Carola Orrego

Carola Orrego
Instituto Universitario Avedis Donabedian · Patient safety and Patient Empowerment

PhD

About

83
Publications
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1,156
Citations
Introduction
Additional affiliations
April 2002 - May 2015
Instituto Universitario Avedis Donabedian
Instituto Universitario Avedis Donabedian
Position
  • Managing Director

Publications

Publications (83)
Article
Full-text available
Background: Patient safety (PS) is a serious global public health problem affecting all countries. Estimates show that around 10 percent of the patients are harmed during hospital care, resulting in 23 million disability-adjusted life years lost per year. Experts emphasize research advancements as a key precondition for safer care. Aim: The Patient...
Article
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Citation: Aparicio Betancourt, M.; Duarte-Díaz, A.; Vall-Roqué, H.; Seils, L.; Orrego, C.; Perestelo-Pérez, L.; Barrio-Cortes, J.; Beca-Martínez, M.T.; Molina Serrano, A.; Bermejo-Caja, C.J.; et al. Global Healthcare Needs Abstract: The COVID-19 pandemic has exposed gaps and areas of need in health systems worldwide. This work aims to map the evide...
Article
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Background:For many chronically ill patients self-management of their disease is difficult. This may be especially true for people with limited health literacy as they are faced with additional challenges in the day-to-day management of their disease. Research has shown that self-management support is most effective when tailored to the needs and p...
Article
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Purpose: We aimed to evaluate the effectiveness of a virtual community of practice (vCoP) in improving primary health care professionals' (HCPs') attitudes toward empowering patients with chronic disease. Methods: We conducted a cluster randomized controlled trial. Practices were units of randomization, and primary HCPs and patients were units o...
Article
In Spain, there is not a national strategy to promote shared decision making (SDM) in clinical practice, and it is still not a requisite for improving the quality of health services, in either the legal norms or professionals’ educational curricula. However, several national strategies in specific health areas increasingly include the principles of...
Article
Full-text available
Introduction : Self-management (SM) interventions are complex interventions and one of the main components of high-quality chronic disease care for which the incorporation of the perspectives of patients and their informal caregivers is crucial. We aim to identify, appraise and synthesise the evidence exploring patients’ and caregivers’ perspective...
Article
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Self-management interventions (SMIs) can improve the life of patients living with obesity. However, there is variability in the outcomes used to assess the effectiveness of SMIs and these are often not relevant for patients. In the context of COMPAR-EU, our aim was to develop a core outcome set (COS) for the evaluation of SMIs for patients with obe...
Article
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Context The literature on self-management interventions (SMIs) is growing exponentially, but it is characterized by heterogeneous reporting that limits comparability across studies and interventions. Building an SMI taxonomy is the first step towards creating a common language for stakeholders to drive research in this area and promote patient self...
Article
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An organization's culture with regard to patient safety is important because it defines the beliefs and practices of the organization, and consequently its efficiency and productivity.Knowing the level of this and the factors that influence or not their dynamic represents a challenge, due to the degree of complexity and specificity of the elements...
Article
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Background Self-management (SM) interventions are supportive interventions systematically provided by healthcare professionals, peers, or laypersons to increase the skills and confidence of patients in their ability to manage chronic diseases. We had two objectives: (1) to summarise the preferences and experiences of patients and their caregivers (...
Preprint
Background: Fostering the understanding of the relationship between the prevalence of adverse events (AEP), the patient safety culture of healthcare professionals (PSC) and patient safety perception (PSP) could be an important step to operationalizing patient safety through an integration of different perspectives. Objective: To assess the relation...
Article
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Background: A large body of evidence suggests that self-management interventions (SMIs) may improve outcomes in chronic obstructive pulmonary disease (COPD). However, accurate comparisons of the relative effectiveness of SMIs are challenging, partly due to heterogeneity of outcomes across trials and uncertainty about the importance of these outcom...
