title: [Barriers and challenges of the functional healthcare risk management units in hospitals of Madrid health service].
abstract: OBJECTIVE
  To identify the barriers and challenges for the effective development of risk management units in hospitals of the Madrid Health Service.
  
  
  METHODS
  Descriptive cross-sectional study aimed at the management teams and members of the functional units of 31 hospitals in the Madrid Health Service. A self-administered questionnaire requesting answers in free text was used, identifying up to five barriers and challenges, and their prioritization by awarding from 1-5 points according to their importance. A discourse analysis was then conducted, grouping common themes and sorting them according to their score.
  
  
  RESULTS
  The overall response rate was 94%. The most frequently identified barriers were lack of time (21%), inadequate safety culture (13%), lack of publication of their activities (10%), and lack of training (10%). The most important challenge was developing the training (18%), followed by improving the culture (17%), communication of safety activities (11%), and achieve leadership from the managers of the services (11%).
  
  
  CONCLUSIONS
  According to the study conditions, the main identified barrier identified was the lack of available time, and the principal challenge found was promoting a proactive learning culture.
authors.affiliation: Subdirección de Calidad, Dirección General de Atención al Paciente, Servicio Madrileño de Salud, Madrid, España. Electronic address: Alberto.pardo@salud.madrid.org.
authors.forename: A
authors.initials: A
authors.lastname: Pardo-Hernández
authors.affiliation: Subdirección de Calidad, Dirección General de Atención al Paciente, Servicio Madrileño de Salud, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Navarro-Royo
authors.affiliation: Departamento de Economía de la Empresa y Contabilidad, Facultad de Ciencias Económicas y Empresariales, Universidad Nacional de Educación a Distancia (UNED), Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Arguedas-Sanz
authors.affiliation: Subdirección de Calidad, Dirección General de Atención al Paciente, Servicio Madrileño de Salud, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Albeniz-Lizarraga
authors.affiliation: Subdirección de Calidad, Dirección General de Atención al Paciente, Servicio Madrileño de Salud, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Morón-Merchante
mesh_terms: D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration; D006739:Hospital Administration; D006801:Humans; D012308:Risk Management; D013030:Spain; D011795:Surveys and Questionnaires
keywords: Gestión de riesgos; Patient Safety; Risk management; Seguridad paciente