1,721,016 research outputs found
Migliorare la performance nelle aziende sanitarie: il contesto lavorativo infermieristico nelle neonatologie
No full textIn this historical period characterized by limited financial resources and growing needs health care companies are facing pressure to reduce costs and increase the results. Therefore it is necessary to pay attention to all modes of use of resources and the professional ones in particular; one of these is surely relevant nursing staff and the work context. Positive corporate environments that enhance the professionalism of the operators determine benefits for companies in terms of better patient outcomes and reduction of costs. The research analyses the nursing work environment of 63 neonatal departments. The results can be used by management to define organizational interventions aiming at better performance level
A local authority governance model: the case of Parma and ‘MasterTown’
No full textIn recent decades, the role and power of local authorities in their relations with citizens has changed. Today, new competences and resources, not usually owned by local authorities, are being embedded into the decision-making process, which necessitates the involvement of local stakeholders. A set of different tools (public-private partnership, project financing, etc.) and purposes (urban renewal, territorial marketing, etc.) has been developed to improve this relationship. This paper presents the experience of Parma, an Italian municipality, where a project called ‘MasterTown’ has been developed with the aim of involving different stakeholders in identifying and planning urban renewal. Analysis shows four key factors for the success of MasterTown project: sharing competences and resources, involving citizens, finding alternative financial resources, and assessing social outcomes. The results could be useful to policy-makers in developing renewal processes meeting the needs of all local stakeholders
L'armonizzazione contabile negli Enti locali: primi risultati alla luce della sperimentazione nazionale
No full textL’attuale situazione della finanza pubblica mostra un certo livello di inefficienza anche a causa degli strumenti che gli enti pubblici utilizzano per controllare i livelli di spesa. In particolare, un bisogno percepito come urgente è l’armonizzazione dei sistemi contabili di tutti gli enti pubblici. Il d.lgs. 118/2011 potrebbe essere la risposta a questo problema. Il decreto definisce principi contabili e nuovi schemi di bilancio che dovranno essere adottati al fine di garantire: consolidamento e trasparenza dei conti, efficienza nella gestione delle risorse e confrontabilità dei dati di bilancio. Il decreto prevede un periodo di sperimentazione dei contenuti della norma. La ricerca cerca di capire quali sono le principali criticità e opportunità riscontrate dagli Enti locali in fase di sperimentazione
A comparison of integration models for professionals with different skills in health care
No full textIntegration between hospital and territory has to be faced as a critical aspect in modern health systems. The evolving of health care demand in Western countries leads the debate on health care system to focus on how to meet the needs of chronic diseases. Creating gatekeeper models for admission to health care facilities presumes a high level of integration between a wide variety of professions that interact in patients’ therapy processes. This paper analyzes two models of integration of professionals with different skills: Clinical commissioning groups (CCGs) in United Kingdom health care system and Case della Salute (CdS) in Italian regional health care system of Emilia Romagna. The analysis of the two models highlights critical situations, strong points, and success critical factors in the two models. In particular, the analysis will highlight how the two systems faced the necessity to integrate the different category of professionals that, during the care process of a chronic patient, have to integrate in order to guarantee the continuity of the care process and the most effective response for the patient. This study highlights the methodologies used to share competences and knowledge on which the building of a system with high professional integration is based
The impact of regional policies on Emergency Department management and performance: the case of the regional government of Sicily
No full textBackground: Improvement in healthcare, seeking the correct balance between quality and costs, is an ongoing concern in many countries. Many countries have developed and implemented improvement programmes in health care, particularly in emergency departments (ED), which play a key role in terms of hospital resources and planning. The regional government of Sicily implemented a project 2010–2012 to improve ED care quality and patient safety. Purpose: This paper aims to evaluate improvements implemented by the Regional Health Authority of Sicily in the 20 main EDs. Method: Performance analysis of EDs was conducted on three levels: care quality (standard Joint Commission International evaluation), efficiency in terms of resources and output (by way of interviews and document analysis) and the role of management in efficiently promoting change (presence of a performance monitoring system). Findings: The results show improvements in all areas and improved performance in all EDs. There is, however, room for improvement in certain areas, and improvement was not uniformly distributed. Practical implications: The quality of local policy and management are key aspects of efficient promotion of performance improvement
Assessment for improving the performance of NICUs: The Italian experience
Full text linkThis paper describes neonatal intensive care units (NICU) in Italy using a set of organizational variables identifying management profile. The correlations between variables, and how these are impacted by structural aspects of the department or hospital, are investigated. The research was conducted within the 5-year far-reaching and complex SONAR study run by the Italian Neonatal Network, which maps NICU, monitors outcomes of member centres, defines organizational models, and identifies best practices to improve care quality. Seven variables relating to activities, organization processes, and behaviour models used in the SONAR study were used here to assess NICU. Data from 54 Italian NICUs, 1601 nursing staff, and 643 doctors were used. We identified high levels of variation in NICUs for all aspects of organization. We also identified important opportunities for improvement, especially in the areas of performance measurement, quality improvement, and learning for healthcare staff. In terms of structural characteristics, we identified big differences between NICUs in the north and south of Italy. The findings provide a description of NICUs in Italy and identify a set of variables useful for management in assessing NICU, which are among the most complex and costly operational units in a hospital
The Healthcare Organization in COVID-19 Age: An Evaluation Framework for the Performance of a Telemonitoring Model
No full textTelemedicine services (TS) are not only supportive for healthcare professionals, but managers also see them as essential for the provision of an efficient, effective, and sustainable healthcare service. Several systems make TS available in different ways and contexts. However, no commonly accepted framework meets the need to draw conclusions about which TS can efficiently be measured. For this purpose, a framework is proposed in order to define a dynamic method of performance evaluation that can be used to improve the sustainable management of a telemonitoring model for COVID-19 patients. A case study analysis based on the experience of three telemedicine networks in different locations providing telemonitoring services (northern, central, and southern Italy) was performed. A total of four phases (1. Identification of the target population; 2. Identification of health needs; 3. Definition of the operational plan; and 4. Monitoring of the service by indicators), and seven indicators have been identified. Despite the differences raised in the Italian contexts, applying a performance evaluation framework could help the managerial sector to understand if the service is working as intended and what effects the service is producing on the healthcare organization. Considering the long-term field experience, this framework is an easy-to-use tool that will allow healthcare organizations to evaluate the performance of their telemonitoring model, and improve it according to new needs. Providing a healthcare service in an efficient context is fundamental for the sustainability of the health system as a whole
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