Article
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Introduction: Virtual Communities of Practices (vCoP) offer patients the possibility to interact and share tools and knowledge necessary for their empowerment. This paper describes the co-design process of a vCoP for the empowerment of people with ischemic heart disease (IHD). Methods: We used a modified experience-based design approach to co-desig...
Article
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Introduction Virtual Communities of Practice (VCoP) or knowledge-sharing virtual communities offer ubiquitous access to information and exchange possibilities for people in similar situations, which might be especially valuable for the self-management of patients with chronic diseases. In view of the scarce evidence on the clinical and economic imp...
Article
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Background In recent decades, many self‐report instruments have been developed to assess the extent to which patients want to be informed and involved in decisions about their health as part of the concept of person‐centred care (PCC). The main objective of this research was to translate, adapt and validate the Patient‐Practitioner Orientation Scal...
Article
Full-text available
Background: Osteoarthritis (OA) is a health condition sensitive to patient's preferences and values regarding the benefits and risks of the different treatment options. In this sense, patient decision aids (PtDA) can play an important role in helping patients to incorporate their values, needs, and preferences into the decision-making process, thu...
Article
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The Covid-19 and other recent pandemics has highlighted existing weakness in health systems across the Latin-America and the Caribbean (LAC) region to effectively prepare for and respond to Public Health Emergencies. It has been stated that quality of care will be among the most influential factors on Covid 19 mortality rates and low systems perfor...
Preprint
Background: Osteoarthritis (OA) is a health condition sensitive to patient’s preferences and values regarding the benefits and risks of the different treatment options. In this sense, patient decision aids (PtDA) can play an important role in helping patients to incorporate their values, needs and preferences into the decision-making process, thus...
Preprint
Full-text available
Background: Osteoarthritis (OA) is a health condition sensitive to patient’s preferences and values regarding the benefits and risks of the different treatment options. In this sense, patient decision aids (PtDA) can play an important role in helping patients to incorporate their values, needs and preferences into the decision-making process, thus...
Article
Introduction : Self-management (SM) interventions are complex interventions and one of the main components of high-quality chronic disease care for which the incorporation of the perspectives of patients and their informal caregivers is crucial. We aim to identify, appraise and synthesise the evidence exploring patients’ and caregivers’ perspective...
Article
Full-text available
Introduction Population ageing and increasing chronic illness burden have sparked interest in innovative care models. While self-management interventions (SMIs) are drawing increasing attention, evidence of their efficacy is mostly based on pairwise meta-analysis, generally derived from randomised controlled trials comparing interventions versus a...
Article
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Background: Communities of practice are based on the idea that learning involves a group of people exchanging experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a virtual community of practice aimed at improving primary healthcare professional attitudes to the empowerment of patients with chronic diseases. Methods...
Article
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Background Virtual communities of practice (vCoPs) facilitate online learning via the exchange of experiences and knowledge between interested participants. Compared to other communities, vCoPs need to overcome technological structures and specific barriers. Our objective was to pilot the acceptability and feasibility of a vCoP aimed at improving t...
Article
Abstract Quality Problem The incidence of central line-associated bloodstream infections (CLABSI) in Latin America has been estimated at 4.9 episodes per 1000 central line (CL) days, compared to a pooled incidence of 0.9 in the United States. CLABSI usually result from not adhering to standardized health procedures and can be prevented using eviden...
Article
Aim: To assess the impact of different forms of use of failure mode and effect analysis methodology for risk prioritization in the ambulatory care process in a mutual benefit association covering work-related accidents and diseases. Methods: The study is based on a previously drafted and individually prioritized risk map by a multidisciplinary t...
Article
Full-text available
Background: Communities of practice are based on the idea that learning involves a group of people exchanging experiences and knowledge. The e-MPODERA project aims to assess the effectiveness of a virtual community of practice aimed at improving primary healthcare professional attitudes to the empowerment of patients with chronic diseases. Method...
