Tema 11 - Administrativos - SAS - Servicio Andaluz de Salud - Volumen 1

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Quality Plan of the Public Health System in Andalusia

Overview of the Quality Plan

• The Public Health System is described as essential in a complex, dynamic society that requires collective effort for improvements.

• Emphasis on the need for a responsible citizenry and highly qualified professionals working together towards health system advancements.

Historical Context

• The initial quality plan (iPlan) was launched in 2000 by the Health Department, focusing on continuous improvement and placing citizens at the center of healthcare services.

• The second quality plan introduced in 2005 aimed to consolidate previous policies while incorporating innovative initiatives for service excellence.

Strategic Actions and Citizen Involvement

Key Strategic Actions

• The third quality plan emphasizes participatory approaches involving citizens, professionals, and healthcare organizations as integral components of the health system.

Focus Areas:

1. Citizen Empowerment: Initiatives aim to enhance user autonomy and participation regarding their health decisions within a trustworthy environment.

2. Professional Relationships: A renewed model encourages professional autonomy while ensuring organizational support meets their needs for development and innovation.

3. Organizational Integration: Establishing shared values between citizens and professionals fosters collaboration towards sustainable healthcare practices that respect individual rights and responsibilities.

The Role of Society in Healthcare

Modern Societal Dynamics

• Discussion on how modern Andalusian society has evolved with increased well-being, education access, and active citizen engagement shaping public health policies.

Healthcare System Evolution and Citizen Participation

Shifting Perspectives on Healthcare Services

• The healthcare system should evolve from a service-centric view to one that guarantees citizens' rights and adapts to societal needs.

• Population characteristics, such as demographics and emerging health issues, significantly influence health policy priorities.

New Roles for Citizens in Health Decisions

• Citizens are increasingly seeking active roles in health decision-making, leading to a more deliberative relationship with healthcare professionals.

• This shift necessitates deep reflection on improving health outcomes and meeting patient expectations while fostering participation within the public healthcare framework.

Enhancing Public Healthcare Engagement

• Active listening mechanisms must be established to ensure citizen engagement aligns with public healthcare principles, reinforcing social legitimacy.

• Advancing service delivery requires a focus on equity, respecting diversity as an organizational value within the community context.

Building Trust and Shared Responsibility

• A trustworthy environment is essential for effective individual decision-making regarding health services, promoting shared responsibility among patients and providers.

• Emphasizing personal differences will guide tailored healthcare approaches that encourage healthy lifestyles and support individual life projects.

Action Lines for Personalized Healthcare Responses

1. Understanding Individual Characteristics:

• Diverse factors like functional capacity and sociocultural backgrounds will shape personalized responses in the healthcare system.

2. Addressing Needs through Innovation:

• Innovations in technology will diversify access options within the healthcare system based on expressed needs of individuals.

3. Rights Development Framework:

• Effective development of citizen rights will occur through comprehensive plans addressing new health challenges alongside family support strategies.

4. Promoting Co-responsibility:

• An active role for individuals in exercising their rights fosters co-responsibility with professionals based on informed knowledge management practices.

5. Integrated Care Processes:

• Redesigning integrated care processes aims to enhance autonomy while ensuring quality standards are met through shared responsibilities between patients and providers.

Communication Strategies for Empowerment

1. Unified Messaging:

• Establishing clear communication channels between patients and professionals strengthens understanding of health issues faced by individuals.

2. Effective Participation Promotion:

• Encouraging citizen involvement through education about their rights enhances accountability in utilizing health services effectively.

3. Transparency as a Tool:

• Making quality parameters accessible empowers citizens by providing insights into assistance results across various public health interventions.

Enhancing Informed Decision-Making in Public Health

Objectives for Citizen Participation

• The goal is to improve informed decision-making by effectively developing citizen participation tailored to various scenarios and decision levels.

• This involves creating both individual and collective participation procedures to engage citizens actively.

• Diversifying communication channels is essential to meet the diverse needs and characteristics of the public, enhancing innovation through technology.

Incorporating Values in Healthcare Decisions

• Objective four focuses on integrating personal values and preferences into healthcare decisions, facilitating knowledge exchange between citizens and professionals.

• Action line 4.1 emphasizes making available health system knowledge accessible to citizens, incorporating innovative management tools.

• Continuous incorporation of citizen expectations, perceptions, values, and preferences is crucial for effective healthcare delivery.

The Importance of Human Capital in Healthcare

Valuing Human Resources

• The primary asset of the Andalusian public health system is its human capital, which includes intellectual and emotional resources.

