THE STANDARD OF EXCELLENCE OF THE EUROPEAN FOUNDATION FOR QUALITY MANAGEMENT AS A TOOL FOR THE IMPROVEMENT OF INFRASTRUCTURE IN PRIMARY CARE.Summary: OBJECTIVE 1 demonstrate that the model of excellence proposed by the European Foundation for Quality Management (EFQM) is effective for improving a team of primary care (CAS) by identifying areas and their subsequent improvement. OBJECTIVE 2 Identify relevant aspects in the evaluation of an EAP for designing a tool based on the European model for Quality Management (EFQM) to facilitate self-evaluation and improvement of the EAP. DESIGN AND METHODOLOGY 1 Study of self-evaluation and reassessment with the EFQM model 2000-2002 after an intervention (improvement projects). FIELD: EAP SUBJECT: Professionals an EAP. VARIABLES: Opportunities for improvement (OM) identified with model FQM-2000. Causes. Indicators to objectify baseline and improvement. INTERVENTIONS: Projects. Improvements to 2 years (effectiveness). PHASES: Analysis of OM identified with the model year 2000. Selection of projects for improvement. Development between 2000-2002. Reassessment year 2002. DESIGN AND METHODOLOGY 2 Autoevaluación with EFQM model. Validation of form with experts. FIELD: Primary care (8 informes-EFQM). SUBJECT: 8 EAP a District Primary Care (DAP) and experts in the model. VARIABLES: Aspect identified as relevant for each sub - criterion match between experts, kappa, Cronbach alpha, validity. PHASES: Identification of points on 8 informes-EFQM EAP our DPA. Consolidation of aspects of each report. Coincidences, X2, matches. Obtaining list of areas for sub - criterion that was supplemented by literature review. Obtaining form, which was sent to 102 experts. Cronbach alpha was obtained and kappa index of Landis-Koch. RESULTS 1 are identified 114 OM. Excluded are externally induced (46). The 68 remaining (52 domestic, 16 mixed) are caused more relevant: deficit organizational (44), external (14), external (14), attitude (9), professional competence (1). We grouped into 31 projects. The group gave priority to the improvement of quality: community activities, ecological approach, teamwork, process management, coordination between levels, among other projects. It was developed according to the methodology of continuous improvement. At 2 years 82.3% of the 68 areas identified improvement: 38 points (55.8%) according to previous goals, 18 (26.5%) without reaching the predetermined standard; 12 remain equally (17.64% ). RESULTS 2 are identified 1801 points on 8 reports EFQM-2000 (225 per report), which are summarized in 708 different aspects (39.4%). Of these. 414 were identified in more than one EAP (58.5%). It simplified aspects in a total of 351 (49.6%). It added 179 points (33.8%) referred to in the literature and are not identified in reports. It was obtained form 530 points which was sent to 102 experts. They responded 89 (87.2%). The final form is obtained with 288 points (simpler), and validated by experts (Cronbach alpha: 0913; kappa index: 0.8327 + / -0.0241). Only 38 of 530 points were different (7.16%) between welfare and non-welfare experts. CONCLUSIONS 1 The model of excellence proposed by the EFQM is useful to identify aspects of our organization that subsequently improved. In addition brings added value as a change in the culture of the organization toward excellence. CONCLUSIONS 2 Winning a validated tool, simpler, concrete, it must 8 allow 2ec its implementation among EAP.
