Root-Cause Approach to New Reality in a Mid- Long-Term Care Hospital in Madrid-Spain

Abstract

La Fuenfría Hospital (HLFF) is one of the three mid-long-term-stay hospital (MLTSH) facilities of the Madrilenian Public Health System of the Community of Madrid-Spain, (SERMAS). The HLFF, is located in the municipality of Cercedilla in the north of the Community of Madrid-Spain. Nowadays, we have at HLFF five clinical care units that are defined as: Chronic Care Unit, (CCU), Palliative Care Unit, (PCU), Tuberculosis Unit, (TBU), Functional Rehabilitation Unit (FRU) and the Neuro-Rehabilitation Treatment Unit (NTU). During the first half of 2016 there was another clinical care unit called of Unstable Chronic Care Unit (UCCU) that ceases to operate from May 2016, by incorporating the beds to this care unit to the CCU.
This lack of systematized processes has generated an undesirable effect on hospital management indicators. Apparently, the decision was based on the usual practice of processing applications at admission of cases. The selection at admission was based on empirical criteria of the cases before the centralization of the process in the Coordination Unit of Care Management (CUCM). This has been generating multiple inequalities and waiting lists that resulted in a clear impact on the care processes of the hospitals of origin. Since the second quarter of 2016, a centralized procedure for the referral of applications of admission to the MLTSH has been established, located in the SERMAS headquarter and specifically in CUCM with the full capacity of filtering the cases to admit at the HLFF.