Gestión integrada de seguridad del paciente y calidad en servicios de salud

Introduction: The quality of medical services is an issue of growing concern for health professionals, researchers, the public, and governments around the world. Commonly, in the medical care, safety has been assumed to be a separate aspect of quality, without considering that patient safety is one of the fundamental dimensions of quality. Objective: To analyze the application of integrated management based on the risks of safety and quality in the National Center for Minimal Access Surgery, using surgery of biliary lithiasis as a case study. Material and Methods: On the basis of structure, responsibilities, and documents established for quality management, some studies of the risk factors for the safety of patients undergoing elective endoscopic surgery were carried out in three stages: preoperative, intraoperative and postoperative. Results: The risk approach changes the management of patient quality and safety from a reactive evaluation in the presence of complications and non-conformities to a proactive management of potential risks. It has an added value of first-line personnel participation in this process that promotes the identification of potential risks, even when no failures have occurred. Errors are learning opportunities that allow the prevention of future damage to patients. Conclusions: The integrated management for patient safety and quality with a risk-based approach guarantees excellent performance indicators in the medical care of the National Center for Minimum Access Surgery. Keywords: quality management, patient safety, integrated management, risks of endoscopic surgery. Introducción: La calidad de los servicios médicos es una cuestión de interés creciente para los profesionales de la salud, los investigadores, el público y los gobiernos de todo el mundo. Comúnmente, en la atención médica la seguridad se trata como un aspecto separado de la calidad, sin considerar que la seguridad del paciente es una de las dimensiones fundamentales de la calidad. Objetivo: Analizar la aplicación de la gestión integrada, basada en los riesgos, de la seguridad y la calidad en el Centro Nacional de Cirugía de Mínimo Acceso, teniendo la cirugía de la litiasis biliar como caso de estudio. Material y Métodos: Sobre la base de la estructura, las responsabilidades y los documentos establecidos para la gestión de la calidad, se realizaron estudios de los factores de riesgo para la seguridad de los pacientes en la cirugía electiva endoscópica en sus tres e