Organizational procedures and health care management. A point of view from primary care centres

Objective: We aimed to know how the directive teams perceive the implementation of organizational procedures in relation with the health care management in the primary care setting. Design: Multicentre cross-sectional descriptive study. Setting: Area 11 Madrid Primary Care Service, Spain. Participants: All directive teams of primary care centres (PCC) (n = 38). Measurements: Data were collected with a self-administered semiestructured questionnaire which included 21 main questions about procedures and use of internal organizational measures relating to the health care management in PCC, grouped in five sections: predictable and non predictable consultations(clinical and administrative), clinical schedules and office management. Results: 100% response rate. 69% of PCC use internal procedures and computerized applications for the renewal of medical chronic prescriptions and 55% for temporary disability. 71% show nurse involvement in terms of dispensing medical prescriptions during clinical consultations. 42% keep on performing administrative procedures of specialized care. 21% don't get compliance with routine control of programs and in 29% of consultations duplicity of visits among medicine and nursing are expected. 97% follow a specific process for urgent attention. 84% request subsequent appointment in the previous clinical consultation. 29% have open schedules availables for 6 months. Conclusions: A wide variability of the implementation of organizational procedures in PCC was observed. Further research is needed to determine whether any organizational and professional changes could contribute to improve efficiency and patient satisfaction. (C) 2010 Elsevier Espana, S.L. All rights reserved.