title: Implementation of a quality management system according to 9001 standard in a hospital in the home unit: changes and achievements.
abstract: OBJECTIVE
  The purpose of this paper is to describe changes and results obtained after implementation of a quality management system (QMS) according to ISO standards in a Hospital in the Home (HIH) Unit.
  
  
  METHODS
  The paper describes changes made and outcomes achieved. This took part in the HiH Unit, Clinico Hospital, Madrid, Spain, and looked at admissions, mean stay, patient satisfaction, adverse events, returns to hospital, no admitted referrals, complaints, compliance to protocols, equipment failures and resolution of urgent consultations.
  
  
  RESULTS
  In June 2008, HiH Unit, Clinico Hospital obtained ISO certification. The main results achieved are as follows. There was an increase in patients' satisfaction--in June 2008, assessment of the quality of care provided by staff was scored at 4.7 (on a scale of 1 to 5); in 2010 it has been scored at 4.96. Patient satisfaction rate has increased from 92 percent to 98.8 percent. No complaints from patients were received. Unscheduled returns to hospital have decreased from 7 percent to 3 percent. There were no medical equipment failures. External suppliers' performance has improved. Material and medication needed by staff was available when necessary. The number of admissions has increased. Compliance to protocols has reached 97 percent. Inappropriate referrals have decreased by 8 percent. Six medications-related incidents were detected; in two cases the incident was not due to an error. In the other four cases error could have been detected before reaching the patient.
  
  
  CONCLUSIONS
  Implementations of an ISO quality management system allow improved quality of care and patient satisfaction in a HIH Unit.
authors.affiliation: Hospital at Home Unit, Department of Medicine, Hospital Clínico San Carlos, Madrid, Spain. matilderodriguez@gmail.com
authors.forename: Matilde
authors.initials: M
authors.lastname: Rodríguez-Cerrillo
authors.forename: Eddita
authors.initials: E
authors.lastname: Fernández-Diaz
authors.forename: Amaia
authors.initials: A
authors.lastname: Iñurrieta-Romero
authors.forename: Ana
authors.initials: A
authors.lastname: Poza-Montoro
mesh_terms: D004777:Environment; D004868:Equipment Failure; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration*; D006739:Hospital Administration / Q000379:methods* / Q000592:standards; D006801:Humans; D010359:Patient Readmission / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011787:Quality of Health Care / Q000458:organization & administration*; D017749:Total Quality Management / Q000379:methods* / Q000458:organization & administration / Q000592:standards