Advance in the search for excellence in the hospital health system.

Advance in the search for excellence in the hospital health system.

In the current process of strengthening the National Health System, the transformation of hospital services is necessary: ​​changes in the mentality and behavior of workers as a core element, the installation of new technologies, the revitalization of health care units and their integration, the universalization of education as well as an appropriate organization and direction. All aimed at ensuring a continuous institutional process of high quality patient care, as an essential requirement to achieve Excellence.
The conduction of quality processes by the management of hospital institutions is based on personal example and requires a high efficiency in the integral training of workers, so that they adopt the right decisions in each moment of action.
In this endeavor, the analysis of their own behavior and that of the collective should be encouraged, stimulating them to carry out assessments with independence and creativity, in order to respond to the problems identified based on the concepts, principles and values ​​contained in the existing legal framework.
International strategies in patient safety are mainly oriented in two major areas: the cultural change of professionals and the implementation of safe practices.

The cultural change of professionals towards a positive culture on patient safety in health institutions is an indispensable requirement to prevent and minimize incidents related to patient safety and to be able to learn from mistakes to reduce the likelihood of their recurrence.
To improve the safety culture, we must continue developing actions aimed at measuring and improving the safety environment, inform and train all health system professionals on safety issues, promote effective care training, train work teams in risk management, promote leadership in security, communicate and learn from incidents and keep professionals informed of the evaluation data of their health organizations, stimulating their active participation in the proposed improvements.
Knowing the security culture of an organization is the first step to its improvement. The research is in safety culture have been oriented primarily to assess the safety environment (attitudes and perceptions that professionals have about safety) and its association with different clinical outcomes, as well as the satisfaction of professionals and patients. 76 Flin R, Mearns K, O'Connor P and Bryden R. Measuring safety climate: identifying the common features. [Internet] Safety Science, Vol 34 (1-3), Feb 2000, 177-192.
Organizations committed to the safety culture focus their efforts on four key aspects: promoting a culture of safety at all levels; evaluate and promote a good safety climate; increase training in patient safety and in the so-called human factors or non-technical factors of the professionals; and develop safety elements at the level of clinical units. Carthey J, Clarke J.Implementing Human factors in health care; [Internet] Patient Safety First. How to Guide 2015. [Accessed February 20, 2015] Available at http://www.patientsafetyfirst.nhs.uk/Content.aspx?path=/interventions/humanfactors/
The importance of the human factor in improving patient safety has grown in recent years and there are several experts who recommend training health professionals in this aspect and favor the incorporation of the principles of the human factor to the organization taking into account physical aspects (design, equipment, etc.), cognitive aspects (status and situation of the professional, communication skills, teamwork ("teamwork to teamwork"), and organizational aspects (organizational culture). Human Factors in Patient Safety Review of Topics and Tools Report for Methods and Measures [Internet] Working Group of WHO Patient Safety WHO 2009; [Accessed February 4, 2015] Available at: http://www.who.int/patientsafety /research/methods_measures/human_factors/humn_factors_review.pdf Gurses AP, Ozok AA, Pronovost PJ.Time to acelérate integration of human factors and ergonomics in patient safety BMJ Qual Saf; 2012: 21 (4): 34 7-51). Carayon et al. Systems Engineering Initiative for Patient Safety (SEIPS) model of work system and patient safety. [Internet] Qual Saf Health Care 2006; 15: i50-i58. doi: 10.1136 / qshc.2005.015842 [Accessed 23 January 2015] Available at: http://qualitysafety.bmj.com/content/15/suppl_1/i50.short. World Health Organization. Multi-professional Patient Safety Curriculum Guide. [Internet] Patient Safety. World Health Organization; 2011. [Accessed February 20, 2015] Available at: http://www.who.int/patientsafet