Article
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Background: Person-centred care can have a big impact on the quality of care. Reviews of research about this topic found that offering care in a more person-centred way usually improves outcomes. Some of the most common ways that have shown to improve person-centred care include helping people learn more about their conditions, prompting people to...
Article
Patients' rights to autonomy, information and participation in their own health care are recognized in the Spanish legal system from the early 2000's. Public institutions have progressively launched several initiatives to promote and improve patients' empowerment and self-care. However, the concept of Shared Decision Making (SDM), although embedded...
Article
Background Central line-associated bloodstream infections (CLABSI) are the leading cause of healthcare-associated bloodstream infections, prolonging hospitalizations, and increasing healthcare costs, morbidity and mortality. The CLABSI incidence for Latin America has been estimated at 7.6 episodes per 1,000 central line days. In developing countrie...
Article
Empowerment is a social process of recognition, promotion, and mobilization of the resources required for individuals and communities to be able to take control of the factors that affect their health. This paper explores the experiences of individuals with chronic illnesses and users of the Spanish healthcare system in order to understand the role...
Article
Full-text available
Background Central line-associated bloodstream infections (CLABSI) are the leading cause of healthcare-associated bloodstream infections, prolonging hospitalizations, and increasing morbidity, healthcare costs and mortality. The CLABSI rate has been estimated at 7.6 episodes per 1,000 central line days in Latin America. In developing countries, CLA...
Conference Paper
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Group Concept Mapping (GCM) was used to explore common understandings among the expert group, to identify learning outcomes for handover training for medical students. GCM is a structured consensus building methodology with five phases: idea generation and pruning, sorting ideas into groups, rating on two values (importance and difficulty to achiev...
Article
Patient handoff has been defined as " the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group on a temporary or permanent basis. " 1 Improperly conducted handoffs can lead to wrong treatment, delays in medical diagnosis, life-threaten...
Conference Paper
Anzahl der Teilnehmer: 10-20 Lernziele: Die TeilnehmerInnen sind am Ende des Workshops in der Lage: 1. den Zusammenhang zwischen medizinischen Übergaben (Handover) und Patientensicherheit zu erklären, 2. selbstständig relevante und operationalisierbare Lernziele für eine Handover Lehreinheit zu formulieren, 3. praxisnahe und innovative Vermittl...
Article
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Background: There is a growing impetus to reorganize the hospital discharge process to reduce avoidable readmissions and costs. The aim of this study was to provide insight into hospital discharge problems and underlying causes, and to give an overview of solutions that guide providers and policy-makers in improving hospital discharge. Methods:...
Conference Paper
Purpose: To develop, by consultation with an expert group, agreed learning outcomes for the teaching of handoff to medical students using group concept mapping. Method: In 2013, the authors used group concept mapping, a structured mixed-methods approach, applying both quantitative and qualitative measures to identify an expert group's common und...
Article
Unlabelled: Multiple injuries are a major source of morbidity and mortality in young people. The aim of this study was to evaluate the effect of a collaborative strategy to improve the implementation of six clinical indicators, recognized internationally, for the treatment of trauma patient. Prospective, multicentre, pre-and post-intervention stud...
Article
It has been published that hospital adverse events are an important source of morbidity and mortality in different countries and settings. The aim of this study was to evaluate the frequency, magnitude, distribution and degree of preventability of adverse events in the Autonomous Community of Catalonia (Spain). We conducted a retrospective cohort s...
Article
Rationale, aims and objectiveThis study aims to assess the use of clinical practice guidelines (CPGs) among health professionals and factors related to their uptake in clinical practice. Methods Cross-sectional study based on an online survey conducted among primary care (PC) and hospital-based care (HC) doctors in Spain in 2011. Questionnaire deve...
Article
BACKGROUND Airway assessment and management are cornerstones of anaesthesia, yet airway complications remain an important source of morbidity.OBJECTIVE We performed a before-and-after evaluation of a collaborative intervention to improve adherence to airway assessment and management guidelines in patients scheduled for surgery under general anaesth...
