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Copyright of Revista CONAMED is the property of Comision Nacional de Arbitraje Medico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article gives an outlook of notification and incident report systems, focusing on problems for the development and application thereof. The fundamental components of databases generated, phases for their implementation, their scope, limitations and motivation for doctor participation are analyzed. An ideal system is presented as one that records all incidents that cause harm to the patient or adverse events, such as those which do not cause harm or "near misses", since these are most frequent and practically reveal the same care system errors as are found in the former, the analysis of which can help in prevention. Therefore, if hospitals only collect information on adverse events, they will be losing the most valuable source of information for identifying patient safety priorities, as well as the chance to measure progress in solving problems that they are trying to correct. Confidentiality and ease of system use are important stimuli for reporting. Report systems must be linked to the safety programs of health institutions and solutions must be focused towards changing the cultural environment of these institutions. Additionally, they must support the process in order to find, control and correct deviations that determine safety incidents since it has been demonstrated that they do not only express active personnel failures but also, and in particular, care system failures. Notification and report systems are useful components in improving quality and patient safety in health services and must be used as part of hospital routine. [ABSTRACT FROM AUTHOR]

The notification and reporting systems collect information on incidents that occur in hospitals and other sites where medical care is provided. These systems, which entail other components of patient safety, are uneven and diverging, with different events entered. Differences in geographic location, language and culture have motivated the World Health Organization to develop the International Patient Safety Classification with the intention of facilitating the international reporting and exchange of information and comparison between institutions. This article describes how the strength thereof has been orientated towards learning and sharing information on the root causes and best practices for prevention, as well as towards the acknowledgment and transparent communication of adverse events. [ABSTRACT FROM AUTHOR]

Copyright of Revista CONAMED is the property of Comision Nacional de Arbitraje Medico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista CONAMED is the property of Comision Nacional de Arbitraje Medico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To gather opinions from medical schools regarding the existence of public policies on the health workforce (human resources for health) and whether sufficient public financing and regulatory mechanisms are in place for undergraduate medical education; and to identify areas of opportunity to improve the availability of general practitioners in the Region of the Americas., Methods: Cross-sectional, descriptive study conducted with 105 medical schools (51 public and 54 private) in 17 countries. A questionnaire with a Likert scale was used to explore three dimensions (political, economic, and regulatory contexts) composed of 4, 2, and 4 variables each, respectively, and validated with the Delphi method. Frequencies of responses to the questions were estimated. A frequency analysis was performed, as well as a bivariate analysis to identify differences between public and private schools, applying the Chi-square test to compare percentages., Results: The political context was considered favorable by 64% of the schools; the economic context, by 37%; and the regulatory context, by 23%. The only significant differences between public and private schools were in the financial resources they administer., Conclusions: It is necessary to strengthen public policies, public investment, and the regulation of medical education in order to improve the education and availability of general practitioners in the countries of the Region., Competing Interests: Conflicto de intereses. Los autores declaran no tener conflicto de intereses.

Objective: To know the characteristics of medical education and identify its strengths and weaknesses., Materials and Methods: A transversal and quantitative study of the characteristics of medical education in 29 medical schools in Mexico was carried out, between April and September 2017. Questionnaire with Likert scale was applied to explore context, regulation, structure, process, results and impact of medical education. Bivariate analysis was performed with a Chi square test and the significance level was equal to or less than 0.05., Results: The political context obtained 64%, economical context 10% and mechanisms of regulation 31%. The educational structure was 61% and the social impact was 93%., Conclusions: Public policies, regulatory mechanisms and public investment must be strengthened to improve the quality of medical education., Competing Interests: Declaration of conflict of interests. The authors declare that they have no conflict of interests.

Objective: Carry out the projection of medical specialists in the Health Sector Mexico by 2030., Method: A predictive approach was developed to project the number of medical specialists by 2030, according to a trend, a desired goal and two conventional scenarios of increased demand for health services. The methodology was developed based on the General Framework to Assess the Future Supply and Demand of Health Personnel, published in 2013 by the Organization for Economic Co-operation and Development (OECD), and a mathematical model and a software were designed to make projections about the number of specialists., Results: According to the trend, between 2013 and 2030, the number of specialists will be increased by 90,554 to 124,558 and the rate will be change of 77/100.000 population to 91/100,000 population. If is necessary to achieve a goal of 120/100,000, will be necessary to train 40,420 additional specialists to the trend number and if the demand for services increases 15% or 30%, will require further training specialists 65,166 and 89,913, respectively., Conclusions: Even with the trend increase, in the 2030 Mexico will not achieve the desired goal of 126/100,000 population, that the OECD countries had in 2011. The results of the projections made, can help to planning the training of specialists in the medium term., (Copyright: © 2017 SecretarÍa de Salud)

