出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction : Until 2014, the social centres for integrated care (SCIC) within Andalusia (Spain) could opt for quality management models: EFQM, standard ISO, UNE 158101. Description of policy context and objective : In 2013, the Regional Government of Andalusia identified the need to improve the quality of the integrated care offered by the different SCICs within the Autonomous Community. In this regard, the Andalusian Agency for Healthcare Quality (ACSA) was selected in 2014 for performing this task, since its quality model is focused on the person. Objective : to develop a certification process that allows SCICs to identify areas for improvement and to share good practices (GP) on integrated care. Targeted population : ACSA prepared a manual of standards based on scientific evidence in order to certify the quality of SCICs in Andalusia: 1,296 SCICs for the elderly, 672 SCICs for disabled people, 240 SCICs for people with drug-related problems and addictions, 174 SCICs for people with mental illness and 132 SCICs for migrants. Methodology : literature review, consensus through a panel of experts and validation before its publication. The manual is structured in 5 blocks (B) and 11 criteria (C): B1. Person: C1. The person as active subject; C2. Accessibility and continuity of attention; C3. Documentation. B2. Organisation: C4. Management by processes; C5. Promotion of quality of life; C6. Strategic management and planning. B3. Professionals: C7. Professional development. B4. Support: C8. Structure and equipment; C9. Information systems. B5. Continuous improvement: C10. Quality tools; C11. Outcomes. Highlights (innovation, impact and outcomes) : The manual of standards is specific to SCIC and covers all types of centres available in the Autonomous Community. Nowadays, there are 70 SCICs in the process of certification, of which 52 are already certified. The certification process has enabled the identification of 997 areas for improvement (14.25 per SCIC on average), of which 616 have been implemented (8.8 per SCIC). It has also facilitated the exchange of 40 good practices among SCICs. The satisfaction of the SCICs with the certification is 9.3/10. In addition, the analysis of SCICs’ certification outcomes has allowed ACSA to generate 2 recommendations aimed at encouraging the safe use of medicines and the management by processes. Comments on transferability : The certification process used for SCICs has the same conceptual structure as the other certification manuals of ACSA. This model of quality improvement has been successfully transferred to other countries, such as Portugal and Brazil; and a report of the OECD (Organisation for Economic Co-operation and Development) recognises it as an important factor of the improvement noted in healthcare in Portugal. OECD (2015), OECD Reviews of Health Care Quality: Portugal 2015: Raising Standards, OECD Publishing, Paris. DOI: http://dx.doi.org/10.1787/9789264225985-en Conclusions (comprising key findings, discussion and lessons learned) : As key findings, it is important to emphasise that the certification has allowed SCICs to identify, implement and share an important number of areas for improvement and GPs. Among the lessons learned, it must be noted the importance of systematically collect areas for improvement as an instrument to improve the quality of integrated care.
关键词：social centres for integrated care ; quality models ; certification ; improvement areas