• Effective management of this vast reservoir of knowledge and emotions is vital for fostering continuous improvement within the organization.

Professional Relationships with Organizations

• A new model aims to enhance professional relationships with organizations by recognizing their needs, expectations, and responsibilities within a complex public health framework.

• This relationship should focus on professional development, service excellence, knowledge management, and sustainability amidst ongoing innovation.

Clinical Management as a Catalyst for Change

Role of Professionals in Patient Care

• Professionals are positioned as facilitators in patient care processes; they must provide accurate information while ensuring quality healthcare services.

• The current organizational model demands more autonomous roles from professionals committed to organizational objectives.

Fostering Professional Development

• Developing clinical management within the Andalusian public health organization enhances professional competencies aimed at achieving excellence.

• It requires alignment with professionals' expectations regarding competencies that enable effective application of knowledge in clinical practice.

Knowledge Management as an Integrative Element

Building an Excellent Health System

• Progressive consolidation of professional development models strengthens a continuous improvement-based health system through effective knowledge management.

• Accreditation models and career development initiatives contribute significantly to solidifying this process while ensuring robust growth opportunities for professionals.

Collaboration for Social Progress

• Knowledge management fosters open strategies that encourage stable alliances with other organizations capable of generating knowledge leading to social progress.

Empowering Professionals Through Competency Development

Commitment to Professional Growth

• Strengthening commitment, autonomy, and participation among professionals is essential for competency development within the healthcare system.

Professional Development and Health System Integration

Objectives for Professional Career Development

• The aim is to fully develop a professional career model that recognizes excellence in competencies related to health assistance, promotion, protection, teaching, and research.

• Ensuring that professional accreditation aligns with the needs of citizens and the healthcare system is crucial for effective professional development.

• Professionals are positioned as facilitators for patients navigating the healthcare system, emphasizing their role in exercising rights and utilizing services responsibly.

Enhancing Clinical Management

• There is a focus on enhancing the role of professionals by integrating all activities within clinical management to improve quality, efficiency, and sustainability.

• Measures will be established across integrated care strategies to encourage professional involvement as facilitators in patient care processes.

Research Strategy Development

• A new strategy for research and development (R&D) in health from 2011-2015 aims to boost biomedical research activities in Andalucía.

• Increasing human capital in biomedical research through talent promotion and professional development is essential for advancing knowledge generation.

Fostering Knowledge Generation

• Promoting partnerships with organizations that generate knowledge can transform it into social and economic progress.

• Introducing social research techniques aimed at improving health-related social aspects will enhance public health outcomes.

Accessibility of Support Tools

• Advancements are needed in incorporating innovation into organizational tools to support knowledge access effectively.

• Redefining professional competencies will enhance flexibility among various roles within the healthcare system.

Organizational Adaptation to Professional Needs

• Adapting organizational structures to meet diverse professional needs ensures a healthy work environment tailored to individual characteristics.

• Developing internal communication tools can help address professionals' expectations while fostering an optimal work climate.

Healthcare Management in Andalucía

Collaborative and Value-Based Healthcare System

• The healthcare management model aims to be more horizontal and participative, focusing on shared values among all stakeholders in the public health system of Andalucía.

• A positive relational climate is essential for making agreed decisions that enhance health outcomes and promote shared responsibility in service usage. This commitment supports the sustainability of the public healthcare system.

Clinical Management Model

• Strengthening the clinical management model is crucial as it serves as a meeting point between professionals and citizens, enabling excellence in integrated and safe care. It also fosters multiple communication channels for participation.

• The promotion of quality culture, innovation, continuous improvement, and ethical development within the organization is vital for creating a transparent healthcare system that resonates with citizens' needs.

Shared Values and Organizational Identity

• An excellent organization is built on shared values that foster cohesion and trust, leading to a cooperative environment where interrelations strengthen organizational resilience. These values must be explicitly articulated and nurtured within a respectful context.

• The public healthcare system of Andalucía strives to be the preferred choice for citizens by providing high-quality services characterized by warmth in care delivery. Achieving this requires establishing a shared vision focused on human-centered quality standards.

Goals for Clinical Management Development

Objective 1: Enhance Clinical Management Excellence

• Fully extend the clinical management model to maximize its potential for excellence and innovation while promoting autonomy among professionals in service management. This includes developing integrated care processes aimed at achieving effective outcomes.

Objective 2: Transform Organizational Structure

• A profound transformation of the organizational model is necessary to support clinical management development while ensuring professional autonomy and decentralization of services, fostering active citizen participation in decision-making processes.

