[Clinical teams: planning and creating Institutes and Units in a Spanish National Health Service hospital].
BACKGROUND
Clinical Teams are framed within the New Organizational Models (1996) and Spanish national health system's Strategic Plan (1997). The objectives of the internal organization model are as follows: A) General: to implement health management systems in the health service. B) Specific: service, quality and financial improvement.


METHODS
Methodology. 1. Jurisdiction. Self-managing despite having no separate legal status. 2. Creation: a) feasibility study and project viability. The drafting committee consisted of representatives of the Services' physicians, other health professionals and non-health employees (Representation and Participation Organizations), and explained the portfolio of specialty services and new diagnosis and treatment techniques to be implemented. Costs and a strategic analysis of the situation were evaluated. The project was approved by management and was sent to the Ministry of Health (formerly to the Territorial Health Agency (ratified) and to the Spanish national health system's General Directorate for Organization and Planning); b) homologation: institutional approval of health centers' self-management and the feasibility of the proposals.


METHODS
1. Resources. Resources of the assigned Services. 2. Structure. Horizontality, simplicity and operativity. 3.


OBJECTIVE
a) clinical: role assigned to Specialized Care Services; b) management: responsibility for proper working order (actions), personnel performance (tasks), and custody and use of material resources (available resources), carried out with active and responsible participation of all departments. 4. Quality plan: patient-oriented care, evidence-based medicine (standards and protocols), evaluation of medical technologies (service corporation) and corporative quality guarantee.


CONCLUSIONS
A voluntary, innovative, participative and decentralized management model.
Vila-Blanco
Julio M
JM
Servicio de Cirugía General y del Aparato Digestivo, Hospital Virgen de la Luz, Cuenca, España. jmvilab@telefonica.net
de Pedro-Moro
José A
JA
Escribano-Ulíbarri
César
C
D006752:Hospital Planning; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D009313:National Health Programs / Q000458:organization & administration*; D009937:Organizational Objectives; D010348:Patient Care Team / Q000458:organization & administration*; D015397:Program Evaluation; D013030:Spain