and 22 in 2010. Delays motivated 76.19% of the claims; disagreements about
organizational procedures motivated 7.14%. More claims are received during summer
months. After the program was implemented in 2008, complaints about delays
decreased by 73.53% and no further complaints about lack of privacy and accidents
within the hospital were received.
Conclusions: Claims analysis is a useful tool for monitoring health care quality. A health
care quality management program is essential for improving emergency care without
generating additional costs.

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