Objective 3: Knowledge as an Essential Value

Research Priorities in Translational Research

Focus on Clinical Management Units

• Emphasizes the need to concentrate research efforts within clinical management units addressing prevalent health issues faced by the population.

• Highlights the importance of identifying mutual interests between professionals and citizens to guide research towards improving service delivery.

Knowledge Sharing and Decision-Making

• Advocates for enhancing mechanisms to disseminate knowledge across interdisciplinary workgroups, including clinical commissions and public health services.

• Stresses the systematic incorporation of decision-making adequacy analysis to inform choices and identify research needs, particularly regarding health inequalities.

Competence Development in Healthcare

• Calls for increasing emphasis on knowledge management competencies in personnel selection, promotion, and development within the Andalusian public healthcare system.

• Underlines the significance of research, teaching, and training for improving health outcomes and ensuring system sustainability.

Strategies for Shared Values in Healthcare

Establishing a Common Value Framework

• Proposes making explicit the organization's value model to foster shared values throughout all operational areas and decision-making processes.

• Suggests integrating values-based training as a fundamental component of professional development to cultivate a shared space indicative of organizational maturity.

Patient Autonomy and Ethical Considerations

• Ensures respect for patient autonomy in health-related decisions, especially concerning critical life stages.

• Encourages co-responsibility among citizens regarding resource utilization as a means to sustain healthcare systems.

Creating Healthy Environments

Addressing Ethical Dilemmas

• Aims to improve organizational structures that facilitate ethical dilemma resolution within integrated care settings.

Enhancing Health Service Spaces

• Strives for healthcare environments that are healthy, comfortable, warm, and safe for patients and their families or caregivers.

Intersectoral Collaboration for Health Promotion

Globalized Contextual Challenges

• Recognizes the complexity of interrelations with various sectors impacting public health policies aimed at promoting well-being.

Addressing Dependency Issues

• Discusses challenges posed by aging populations with multiple pathologies requiring integrated approaches from both healthcare and social services.

Education's Role in Public Health

Training Future Healthcare Professionals

• Highlights direct involvement in training thousands of students in health professions while also contributing significantly to specialized education within Andalusia’s public healthcare system.

Promoting Healthy Habits Among Youth

• Emphasizes contributions toward instilling healthy lifestyle habits among children through educational initiatives led by public healthcare systems.

Innovation Through Collaboration

Interdisciplinary Partnerships

• Points out collaboration with universities and other research entities enhances technological advancements applicable to health sectors.

Economic Impact of Healthcare Sector

Transitioning the Healthcare System Towards Sustainability

Environmental Protection and Energy Efficiency

• The healthcare system's role in promoting environmental protection, energy efficiency, and waste management is crucial for a sustainable society.

• Collaboration on national or interregional projects, as well as partnerships with the European Union and international organizations, enhances the public health system in Andalucía.

Governance and Strategic Alliances

• Effective governance requires shared values and common objectives to navigate complex environments, necessitating both formal and informal networks.

• Establishing stable alliances with various strategic agents—public administrations, universities, businesses, social agents, and citizen groups—is essential for improving healthcare outcomes.

Action Lines for Health Improvement

1. Quality of Care

• Focus on creating high-quality care environments by coordinating efforts among different stakeholders to eliminate duplications in care and optimize resources for elderly patients with chronic illnesses or dependencies.

2. Healthy Social Environment

• Promote a healthy social environment through strategic alliances that encourage multisectoral actions while raising awareness about health impacts from policies in other sectors.

3. Economic Development

• Contribute significantly to Andalucía's economic development by fostering partnerships with technology and industrial sectors to create knowledge-intensive jobs.

4. Safe Work Environments

• Collaborate with labor organizations to ensure workplaces are safe and promote positive health behaviors among individuals collectively.

5. Integrated Training Models

• Develop integrated training models across institutions to provide high-quality healthcare education that prepares future generations for a prosperous community focused on healthy lifestyles and responsible social values.

Research, Innovation, and International Collaboration

Research & Development

• Position Andalucía as a hub for research, development, and innovation by deepening collaborations with universities and public research bodies while integrating into the Andalusian biocluster fully.

Interregional Cooperation

• Foster interregional collaboration that enhances capacity building while projecting a renewed image of Andalucía’s healthcare system internationally through shared efforts in improving living conditions globally.

