scholarly journals An individual care plan for a high risk elderly population in the Local Health Authority of Bologna

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Ciotti ◽  
F Catalani ◽  
F Martino ◽  
I Camplone ◽  
C Valisella ◽  
...  
Keyword(s):  
Nursing Care ◽  
Health Authority ◽  
Healthcare Professionals ◽  
Early Recognition ◽  
Care Plan ◽  
Local Health Authority ◽  
Local Health ◽  
Individualized Care ◽  
Professional Management ◽  
Very High

Abstract Issue Fragility is a major challenge that demand a comprehensive public health response, since a high rate of population is aging and becoming vulnerable. Description of the Problem The Local Health Authority of Bologna, about 850,000 inhabitants, has implemented a new qualitative and quantitative Project on fragile patients. Frailty was measured by the “Risk Profile of the Emilia-Romagna region,”, an algorithm that provides a risk index, based on patients'record, which divide population in risk categories (high/very high, moderate and low risk) of hospitalization. The 585 General Practitioners (GPs) have enrolled their fragile patients with high and very high risk (about 6% of the population). GPs and other healthcare professionals are asked to define an Individualized Care Plan (ICP) according to an integrated and multi-professional management perspective. Patients' and healthcare professionals' subjective experience was collected throughout a structured interview. Results From October 2018 to April 2019, 260 patients were included in the project and they received a ICP which included different interventions such as: integrated nursing care (105), nursing care in chronic ambulatory (55), community hospital care (9), social assistance (92), physiotherapy (88), specialist activities (114). Qualitative data highlighted high level of satisfaction both in patients and clinicians. The strengths of the Project are: 1) an integrated management (with a multi- professional team) of frailty population, 2) proactive and individualized treatment plan. Limitations are: 1) different approaches among clinicians in the Local Health Authority of Bologna with possible inequalities of accessibility to the treatment; 2) difficulties in the relationships among clinicians. The early recognition and the specialistic management of the fragile population have to be considered a priority in health practice in order to provide effective medical intervention. Key messages Individualized Care Plan (ICP) and integrated and multi-professional management. Importance of fragility early recognition.

scholarly journals Subsequent attendance in a breast cancer screening program after a false-positive result in the Local Health Authority of Bologna (Italy)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lorena Squillace ◽  
Lorenzo Pizzi ◽  
Flavia Rallo ◽  
Carmen Bazzani ◽  
Gianni Saguatti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Positive Result ◽  
Breast Cancer Screening ◽  
Health Authority ◽  
False Positive ◽  
Screening Program ◽  
Local Health Authority ◽  
Local Health ◽  
False Positive Result

AbstractWe conducted a cross-sectional study to assess the likelihood of returning for routine breast cancer screening among women who have experienced a false-positive result (FPR) and to describe the possible individual and organizational factors that could influence subsequent attendance to the screening program. Several information were collected on demographic and clinical characteristics data. Electronic data from 2014 to 2016 related to breast screening program of the Local Health Authority (LHA) of Bologna (Italy) of women between 45 and 74 years old were reviewed. A total of 4847 women experienced an FPR during mammographic screening and were recalled to subsequent round; 80.2% adhered to the screening. Mean age was 54.2 ± 8.4 years old. Women resulted to be less likely to adhere to screening if they were not-Italian (p = 0.001), if they lived in the Bologna district (p < 0.001), if they had to wait more than 5 days from II level test to end of diagnostic procedures (p = 0.001), if the diagnostic tests were performed in a hospital with the less volume of activity and higher recall rate (RR) (p < 0.001) and if they had no previous participation to screening tests (p < 0.001). Our results are consistent with previous studies, and encourages the implementation and innovation of the organizational characteristics for breast cancer screening. The success of screening programs requires an efficient indicators monitoring strategy to develop and evaluate continuous improvement processes.

scholarly journals Involving clinicians in management: assessing views of doctors and nurses on hybrid professionalism in clinical directorates

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Prenestini ◽  
Marco Sartirana ◽  
Federico Lega
Keyword(s):  
Management Practices ◽  
Healthcare Professionals ◽  
Clinical Work ◽  
Local Health Authority ◽  
Local Health ◽  
Policy Makers ◽  
Polarity Index ◽  
Validated Questionnaire ◽  
Clinical Directorates ◽  
Doctors And Nurses

Abstract Background Hybrid professionalism is one of the most effective ways to involve clinicians in management practices and responsibilities. With this study we investigated the perceptions of doctors and nurses on hybridization in clinical directorates (CDs) in hospitals. Methods We investigated the attitudes of healthcare professionals (doctors and nurses) towards eight hospital CDs in the Local Health Authority (LHA) of Bologna (Emilia Romagna, Italy) 6 years after their implementation. We used a validated questionnaire by Braithwaite and Westbrook (2004). Drawing on Palmer et al. (2007), we added a section about the characteristics of department heads. In all, 123 healthcare professionals in managerial roles completed and returned the questionnaire. The return rate was 47.4% for doctors and 31.6% for nurses. Results Doctors reported an increase in clinical governance, interdisciplinarity collaboration, and standardization of clinical work. Hybridization of practices was noted to have taken place. While doctors did not see these changes as a threat to professional values, they felt that hospital managers had taken greater control. There was a large overlap of attitudes between doctors and nurses: inter-professional integration in CDs fostered alignment of values and aims. The polarity index was higher for responses from the doctors than from the nurses. Conclusion The study findings have implications for policy makers and managers: mission and strategic mandate of CDs; governance of CDs, leadership issues; opportunities for engaging healthcare professionals; changes in managerial involvement during the COVID-19 pandemic. We also discuss the limitations of the present study and future areas for research into hybrid structures.

