More than 5000 Critical incidents to learn from: Local and national review in Spain. 
Background and Goal of Study: In this paper we would like to present The Safety Working Group In Anaesthesia (GTSA) activity since 2006 and emphasize the milestone of more than 5,000 incidents in the Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR-ANESTIC) database. The GTSA is an expert committee of Hospital Universitario Gregorio Marañón (HGUGM) in Madrid formed by attending and trainees as well. It was established to improve and to promote safety in daily practice and safety culture. The group activity is based on the SENSAR-ANESTIC database, where critical incidents are reported. Critical incident (CI) is defined as event or circumstances that caused or could have caused unnecessary harm to a patient. It may have been originated from intentional or unintentional acts. The staff analyses the facts and proposes measures following the modern non-punitive approach allowing learn from them, designs system improvements and removes latent contributory factors. 
Materials and Methods: We present a descriptive and retrospective analysis of GTSA and SENSAR-ANESTIC activity. Data is collected from: - SENSAR-ANESTIC national database (since 2009). 
Results and Discussion: The Spanish national group SENSAR- ANESTIC currently includes 85 hospitals and thanks to the work of hundreds of analysers (396) analysed more than 6174 CI and proposed at least 9,900 corrective measures. 668 of those CI belong to HGUGM corresponding to 10,81% from the total, several corrective measures has been proposed as well (email alerts, newsletters, bibliographic reviews and periodic dissemination of results, annual courses and video-simulation training). The main value of the system is to have been the vehicle of insertion of a safety modern culture in areas in which it is used. A fair, transparent and diligent safety culture focused on system failure and feedback learning. 
Conclusion: The number of CI grows exponentially nationwide as a learning source to improve the safety culture. The GTSA contributes significantly to the total of CI. Based on previous publications the idea of higher reporting CI rates associated with a more positive safety culture, we think that this working group has helped to improve the safety culture at the local level.

More than 5000 critical incidents to learn from: local and national review in Spain