[Clinical safety audits for primary care centers. A pilot study]

Area of Science:

• Healthcare Management
• Patient Safety
• Clinical Quality Improvement

Context:

• A descriptive cross-sectional survey was conducted within 13 primary care teams (PCT) of the Catalonian Health Institute (ICS Costa de Ponent, Barcelona).
• The study involved 55 healthcare professionals across various roles, including directors, nurse directors, customer care administrators, and general practitioners.
• Participants were selected from teaching/non-teaching, urban/rural, and small/large healthcare centers (HCC).

Purpose:

• To identify organizational processes, rule violations, and professional performances that compromise clinical safety.
• To pinpoint specific areas of uncertainty within primary care settings.
• To inform future accreditation systems by highlighting areas needing improvement.

Summary:

• A total of 33 indicators across procedures, attitude, training, and communication were evaluated.
• Levels of insecurity were defined as less than 50% positive answers for each indicator.
• Key areas of insecurity identified included onboarding new professionals, injection administration, home care, specialist consultations, managing aggressive patients, critical incidents, and communication with patients and immigrants.

Impact:

• Clinical safety is a recognized priority within the participating health centers.
• The identified areas of uncertainty are actionable and will be integrated into the Catalonian Government's accreditation system.
• General practitioners reported higher levels of insecurity compared to directors, and teaching, rural, and small HCCs demonstrated a greater sense of security.