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The COVID-19 pandemic has forced the adoption of drastic changes in primary care, modifying the organization and work dynamics previously established. From one day to the next, professionals had to adapt to the new situation to be able to attend cases and contacts tracing, to avoid contagion and to maintain attention to other health problems. At the beginning of the pandemic, professionals had to establish new practices and care circuits in primary care in an improvised way, due to lack of updated guidelines, without adequate means of protection, evaluating their risks and benefits on the fly. We present the main organizational changes in the first level of care and describe, from the point of view of patient safety and the consequences for patients and professionals of the priority care for COVID-19. Finally, we consider how to incorporate the knowledge acquired during the pandemic, analyzing the advantages and disadvantages of the adopted measures to maintain as much as possible a safe, accessible and quality primary care., (Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

The greatest asset of any health system is its professionals, and they must be cared for in order to take care. It is necessary to emphasize that they are key for the resilience of our health systems. This is particularly important in crisis times and especially important for primary health care.During the COVID-19 pandemic, working conditions have been the main common latent factor for patient safety incidents. Primary Care professionals have worked in unsafe working conditions, with lack of means of protection, great uncertainty, lack of scientific knowledge and rapidly changing work protocols for dealing with cases and contacts of COVID-19 infection, with a high care pressure, long working hours, suspension of vacations, and even changes in their jobs. All of this has contributed to their becoming, not only the first victims of the pandemic, but also the second victims of the adverse events that occurred during it.Therefore, in this article we analyze the main risks and damages suffered by professionals in Primary Care and provide keys to contribute to their protection in future similar situations., (Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

The health system failed to guarantee the safety of both professionals and citizens who came to the centers at the beginning of the pandemic. The lack of materials and guidelines for the prevention of infections caused in Spain the worst catastrophe in the history of patient safety and occupational health in healthcare. It also happened in other countries but Spain had the highest rates of infected health workers in the world. It was a largely avoidable event. We review what measures have been taken to prevent infections in primary care centers, such as hand hygiene, masks and personal protection material or the maintenance of social distance, among others. We update the recommendations and raise the perspectives in a situation that requires flexibility and adaptability to maintain quality and safe care., (Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: Examine the effects of an educational intervention to improve patients' level of activation and promote their participation improving their safety during health system pathway., Material and Methods: Selection and study of the care process on which to apply the research. Design and edition the audiovisual educational material. Intentional sampling of patients on the waiting list for scheduled operation by the Traumatology Service. Telephone collection through study's explanatory script. Realization of two focus groups, with heterogeneous distribution by gender, age and level of studies. Visualization of the educational video and exploration of aspects of interest through semi-structured questions script, based on the research objectives. Recording and transcription of generated speeches. Qualitative analysis of resulting information., Results: Patients are aware that failures and errors occur, and recognize the weaknesses of the system and professionals. The educational activity brings more value to people with less previous experience or less knowledge about the dynamics of the health system. The interaction between people with different experiences entails an exchange of knowledge, enhancing the educational effect of the intervention. The level of knowledge and the degree of activation increases in all participants, regardless of their starting situation., Conclusions: Strengthening the role of the patient as a safety barrier through an educational intervention of an audiovisual nature is feasible in real conditions and useful for the objective pursued., (Copyright © 2019 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To determine the prevalence and type of the clinical safety problems contained in the complaints made by patients and users in Primary Care., Material and Methods: An observational, descriptive, cross-sectional study was conducted by analysing both the complaint forms and the responses given to them in the period of one year., Results: At least 4.6% of all claims analysed in this study contained clinical safety problems. The family physician is the professional who received the majority of the complaints (53.6%), and the main reason was the problems related to diagnosis (43%), mainly the delay in diagnosis. Other variables analysed were the severity of adverse events experienced by patients (in 68% of cases the patient suffered some harm), the subsequent impact on patient care, which was affected in 39% of cases (7% of cases even requiring hospital admission), and the level of preventability of adverse events (96% avoidable) described in the claims. Finally the type of response issued to each complaint was analysed, being purely bureaucratic in 64% of all cases., Conclusions: Complaints are a valuable source of information about the deficiencies identified by patients and healthcare users. There is considerable scope for improvement in the analysis and management of claims in general, and those containing clinical safety issues in particular. To date, in our area, there is a lack of appropriate procedures for processing these claims. Likewise, we believe that other pathways or channels should be opened to enable communication by patients and healthcare users., (Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.)