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Table 2 Evaluation of individual center's performance: domains, themes, indicator and measurable element

From: Results of a sector-wide quality improvement initiative for substance-abuse care: an uncontrolled before-after study in Catalonia, Spain

Domain

Theme

Indicator

N (cases revised)*

Standard

Compliance

     

At baseline

At follow up

Change

Care pathway

Process of admittance

1. Ensure follow up visits after user contacts and hospitalizations.

2476

75%

100.0%

100.0%

0.0%

 

Process of care

2. Offer an individualized treatment plan in appropriate timeframe.

1312

90%

100.0%

95.5%

-4.5%

  

3. Offer vaccination against hepatitis B to all users at risk.

757

90%

40.9%

63.6%

55.5%

  

4. Provide access to counseling services to HIV positive users.

703

85%

4.5%

57.1%

1168.9%

  

5. Provide a list of treatments and services, including a description of the nature of the intervention.

184

100%

45.5%

86.4%

89.9%

 

Pharmacological treatment

6. Register patients drug prescriptions properly.

1223

100%

72.7%

90.9%

25.0%

 

Follow up care

7. Follow up users in the methadone maintenance programme at least every 6 months.

1119

90%

90.9%

77.3%

-15.0%

  

8. Support the user in adhering to the care pathway.

14256

85%

65.0%

86.4%

32.9%

  

9. Actively follow up patients that do not attend the dispensing of methadone.

542

90%

50.0%

50.0%

0.0%

 

Prevention

10. Promote and participate in prevention activities (on own initiative, in coordination with community agencies or by indication of agencies).

64

100%

95.5%

95.5%

0.0%

 

Harm reduction program

11. Have standardized guidelines for the prevention of risk behaviors associated with substance use and sexual behavior.

152

100%

63.6%

90.9%

42.9%

  

12. Provide injection equipment (syringes) to intravenous drug users.

52

100%

59.1%

100.0%

69.2%

  

13. Have programs aimed at (potential) users not yet in contact with the center.

53

100%

86.4%

90.9%

5.2%

Relations and user rights

Confidentiality

14. Ensure confidentiality of all user-related data.

83

100%

40.9%

72.7%

77.7%

 

Information

15. Ensure that users have all the necessary information to take an informed decision regarding all health-related actions.

1150

100%

4.5%

22.7%

404.4%

 

User satisfaction

16. Demonstrate a system of dealing with complaints (ensuring feedback within two weeks)..

59

80%

80.0%

76.9%

-3.9%

  

17. Assess the satisfaction of users with the services received.

100

100%

36.4%

36.4%

0.0%

 

Family involvement

18. Have an action plan with families, encompassing monitoring and periodic contacts, every six months.

683

80%

90.9%

86.4%

-4.9%

 

Community involvement

19. Promote the reintegration of the user in the community.

528

80%

100.0%

95.5%

-4.5%

  

20. Engage in efforts to improve community acceptance.

57

100%

100.0%

95.5%

-4.5%

  

21. Conduct activities to improve social acceptance of care in collaboration with associations, councils, regional councils, etc.

56

90%

86.4%

95.5%

10.5%

Environment and infrastructure

Appropriateness of the facilities

22. Designate a space reserved for the intake and dispensing of methadone.

53

100%

81.8%

95.5%

16.7%

 

Organization and waiting times

23. Provide written information to the population at risk about the services, including information on treatment, hours, place of care.

124

100%

40.9%

95.5%

133.5%

  

24. Anticipate the provision of services to patients outside opening hours.

61

100%

63.6%

81.8%

28.6%

  

25. Initiate diagnosis and therapy in a period no longer than 2 weeks of initial visit.

1325

80%

88.2%

76.2%

-13.6%

 

Documentation systems and registries

26. Document the clinical history for all users actively attended in center.

1266

100%

59.1%

86.4%

46.2%

  

27. Make accessible the clinical documentation generated during the visits to all members of the multi-professional team.

1321

95%

95.5%

100.0%

4.7%

Organization and management

Multi-professionalcare

28. Assess all patients in the care at least once by the professionals who comprise the multi-professional team.

1197

75%

31.8%

63.6%

100.0%

 

Protocols

29. Demonstrate protocols for the triage of users with organic pathologies.

159

100%

36.4%

90.9%

149.7%

  

30. Demonstrate protocols for the triage of users with psychopathologies.

81

100%

45.5%

72.7%

59.8%

  

31. Demonstrate protocols for the triage of pregnant woman users.

101

100%

40.9%

90.9%

122.2%

 

Continuing education

32. Professional should participate in continuing education activities.

375

80%

45.5%

63.6%

39.8%

 

Professionals' opinion

33. Carry out regular surveys on the opinion of professionals.

57

100%

18.2%

40.9%

124.7%

 

Coordination with other levels of care

34. Establish stable relationships and coordination with affiliated social services and legal agencies.

170

100%

45.5%

68.2%

49.9%

  

35. Coordinate work plan with the health care area administration, mental health centers and referral hospitals.

219

100%

54.5%

72.7%

33.4%

  1. * the differences in the denominators between indicators is due to the level at which the indicators is selected: records (depending on type of user) at user level or organizational policies at center level.