Environmental Management within Healthcare

Comprehensive Environmental Management System

• Establish an integral environmental management system that identifies the ecological impact of healthcare services while promoting environmentally respectful practices during decision-making processes within health organizations.

Climate Change Mitigation Efforts

• Actively participate in combating climate change by promoting renewable energy sources, enhancing energy efficiency measures at major healthcare centers through solar energy systems installation, low-consumption lighting upgrades, etc., thus reducing fossil fuel dependency.

Waste Management Practices

• Encourage best practices in waste management by minimizing hazardous waste production while implementing selective collection systems for recyclable materials within healthcare settings.

Patient-Centered Care Initiatives

Gender Perspective Integration

• Continuously incorporate gender perspectives into addressing health issues alongside considerations of multiculturalism and disability challenges faced by diverse populations within local contexts.

Local Adaptations

• Tailor local adaptations of health service plans to address geographical diversity among citizens effectively.

Health Accessibility Enhancements

• Expand access channels proactively targeting specific groups facing unique health situations; initiatives include telehealth services like "salud 24 horas" aimed at caregivers.

Proactive Access Promotion

• Identify diverse channels facilitating proactive access to citizens via digital platforms such as web portals designed for information sharing regarding health matters.

This structured approach provides clarity on key discussions surrounding sustainability within the healthcare sector in Andalucía while emphasizing collaborative efforts towards improved public health outcomes amidst environmental considerations.

Crónica Proyecto: Avances en Derechos de la Ciudadanía

Desarrollo de Nuevos Derechos

• Defining and promoting the development of new citizenship rights, including the law on health information and the law on rights and guarantees regarding dignity in the dying process.

Garantía de Derechos Fundamentales

• Ensuring effective development of fundamental rights such as information, privacy, confidentiality, and decision-making through informative strategies for citizens and professionals.

Formación y Comunicación

• Incorporating training and communication about established rights within the public healthcare system of Andalucía into professional training plans across all centers.

Colaboración entre Ciudadanía y Profesionales

• Establishing collaborative work strategies between citizens and professionals to share knowledge about rights, information on results, or identify improvements in co-responsibility frameworks.

Herramientas para Seguimiento de Calidad

• Providing citizens with tools to monitor quality criteria in care through integrated assistance processes.

Modernización e Innovación en Procesos Asistenciales

Definición del Proceso de Soporte

• Defining support processes for integrated care within each clinical unit related to their service portfolio.

Herramientas Simplificadas para Profesionales

• Designing simplified and updated tools for professionals to implement integrated care processes effectively.

Sinergia con Estrategias Organizacionales

• Modernizing based on synergy with various organizational strategies within clinical management frameworks.

Inclusión de Perspectiva de Género

• Integrating gender perspectives into integrated care processes addressing lifestyle choices and special needs of individuals with disabilities or dependencies.

Estrategia para la Seguridad del Paciente

Evaluación y Mejora Continua

• Extending and consolidating patient safety strategy by evaluating implementation levels at healthcare centers for continuous improvement actions.

Inclusión del Paciente en Estrategia de Seguridad

• Involving patients and caregivers in safety strategies using tools like integrated assistance processes to enhance engagement.

Incorporación Efectiva de Cuidados en el Sistema Sanitario

Integración de Cuidados en Estrategias Sanitarias

• Effectively incorporating care into various health strategies within the public healthcare system of Andalucía.

Adaptación del Rol Enfermero

• Adapting nursing roles to respond effectively to patient rights, dignity during death processes, and advance directives.

Formación y Desarrollo Profesional

Acreditación Profesional

Development of Clinical Training and Quality Assurance

Strategic Development in Clinical Tools

• The integration of three key elements aims to enhance the development of supportive tools for clinical decision-making, including artificial intelligence systems and virtual patient simulations.

• A strategic plan focuses on comprehensive training models, emphasizing quality in practical clinical education and partnerships aimed at improving educational standards.

Professional Training and Accreditation

• Initiatives include the accreditation of tutors for undergraduate and postgraduate residents, alongside a common complementary program for specialists in health sciences.

• Establishment of an observatory for training quality in health sciences, supported by a network of experts evaluating competencies within the Andalusian public healthcare system.

Competency Model Enhancement

• Project seven emphasizes deepening professional competency models by defining roles that align with system needs and adapting nursing roles to new care models across various medical fields.

• Incorporation of best practices into integrated care processes is essential for developing competencies across different professions within the healthcare sector.

Clinical Management Model Implementation

• Project eight involves rolling out a new clinical management model throughout the Andalusian public healthcare system, focusing on extending this model across all care areas.

