Protocolo de analgesia epidural obstétrica en el contexto de la gestión innovadora de la asistencia y de los criterios de calidad y seguridad

摘要

ABSTRACT Obstetric epidural analgesia was introduced in our hospital (Hospital Comarcal de Antequera) shortly after its opening in the year 2000. Up to the year 2002 a protocol was designed and a coordinator for the different areas was nominated. The clinical management section of the surgical unit began to work in the year 2002 and it implies another way of working as follows : to take part in the comprehensive process of pregnancy-labour-postpartum period, and its relationship with the general practitioner and midwife follow-up. The obstetric activity has been marked by productivity aims, human resources and the workload implied by the obstetric anaesthesia and analgesia, necessary material resources, economic resources management, competencies map for all the staff and with the computerization we will obtain activity indicators with all the previous plus the statistical data. - We will show in this article all the quality and security criteria work out by the clinical management unit: clinical audit of the protocol, analgesia efficiency, patient satisfaction, dystocic deliveries analysis, walking epidural development, morbidity analysis from another protocol: regional techniques complications or side effects and detection, research and analysis of the critical incidents. - It is not enough to perform the technique; there is no doubt about it. The clinical management unit has worked out information mechanisms about what we do and the following corrections and improvements. That is the way to follow and it includes an adaptation period for the professionals. Professional satisfaction and economic motivation have been assigned by aims. The future challenge is how to negotiate the annual aims between the professionals and the managers.