[Walkrounds and briefings in the improvement of the patient safety]

Training, to increase the safety culture, the reporting of adverse events, and to implement improvements using WalkRounds and Briefings.

Monte Naranco Hospital, hospital with 200 beds and mainly with geriatric patients.

Patient safety surveys and evaluations of the leaders.

face-to-face 1/2h interviews with the healthworkers (3-5 people), and in the changes of shifts from 2004-2009. Analysis tools: a) Patient safety surveys (University of Texas and Agency for Healthcare Research and Quality - AHRQ); b) WalkRounds and Briefings forms; c) classification of contributory factors, and the severity of adverse events.

Surveys were conduted on 36.9% and 33.8% of the healthworkers, respectively). WalkRounds training: 84 healthworkers. Number of WalkRounds: with Pharmacy Service (493), and with Patient Complaints Service (147), and Briefings: 307. Reporting of adverse events: Medication errors (71.1%), equipment (7.2%), others (21.7%). Contributory factors Working environment (30.1%), work team (29.2%), others (40.7%). In the post-briefing survey 86.7% of the healthworkers thought that it was a useful tool. New needs: feedback of the personnel with control charts.

WalkRounds and Briefings allow a higher number of adverse events (more than 20%) to be detected, and are useful for the training of healthworkers. There is better feedback and there was less problems with equipment and outpatient units. Face-to-face communication with the healthworkers is a key element in patient safety and helps to know the needs to the front line wards.