Specialised health training and indicators to measure the quality of teaching

7 Jun
Alicia Avila

To work as a specialist in the health system -in any speciality in medicine, pharmacy, psychology, nursing or other- not only do you need to have a university degree but also the corresponding specialist qualification. To get it you need to pass the selective test traditionally known as the MIR in Spain (national specialisation examination) for specialist doctors, PIR for psychologists, FIR for hospital pharmacists, to give some examples and which has been done annually for more than 30 years. The training of specialists in the Health System is done in public and private health centres and teaching venues, previously accredited, to which professionals have access once they have passed the selection process, in rigorous order of registration.

The allocation of chosen places for this year recently finalised and the residents took up their places at the end of May. The specialist health press has made use of all kinds of headlines, commenting on the results of autonomous communities, the most sought after specialties by residents or the best positioned centres. Nevertheless, not all the comments that have been published, sometimes too hastily, contain an accurate and rigorous analysis. The ability of centres to attract teaching staff in Catalonia has not regressed nor changed much in recent years; the hospitals and teaching centres most sought after in Family and Community Care by new residents are still the same at a state level.

Why is it important to be an attractive teaching centre for residents? Obviously, because all centres aspire to have the students with the best marks, not only for the prestige that this has or for the base of knowledge they have shown to have, but also because of the possibility of retaining them and contracting them at the end of their residency. The lower the mark in the MIR, the greater the chances are of abandoning a speciality and in practice a significant number of foreign residents are seen as having greater difficulties for future employment.

To promote the intrinsic and perceived quality in specialised training given to residents, the Department of Health of the Generalitat de Catalunya has implemented a Management Plan of Teaching Quality and within this, a set of structural, procedural and results indicators related to the places offered, which have been published in a report since last year at the Central de Resultats (Results Centre, Catalan Health System Observatory) under the auspices of the AQuAS.

Furthermore, a survey of satisfaction is carried out with all residents in Catalonia which has had an effective participation of 76% this year and which offers complementary information to that of the Plan of Quality. Both instruments, beyond the fact of generating transparency and information regarding a healthy specialist training, make it possible to benchmark different centres with the aim of achieving greater competitivity and improved teaching in Catalonia.

Ultimately, guaranteeing profiles of excellence of specialist health professionals is the permanent aspiration of the Health Authority via a learning process based on supervised and mentored practice to attain the necessary professional skills to offer a safe and high quality practice. In this way, the health system will be capable of training better specialists to meet the needs of the population in health.

Post written by Alícia Avila, Assistant Director-General of Professional Planning and Development. Health Department.

Health data: Do we give citizens what they want?

24 Nov
central-de-resultats-qualitatiu
Dolores Ruiz-Muñoz, Anna García-Altés and Hortènsia Aguado

The right to receive advice with regards to the information available on the network is reflected in the Carta de drets i deures de la ciutadania en relació a la salut i l’atenció sanitària (Citizens Bill of Rights and Duties relating to health and healthcare), updated in 2015. In particular, it specifies that a person has the right to obtain accurate and reliable recommendations from health professionals in terms of the available health information on the network (web pages, applications, etc…).

It is a fact that, from different professional sectors, we are more and more frequently identifying citizens as a key group to take into consideration when communicating the outcomes of our work, including the health sector. The different actors involved in disseminating health information resulting from the Catalan health system activity are no exception. When we publish our data we do it more and more in a way that is not only aimed at informing health professionals on the one hand but also at being accountable to citizens as end users.

But have we really asked citizens what information they want to obtain from us?

From the Results Centre of the Catalan Health System Observatory we publish a series of reports annually with quantitative indicators that aim to measure, assess and disseminate the results obtained in the different areas of the public health system. Up to the present, to disseminate this information beyond the comfort zone of the health sector, we have published a series of infographics with the information that we have considered to be most relevant for citizens, making the effort to create a user friendly format.

infografia-atencio-primaria

 

During the first semester of 2016, we spent time reflecting on our labour and we realised that we did not in fact know whether what we were publishing for citizens really reached or interested them. We did not even know what it was that citizens wanted to receive from us. To answer these questions we carried out a qualitative study of Catalan citizens to find out what their needs for health information were, but not limiting ourselves to that produced by the Results Centre.

We created three discussion groups and invited citizens randomly selected from Registre Central d’Assegurats del CatSalut (CatSalut’s Central Registry of the Insured) to freely express what they felt their necessities for health information were. What we discovered was that the population is not interested in receiving health information in a general or systematic way but rather only wants health information when they have a specific personal need and which is directly related to what is affecting them at a given time. They are not interested, therefore, in receiving health information about the population as a whole nor of how the health system works. They state that this information is necessary but feel it is health professionals who need to have it and know how to manage it. In this way, they place their trust in the health system by dissociating themselves from this type of information.

