title: [Clinical safety audits for primary care centers. A pilot study].
abstract: OBJECTIVE
  To identify organizational processes, violations of rules, or professional performances that pose clinical levels of insecurity.
  
  
  METHODS
  Descriptive cross-sectional survey with customized externally-behavioral verification and comparison of sources, conducted from June 2008 to February 2010.
  
  
  METHODS
  Thirteen of the 53 primary care teams (PCT) of the Catalonian Health Institute (ICS Costa de Ponent, Barcelona).
  
  
  METHODS
  Employees of 13 PCT classified into: director, nurse director, customer care administrators, and general practitioners.
  
  
  METHODS
  Non-random selection, teaching (TC)/non-teaching, urban (UC)/rural and small/large (LC) health care centers (HCC). A total of 33 indicators were evaluated; 15 of procedures, 9 of attitude, 3 of training, and 6 of communication. Level of uncertainty: <50% positive answers for each indicator.
  
  
  METHODS
  no collaboration.
  
  
  RESULTS
  A total of 55 professionals participated (84.6% UC, 46.2% LC and 76.9% TC). Rank distribution: 13 customer care administrators, 13 nurse directors, 13 HCC directors, and 16 general practitioners. Levels of insecurity emerged from the following areas: reception of new medical professionals, injections administration, nursing weekend home calls, urgent consultations to specialists, aggressive patients, critical incidents over the agenda of the doctors, communication barriers with patients about treatment plans, and with immigrants.
  
  
  CONCLUSIONS
  Clinical safety is on the agenda of the health centers. Identified areas of uncertainty are easily approachable, and are considered in the future system of accreditation of the Catalonian Government. General practitioners are more critical than directors, and teaching health care centers, rural and small HCC had a better sense of security.
authors.affiliation: Medicina de Familia y Comunitaria, EAP Centre SAP Delta del Llobregat, Unitat Docent de Costa de Ponent, ICS, Barcelona, España. mirusa77@hotmail.com
authors.forename: Míriam
authors.initials: M
authors.lastname: Ruiz Sánchez
authors.forename: Francisco
authors.initials: F
authors.lastname: Borrell-Carrió
authors.forename: Cristina
authors.initials: C
authors.lastname: Ortodó Parra
authors.forename: Neus
authors.initials: N
authors.lastname: Fernàndez I Danés
authors.forename: Anna
authors.initials: A
authors.lastname: Fité Gallego
mesh_terms: D054869:Clinical Audit; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D010865:Pilot Projects; D011320:Primary Health Care / Q000592:standards*
keywords: Atención primaria; Auditoría; Calidad asistencial; Management audit; Patient safety; Primary health care; Quality of health care; Safety management; Seguridad clínica; Seguridad del paciente