Article
Full-text available
Clinical guidelines (CGs) are popular for healthcare decision making but their acceptability and use by healthcare providers is influenced by numerous factors. Some of these factors are professional-related, such as knowledge and perceptions of and attitudes toward CGs in general. The aim of our study was to evaluate attitudes and perceptions of Sp...
Data
Surgical patient safety is a priority in the national and international quality healthcare improvement strategies. The objective of the study was to implement a collaborative intervention with multiple components and to evaluate the impact of the patient surgical safety checklist (SSC) application. This is a prospective, longitudinal multicenter st...
Article
Full-text available
Background: Organizational culture is seen as having a growing impact on quality and safety of health care, but its impact on hospital to community patient discharge is relatively unknown. Objectives: To explore aspects of organizational culture to develop a deeper understanding of the discharge process. Research Design: A qualitative study of stak...
Conference Paper
to see the Slideshare of this workshop, go to this link: http://www.slideshare.net/Drachsler/patient-workshop-at-gma2013
Article
Background: Organizational culture is seen as having a growing impact on quality and safety of health care, but its impact on hospital to community patient discharge is relatively unknown. Objectives: To explore aspects of organizational culture to develop a deeper understanding of the discharge process. Research design: A qualitative study of...
Article
Full-text available
Background Advocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients. Objective The aim of the paper is to explore the barriers and facilitators to patient-centred care in the hospital discharge process. Methods A qualitative study using purposive sampling of 192 individual interv...
Article
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Background Handover practices at hospital discharge are relatively under-researched, particularly as regards the specific risks and additional requirements for handovers involving vulnerable patients with limited language, cognitive and social resources. Objective To explore handover practices at discharge and to focus on the patients’ role in hand...
Article
Full-text available
Background Patient safety experts have postulated that increasing patient participation in communications during patient handovers will improve the quality of patient transitions, and that this may reduce hospital readmissions. Choosing strategies that enhance patient safety through improved handovers requires better understanding of patient experi...
Article
To assess the efficiency of pharmacological antiemetic prophylaxis in patients subjected to surgery under general anaesthetic in different postoperative nausea and vomiting (NVPO) risk groups. A randomised, observational, prospective and multicentre cohort study was conducted. The study included 1239 patients from 26 hospitals who were subjected to...
Article
Objective To assess the efficiency of pharmacological antiemetic prophylaxis in patients subjected to surgery under general anaesthetic in different postoperative nausea and vomiting (NVPO) risk groups.Material and methodsA randomised, observational, prospective and multicentre cohort study was conducted. The study included 1239 patients from 26 ho...
Article
Full-text available
Major adverse cardiac and cerebrovascular events (MACCE) represent the most common cause of serious perioperative morbidity and mortality. Our aim was to identify risk factors for MACCE in a broad surgical population with intermediate-to-high surgery-specific risk and to build and validate a model to predict the risk of MACCE. A prospective, multic...
Article
To assess the prevalence of surgical site infection (SSI) after elective operations for colon and rectal cancer after the application of evidence-based preventive measures and to identify risk factors for SSI. Prospective, observational, multicenter. Tertiary and community public hospitals in Catalonia, Spain. Consecutive patients undergoing electi...
Article
Full-text available
Clinical practice guidelines (CPGs) have become a very popular tool for decision making in healthcare. While there is some evidence that CPGs improve outcomes, there are numerous factors that influence their acceptability and use by healthcare providers. While evidence of clinicians' knowledge, perceptions and attitudes toward CPGs is extensive, re...
Article
Full-text available
Surgical care is an important burden in healthcare, and the complications and harm related to surgery are of special concern. Clinical practice guidelines in perioperative care should provide the opportunity to minimise these risks and improve surgical outcomes, but their quality has not yet been evaluated systematically. To evaluate the quality of...