1,721,089 research outputs found
Logiche e strumenti di gestione per processi in sanità
No full textIl libro rappresenta il documento finale di un progetto di sperimentazione gestionale condotto negli ultimi due anni presso l’azienda ospedaliera Sacco di Milano. Il progetto, il cui titolo è lo stesso del libro, è stato condotto sotto l’egida della Regione Lombardia e del Ministero della Sanità e prevedeva la sperimentazione di una metodologia di gestione per processi in ambito ospedaliero, basata sull’utilizzazione dello strumento del percorso diagnostico-terapeutico
Lights and shades in the managerialization of the Italian National Health
No full textAfter fifteen years from the first of a series of reforms that introduced managerial paradigms and techniques into the Italian National Health System (INHS), it is possible to provide a critical assessment of the outcomes of such changes. The aim of this paper is to assess how these reforms have changed the INHS, to what extent they concurred to improve the system, where they failed and which issues are still in agenda. To do so we run through the recent history of the INHS and propose an interpretative framework to understand the grounds for its light and shade results. The basis for the analysis is triple. The study draws from researches, literature review, action-researches and field investigations conducted over the last 10 years in the INHS
Organizational design and development for healthcare services: Foundations and Perspectives
No full textThe book is an attempt to reunify in a comprehensive framework the complex and diverse issues related to organizational development, with its focus centered on those design topics tha traditionally have been understimated. It is a proposal, both scientific and pragmatic, to fill a gap in the literature, through the methodical analysis of conceptual and practical topics that have usaully been dealth with separately and, in some cases, have only been touched upon. Topics which in this book are investigated in depth with specific reference to healthcare sectors and organization
The rise and fall(acy) of clinical directorates in Italy
No full textClinical Directorates (CDs), in the sense of “intermediate organizational arrangements through which defined parts of larger
hospitals health services are managed”, were introduced in the Italian National Health Service (INHS) by law after the major
reform of 1992. By means of such reform, accountability chains within INHS hospitals were streamlined. Changes looked at
strengthening the role of management in hospitals as a strategy to improve efficiency in the provision of services. From this
stream of managerialism emerged the attempts to re-organize hospital activities along the lines of clinical directorates.
The aim of this paper is to outline the context in which CDs initially developed in Italy as the “one best way” to address
current hospital problems and the reasons why they are now challenged due to not coming up to expectations. To do so we run
through the last 10 years of history of CDs in Italy and propose an interpretative framework to understand the grounds for their
partial failure and success
Strategic, organisational and managerial isses related to innovation, entrepreneurship and intrapreneurship in the hospitalcontext: The Italian experience
No full textTechnological innovation in the hospital context is always
knowledge-related. It concerns the know-why, when based on
theoretical foundations (competencies), and the know-how when
related to practical skills. New medical devices, technologies and
techniques originate from the new know-why and require new
know-how to be exploited fully and effectively. Given the
continuous and increasing development of innovations in the
healthcare sector, modern hospitals face the complex task of
mastering internally and externally-created innovation. The capacity to envision, stimulate, recognise, evaluate and manage both lines of innovation (know-why and know-how) is key to supporting large and leading hospitals (notably the teaching ones) in their quest to fulfil their mission and gain a sustainable competitive advantage.
Such hospitals are required to position themselves as close as
possible to the leading edge of innovation. In this light, the paper
tackles the strategic, organisational and managerial issues of how to build a work environment focused on innovation, entrepreneurship and intrapreneurship (the strategic issue); define and consolidate roles and responsibilities related to envisioning and managing innovation (the organisational issue); and strengthen the operating mechanisms (planning, budgeting and control, human resources management, information systems, etc) and focus on stimulating entrepreneurship, intrapreneurship and innovation creation (the managerial issue)
Management della Sanità: lineamenti essenziali e sviluppi recenti del settore e dell'azienda sanitaria
No full textIl libro affronta i quadri concettuali e teorici che caratterizzano la specificità della policy e management in sanità, e trasla tali quadri nella realtà pratica con analisi di casi, review di evidenze, discussione delle sfide aperte
Beyond rhetoric: what health services management research must do for research and practice
No full textL'articolo traccia le traiettorie future per la ricerca nel campo dell'healthcare management
Beyond rhetoric: inquiry on the essence of strategic management in public healthcare organizations
No full textLiterature on strategic management in public sector organizations often borrows from theory developed in business oriented contexts. The recent influence of new public management is evident, and rhetoric about the usefulness and goodness of strategic planning tools developed for the private sector is at its peak. The work of public managers, however, is not adequately reflected in the proposed frameworks of this body of literature research. There is a need for a conceptual framework that better captures the essence of strategic public management and provides a better foundation for research. The aim of this paper is to contribute to the building of this framework. Given this research goal, we performed a study based on semi-structured individual interviews with CEOs and medical directors of public health organizations (PHOs). Findings were analyzed, and a theoretical framework emerged. A preliminary version of the contents and the structure of the framework was discussed on several occasions with CEOs and MDs of PHOs participating in leadership programs at Bocconi School of Management (SDA). After revision, the framework was consolidated around the following five dimensions: playmaking, enabling (and engaging), aligning, compromising, and equivocality. Each dimension is defined and discussed. The conclusion offers managerial implications and further research aim
Organisational design for health integrated delivery systems: theory and practice
No full textIntegrated delivery systems (IDS) are worldwide emerging as the dominant organizational form in the healthcare sectors. This article, drawing from international comparisons, focuses on organizational design of IDS. The analysis derives from an extensive literature review, which shows over the last years a significant lack of works on design issues, and from a number of experiences in community care settings, which provide useful insights on changes taking place in governance and delivery of health services at the local level. The frameworks discussed depict the major options of reorganization that can be observed in local integrated health systems of industrialized countrie
Leadership e management dell'azienda sanitaria: conoscere il settore e il sistema, organizzare i servizi, dirigere i professionisti
No full textNo abstract availabl
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