Peri-operative elective path optimization through algorithms in the Local Health Authority of Bologna

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Leonessi ◽  
P Tubertini ◽  
A Longanesi ◽  
E Malaguti ◽  
S Guicciardi ◽  
...  
Keyword(s):  
Mathematical Models ◽  
Health Authority ◽  
Surgical Planning ◽  
Waiting Times ◽  
Local Health Authority ◽  
Local Health ◽  
Surgical Interventions ◽  
Patient Preparation ◽  
Surgical Teams ◽  
Available Resources

Abstract Background High costs of healthcare and population ageing force the health system to constantly improve its efficiency in order to provide patients the best possible care with the available resources. In this perspective, the Local Health Authority and the University of Bologna started an experimentation to re-organize, manage and control the peri-operative elective path of general surgery, a discipline that works in a multiplatform environment according to a Hub & Spoke logic. Methods The experimentation is built on two mathematical programming models. The first one defines patient preparation appointments (i.e. diagnostic and anesthesiologic visits), harmonizing patient preparation with available resources, and planning migration from Hub to Spoke platforms, in order to optimize waiting time and facilities utilization. The second model defines weekly optimal admission plans. Both models consider the availability of resources in terms of surgical teams, operating room slots and number of beds for each operating unit. The proposed approach works on a four-week time horizon following a rolling horizon framework (weekly update) in order to effectively manage high priority patients. Results Both models have been tested on real-world instances over a six-month observation period. Overall, it was possible to increase the efficiency of surgical programming by reducing the waiting times for surgical interventions in over 20% of cases of high priority patiets in four local departments. Conclusions The proposed model represents one of the few cases in Italy of surgical programming developed through mathematical models. It will be necessary to evaluate the evolution of its effectiveness to optimize the system's ability to respond to the growing health needs of the population. Key messages Mathematical models are needed to optimize surgical planning. Efficiency of surgical planning may reduce waiting times for high priority procedures.

LOCAL-HEALTH-AUTHORITY CLINICS

The Lancet ◽  
1961 ◽  
Vol 278 (7198) ◽  
pp. 368-369 ◽  
Author(s):  
R.L. Midgley
Keyword(s):  
Health Authority ◽  
Local Health Authority ◽  
Local Health

scholarly journals An outbreak of measles in Reims, eastern France, January-March 2008 - a preliminary report

2008 ◽  
Vol 13 (13) ◽  
pp. 1-2
Author(s):  
S Thierry ◽  
S Alsibai ◽  
I Parent du Châtelet ◽  
on behalf of the investigation team
Keyword(s):  
Health Authority ◽  
Preliminary Report ◽  
Local Health Authority ◽  
Local Health

Between the end of January and 12 March 2008, 16 cases of measles were reported to the local health authority in Reims in eastern France. The outbreak has to date affected nine adults and seven children, aged from seven months to 28 years. Among these cases, 13 were biologically confirmed.

scholarly journals Investigation Into the Pharmacist’s Role in Breastfeeding Support in the “Roma B” Local Health Authority in Rome

2019 ◽  
Vol 35 (3) ◽  
pp. 91-97
Author(s):  
Romana Prosperi Porta ◽  
Maria Antonietta D’Errico ◽  
Elise M. Chapin ◽  
Isabella Sciarretta ◽  
Paolo Delaini
Keyword(s):  
Health Authority ◽  
Geographical Area ◽  
Local Health Authority ◽  
Local Health ◽  
Breastfeeding Support ◽  
Perceived Need ◽  
Health Strategy ◽  
Nursing Mothers ◽  
Fact Finding

Background: Breastfeeding is the biological norm for feeding infants and a public health strategy with such a significant impact on the health of the population in the short, medium, and long terms that it should be considered a priority. A pharmacy can be a place for breastfeeding support, since it is open 24 hours a day and is easily accessible. Objective: The main objective of our fact-finding investigation into the breastfeeding support role of pharmacists in the “Roma B” Local Health Authority was to understand how often pharmacists came into contact with nursing mothers, and if pharmacists felt the need to have a greater knowledge of issues regarding breastfeeding. Methods: This survey was done by administering 144 questionnaires (to 1 pharmacist per pharmacy) with items about the support and the protection of breastfeeding and lactation, the perceived need for specific training courses, and openness to establishing virtuous network mechanisms with stakeholders who work in breastfeeding in that geographical area. Results: Our survey shows that mothers come to pharmacies for advice about various health problems. Although pharmacists had little knowledge about breastfeeding, they were interested in participating in a training course. Ninety percent of them declared their interest in collaborating with local breastfeeding stakeholders. Conclusions: The role of the pharmacist in the protection, promotion, and support of breastfeeding has become increasingly important, along with the awareness of being competent and ethical on issues about breastfeeding.

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