La carta de servicios del Instituto Andaluz del Patrimonio Histórico

La elaboración de la Carta de Servicios del IAPH, aprobada por resolución de 17 de enero de 2005 de la Dirección General de Bienes Culturales, se enmarca dentro del proceso general de mejora de la calidad de los servicios de la administración autonómica andaluza. El punto de partida de su contenido es el proyecto del Catálogo de Servicios del IAPH 2003, donde ya se incluyeron las diferentes especialidades de servicios que suministra la institución: servicios de documentación, intervención, arqueología subacuática y formación-comunicación. Este primer catálogo fue revisado, adaptado a la normativa general para las Cartas de Servicios de la Junta de Andalucía (Decreto 317/2003) y a las pautas desarrolladas por la Dirección General de Administración Electrónica y Calidad de los Servicios, con la que se ha trabajado en estrecha colaboración, dando lugar a la actual Carta de Servicios del IAPH formada por 50 servicios asociados a compromisos e indicadores de calidad. La publicación de la Carta, así como de un folleto divulgativo, supone que por primera vez los servicios del IAPH se ofrezcan bajo una oferta pública, con unos compromisos de calidad explícitos a la ciudadanía. Se hace así necesario el seguimiento continuo de los indicadores de gestión de cada servicio para medir el cumplimiento de los compromisos establecidos. El balance final se plasmará en el Informe de Evaluación 2005, que será el punto de partida para la actualización de la Carta y la mejora de la calidad de nuestros Servicios

El Sistema Integrado de los Servicios del Instituto Andaluz del Patrimonio Histórico: la calidad orientada a los usuarios

El Sistema Integrado de los Servicios del IAPH es una herramienta fundamental para la transferencia a la sociedad del conocimiento especializado de la institución y una de sus líneas estratégicas. En las XI Jornadas Españolas de Documentación Científica (Fesabid 2009) se ha presentado en el marco de las Experiencias de Calidad orientadas a los usuarios, con el objetivo de satisfacer el mayor número de sus expectativas y necesidades concretas. La comunicación presentada se encuentra disponible en www.fesabid.org/zaragoza2009 Libro_Actas_Fesabid_2009.pd

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

The dissemination of SIPHA Information

Español: El objetivo final del Sistema de Información del Patrimonio Histórico de Andalucía es difundir el conocimiento de este patrimonio a través del desarrollo de unos servicios públicos adecuados a las necesidades de información de los usuarios y con unos compromisos de calidad previamente establecidos. Esta difusión se aborda desde diversas perspectivas que actualmente coexisten, concretamente mediante servicios de información para la atención y resolución de las preguntas de los usuarios, que cuentan con la intermediación y el asesoramiento de personal específico, con los servicios de acceso en línea y la implantación de productos interactivos que el usuario puede interrogar directamente, como la base de datos de patrimonio inmueble de Andalucía en Internet, y a través de la divulgación de productos culturales de una temática específica de especial interés, tanto en formato CD-ROM como disponibles en el Portal Web del IAPH. El desarrollo de todos los servicios se ha basado en la idea de lograr un proceso de mejora continua de su calidad que utiliza como herramienta fundamental la autoevaluación periódica, aunque en los últimos años se ha enriquecido con la evaluación externa por parte de los usuarios. Inglés: The ultimate goal of the Andalusian Historic Heritage Information System is to disseminate knowledge of this heritage through the development of public services adapted to users' information needs and with a previously determined commitment to quality. This dissemination is approached from different perspectives that currently coexist, concretely through information services that attend and answer user question (which demand the mediation and assessment of specific personnel), with online access services and the installment of interactive products that the user can engage with directly, such as the Andalusian unmovable heritage database on Internet, and through the spreading of cultural products of a specific topic both in CD-ROM format as well as on the IAPH Web Portal. The development of all of the services is based on the idea of achieving a process of continual quality improvement that uses periodic selfevaluation as a fundamental tool, even though in the last years it has been enriched with external evaluations carried out by users

Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database

Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p &lt; 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p &lt; 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013