Furthermore, they consider it of interest that the information be made available on the networks but state that, whether they actively search for it on the internet or not, what they need is to be able to contrast the information at a later stage with their primary care physician or specialist, and that it be this professional who discerns what the best information available is for each occasion. What is more, they clearly identify this professional as being the person who needs to know the health information produced systematically by the Catalan health system.

We presented the results of this study at a recent congress, to be exact, the XXXIV Congress of the Spanish Society for the Quality of Healthcare and the XXI Congress of the Andalusian Society for the Quality of Healthcare, generating a very interesting posterior debate regarding these results. One of the attendees at the congress stated their concern for the fact that citizens were not interested in receiving general health information. The debate centred on how we could educate the population into showing an interest in this information and on how to make it reach them. We believe that the key underlying question here is whether this need be done at all.

The public at large have an overwhelming amount of information at their disposal on an infinite number of different subjects on a daily basis. It seems clear that when a person has a specific need regarding their state of health they consult a professional in whom they trust. It is obvious that to us, as healthcare professionals, we will always feel that the information we produce is of such interest as to make others want to know about it, but it is also probable that our enthusiasm makes us biased when interpreting reality. We should perhaps ask ourselves whether we need to make the effort to provide the public with information they say they do not need nor interests them, and whether we are prepared to accept their decision and respect it.

Post written by Dolores Ruiz-Muñoz, Anna García-Altés and Hortènsia Aguado.

Results Centre. Mental Health and Addictions Areas. 2014 data.

27 Aug

AGA2Anna García-Altés, Head of the Catalan Health System Observatory

This report presents the results of all SISCAT mental health centres for 2014. This year, the structure of the report is slightly different from previous years. It deals with fewer topics but in a more concrete, in depth manner. A special effort has been made to include new indicators such as the age of the first visit, or the percentage of patients with Severe Mental Disorders (SMD) in the AMHC requiring hospitalization during the year. However, The tables with the values ​​of all indicators centre by centre -the distinguishing feature of the Results Centre- remain. As in previous years, all reports include innovative experiences that provide good care results, included in the Observatori d’Innovació en Gestió de la Sanitat in Catalonia as well as the experts’ opinions. Continue reading

Results Centre. Long-term Care Setting. 2014 Data.

20 Aug

AGA2Anna García-Altés, Head of the Catalan Health System Observatory

This report presents the results of all SISCAT long-term care centres for 2014. This year, the structure of the report is slightly different from previous years. It deals with fewer topics but in a more concrete in-depth manner. Similarly to last year, the results emerging from the information provided by the basic minimum acute hospitalization data sets and long-term care resources are presented which allows us to evaluate the coordination between care levels and early referral to a convalescent care centre. The tables with the values ​​of all indicators centre by centre -the distinguishing feature of the Results Centre- remain. As in previous years, all reports include innovative experiences that provide good care results, included in the Observatori d’Innovació en Gestió de la Sanitat in Catalonia as well as the experts’ opinions. Continue reading

Results Centre. Primary Care Setting. 2014 Data.

13 Aug

AGA2Anna García-Altés, Head of the Catalan Health System Observatory

This report presents the results of all SISCAT primary care teams (PCT) for 2014. This year, the structure of the report is slightly different from previous years. It deals with fewer topics but in a more concrete, in-depth manner. A special effort has been made to include indicators of nursing care evaluations, an area little discussed up until now in the Results Centre reports, and other new indicators from records that so far have not been analyzed in the reports. Some examples of these indicators are: the percentage of diabetic patients with related treatment diagnoses or the A&E MBDS indicators. However, the tables with the values ​​of all indicators centre by centre -the distinguishing feature of the Results Centre- remain. As in previous years, all reports include innovative experiences that provide good care results, included in the Observatori d’Innovació en Gestió de la Sanitat in Catalonia as well as the experts’ opinion. Continue reading

Results Centre. Hospital Setting. 2014 Data.

6 Aug

AGA2Anna García-Altés, Head of the Catalan Health System Observatory

This report presents the results of all public hospitals network (SISCAT) for 2014. The structure of this year’s report is slightly different from previous years. It deals with fewer topics but in a more concrete, in depth manner. A special effort has been made to include indicators of nursing care evaluations, an area little discussed up until now in the reports of the Results Centre, and other new indicators from records that so far have not been analyzed in the reports. Some examples of such indicators are: mortality in low mortality DRG’s, mortality in patients who have developed complications, bedsores, or indicators relating to donation and transplants registration and the A&E MBDSHowever, the tables with the values ​​of all indicators centre by centre -the distinguishing feature of the Results Centre- remain. As in previous years, all reports include innovative experiences that provide good care results, included in the Health Care Innovation Observatory in Catalonia (OIGS) as well as the experts’ opinion and specific results indicators of a monographic hospital, this year the Hospital Maternoinfantil de Vall d’Hebron.
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