AEs are common and potentially amenable to prevention. GTT-identified AEs are seldom caught by commonly used AE-detection systems.

To enhance learning opportunities and guide quality improvement, BHCS collected data-such as preventability and AE source-to characterise the nature of AEs. Data are provided regularly to hospital teams to direct quality initiatives, moving from a general focus on reducing AEs to more specific programmes based on patterns of harm and preventability.

The GTT can be adapted to health-care organizations' goals and resource limitations. This flexibility was essential in crossing our organization's "value threshold."

Implantación de una historia clínica informatizada: encuesta sobre el grado de utilización y satisfacción en un hospital terciario Implantation of a computerised clinical history: survey on the degree of utilisation and satisfaction in a tertiary hospital RESUMENFundamento. Evaluar en un hospital terciario, el grado de utilización de una historia clínica informatizada (HCI), las opiniones de los profesionales sobre sus ventajas e inconvenientes y su nivel de satisfacción con la misma. Material y métodos.Encuesta enviada por correo a todos los médicos del Hospital Virgen del Camino en Pamplona.Resultados. De los 445 médicos del centro, contestaron la encuesta 174 (39%). De éstos, el 79% consideran que la HCI es mejor que la historia clínica tradicional, el 61% la utilizan para consultar e introducir datos de manera habitual y el 55% están muy de acuerdo con que la HCI ofrece ventajas para el paciente. Los principales problemas detectados son la posible pérdi-da de confidencialidad, y la falta de tiempo, de dotación informática y de mayor formación, para el manejo del programa. El 90% de los encuestados opina que se debe continuar con su implantación y sólo el 6% dice estar poco satisfecho con la aplicación.Conclusión. Existe una extendida utilización de la HCI entre los médicos del Hospital Virgen del Camino y su opinión sobre el programa puede considerarse globalmente favorable. Se deben desarrollar medidas para subsanar los problemas detectados mediante este estudio.Palabras clave. Historia clínica informatizada. Encuesta. Hospitales. Satisfacción. ABSTRACTBackground. To assess the utilization of an electronic medical record (EMR), the degree of satisfaction with this tool, as well as to detect problems in its utilization, in a tertiary hospital in Spain.

Improving the quality of patient care requires a culture attuned to safety. We describe the development, implementation, and psychometric evaluation of the Attitudes and Practices of Patient Safety Survey (APPSS) within the Baylor Scott & White Health system. The APPSS was designed to enable safety culture data to be collected and aggregated at the unit level to identify high-priority needs. The survey, with 27 Likert-scale core questions divided into 4 concept domains and 2 open-ended questions, was administered electronically to employees with direct patient care responsibilities (n = 16,950). The 2015 response rate was 50.4%. The Cronbach's α values for the four domains ranged from 0.78 to 0.90, indicating strong internal consistency. Confirmatory factor analysis results were mixed but were comparable to those of established safety culture surveys. Over the years, the adaptability of the APPSS has proven helpful to administrative and clinical leaders alike, and the survey responses have led to the creation of programs to improve the organization's patient safety culture. In conclusion, the APPSS provides a reliable measure of patient safety culture and may be useful to other health care organizations seeking to improve the quality and safety of the care they provide.

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