Background: Medical care is not a harmless practice. It involves intrinsic risks for those who receive it. Risk assessment in health care has been a common practice for several decades; however, evaluation for comprehensive risk management in health care facilities is a more recent practice. This paper proposes that patient safety results from measures at different levels: public health, health care facilities and clinical practice. In each of these, it is possible to assess and manage risks towards improvements in patient safety in order to reduce both incidents and related adverse events., Methods: We designed a method to assess risk in terms of hospital patient safety based on theoretical models used in public administration, health systems in industrialized countries and the General System Theory. We evaluated risk in a general hospital of 170 beds with four basic services and 16 medical and surgical specialties. The evaluation was conducted by an external body with the participation of local managers and staff., Results: The evaluation revealed that the structural and outcome components had a moderate risk, with overall scores of 73.3% and 70.0%, respectively. The process component had a high risk, with an overall score of 41.6%., Conclusions: The methodology proved to be a useful tool for the assessment of risks and risk management strategies related to medical care. Available information at the hospital facilitated implementation of the method.

Background: Identifying the level of culture and awareness on patient safety is essential in order to improve the quality of care. The objective of our research was to assess patient safety culture in healthcare professionals., Methods: Derived from the implementation of a survey on patient safety to 174 health professionals, data related to demographic characteristics were analyzed. Scores were determined on the 12 dimensions of the scale including additional items on perception and degree of overall patient safety, frequency and number of events reported, as well as Cronbach's alpha for the different dimensions. Descriptive statistics were used., Results: Overall perception on safety was 51%. The lowest dimension was communication openness (38%), whereas organizational learning had the highest scores (68%). Analysis showed low Cronbach's alpha for dimensions of overall perception on safety (0.35), non-punitive response to error (0.55) and staff allocation (0.12)., Conclusions: A low overall perception on patient safety indicates the need for increased institutional actions for improvement. Low Cronbach's alpha in some measurements may suggest the need for adjustments to the instrument. Results on the overall perception on patient safety, nonpunitive response to error and staff allocation (staffing) should be interpreted with caution, given the low reliability of such dimensions.

Objective: To carry out the epidemiological analysis of 122 influenza A (H1N1) deaths confirmed by laboratory and help to improve the diagnosis and timely managing of cases., Material and Methods: A total of 122 clinical records were analyzed of patients with confirmed influenza A (H1N1) virus infection who died., Results: Fifty-one percent of patients were female and 49% were male. A total of 45.l% who died were between 20 and 39 years old. Overall fatality was 2.2% and ranged between 0.3% for the l0 to l9 year-old group to 6.3% for the 50 to 59 year-old group. Forty-three percent of deaths were concentrated in only two of the thirty-two states and 5l% received medical attention in social security institutions. Only l7% received hospital attention within 72 hours and 42% died within 72 hours of hospital attention., Discussion: Novel Influenza A (H1N1) virus produces higher mortality in young people whereas seasonal influenza has a greater impact on young children and older people. Delay in medical care and the associated morbidity were relevant factors for death.

Objective: To analyze medical complaints over a period of 11 years, for making recommendations for prevention and improving planning for responding., Material and Methods: We studied the medical complaints at the National Medical Arbitration Commission (Conamed, per its acronym in Spanish) between 1996 and 2007 using descriptive statistics to identify their general profile in relation to the variables of time, place and person. We also studied the frequency of evident medical malpractice as well as the severity of the damage it produces., Results: The request for responses to medical complaints increased between 1996 and 2007 and there was less demand between July and December. Two states in the country account for 69.7% of the complaints and 74.0% are from public institutions. Fifty-eight percent come from women and the 25-34 and 65+ age groups have the highest percentage. We found in 27.0% of the complaints there is evidence of medical malpractice and obstetrics and gynecology have the highest percentage of complaints, physical harm and severity of injury. Complaints about treatment are nearly four times more than diagnosis., Conclusions: It is necessary to improve the quality of diagnosis and treatment and identify cost-effective measures to reduce medical malpractice and the severity of physical damage in patients.