• Emphasis on measuring health outcomes through clinical unit evaluations while ensuring professionals have integrated access to knowledge management platforms.

Organizational Transformation Support

• Project nine aims to transform organizational structures to support clinical management by defining criteria that promote flexibility within public healthcare organizations.

• Continuous updates are necessary for accreditation models to adapt to emerging organizational needs while incorporating functional structures that reflect citizen feedback in decision-making processes.

Work Environment Improvement Strategies

Enhancing Workplace Conditions

• Actions include creating improvement plans tailored to each center's work environment, promoting work-life balance through initiatives like childcare services and wellness activities.

• Strategies will focus on workplace health promotion covering physical activity, stress management, nutrition, and violence prevention measures.

Evaluation Mechanisms

• Implementing labor climate assessments as tools for gathering information aimed at enhancing workplace conditions within healthcare centers.

Sustainability Initiatives

Energy Use and Resource Management

• Action plans will be developed focusing on renewable energy usage and responsible resource management within healthcare facilities.

International Cooperation Strategies

Global Health Collaboration

• Developing international cooperation strategies focused on health development while integrating Andalusian cooperation criteria into all relevant activities.

Enhancing Ethical Standards and Patient Rights in Healthcare

New Roles and Structures for Ethics Committees

• The need to regulate the new roles and structures of ethics committees in healthcare is emphasized, focusing on both clinical ethics and research ethics.

• Accessibility for professionals involved in patient care is highlighted, particularly regarding the integration of advance directives into health records.

Promoting Citizen Engagement in Health Decisions

• Efforts are being made to make it easier for citizens to exercise their right to express advance directives concerning their health.

• Continuous information flow between patients and healthcare providers is crucial, supported by the implementation of informed consent strategies across organizations.

Information Systems for Knowledge Management

• An effective integrated information system is necessary for decision-making at various organizational levels.

• Systematic generation of results-oriented information will facilitate ongoing evaluation of health interventions.

Transparency and Best Practices

• Incorporating agile indicators based on best practices can enhance adaptability to current evidence.

• Establishing flexible communication channels will promote transparency within the public healthcare system in Andalusia.

Telemedicine Strategy Development

• A comprehensive telemedicine framework is being developed, including criteria for feasibility and effectiveness.

• Integration of telemedicine tools into existing health service portfolios aims to improve accessibility while ensuring data protection standards are met.

Research and Innovation Strategy

• Continued development of R&D strategies from 2011 to 2015 focuses on fostering open innovation through collaborative environments like living labs.

• Enhancing human capital within the public healthcare system is a priority, aiming at better integration of knowledge management processes.

Public Health Model Development

• The approval and dissemination of public health laws aim to define competencies required across various professional profiles within the public health sector.

• Local action models are being developed to empower local entities in improving collective health outcomes through mutual aid initiatives.

Strategies for Health Promotion and Prevention

• Integrating health promotion into clinical management models ensures that preventive measures align with overall healthcare strategies.

Public Health Risk Prevention and Protection Strategies

Key Strategies for Public Health

• Emphasizes the importance of professional development and the availability of sensitive surveillance systems equipped with predictive tools, integrated research protocols, and effective communication systems during alert situations.

• Advocates for a methodology based on evidence review, research, and participation to identify and evaluate interventions across various domains that can predictably impact public health.

• Stresses the systematic integration of epidemiological information into service planning processes and evaluation of intervention outcomes related to major health issues, their determinants, and health inequalities affecting the Andalusian population.

• Highlights the need for improved access to information by incorporating new work areas and enhancing the capacity and quality of epidemiological analysis within Andalucía's public health system through an integrated health surveillance information system.

• Discusses incorporating health outcome evaluations in comprehensive plans targeting major mortality causes while implementing quality management models in health protection services.

Implementation Plans

• Outlines steps for developing risk analysis as a fundamental element in health protection policies, including creating guidelines, methods, and action protocols to enhance risk assessment.

• Focuses on designing training plans that include knowledge dissemination as an essential component while promoting professional accreditation.

• Encourages facilitating citizen access to public health services by simplifying procedures through appropriate instruments that expedite actions related to protection services.

Community Engagement in Public Health

• Promotes strategies for citizen engagement in improving public health by developing knowledge dissemination strategies tailored to community needs regarding population health data and its determinants.

• Discusses effective citizen participation adapted to different environments within healthcare strategies focusing on socio-healthcare attention plans like Alzheimer's care or early childhood intervention programs.