Keywords
Covid-19
Quality management
Local health
Digital healthcare
Recovery Plan
Quality management
Local health
Digital healthcare
Recovery Plan
Abstract
Introduction: The Covid-19 pandemic represented an unprecedented challenge for the healthcare world and the introduction of a new stronger and believable project plays a fundamental role for the quality of work and the provision of qualitative care.
Aim: The survey provided by ASIQUAS aims to examines the impact of “Health” chapter included in the Recovery Plan, through the assessment of management quality of the Covid-19 pandemic.
Methods: Starting from a literature review, in September 2021, a web-based survey has been conducted and administered by email.
It has been taken into account measures widely used by different healthcare structures in order to analyze the projects implemented in the face of pandemic and to evaluate the new real possibility to invest funds in new healthcare structures and projects.
Results:
The survey consists of 19 multiple choices and respondents were from different types of structures, including regional departments and regional health agencies (1.4%), universities, research centers and IRCCS (11%), hospitals and university polyclinics (34.2%), Local Health Authorities (39.7%), socio-health organizations and Others (13,7%).
The pandemic has highlighted many vulnerabilities at both hospitals and territorial level. The major weaknesses revealed by the survey are mainly due to.the lack of support from new staff units and poor availability of specific training tools for Covid-19 procedures.
The Recovery Plan is still unclear with a lot of concern about the implementation and many limits of diffusion.
Conclusions: It becomes essential to guarantee a new effective and interoperative model of integration.
Today we can start more aware for the implementation of a system closer to everyone’s needs, making shortcomings the new strength and starting point.
References
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4. Titolo V- Le regioni, le Province e i Comuni, available from: https://www.governo.it/it/costituzione-italiana/parte-seconda-ordinamento-della-repubblica/titolo-v-le-regionile-province-e-i
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7. Geddes da Filicaia, M. A different territorial health is possible!. Epidemiol Prev. 2021 Nov-Dec.
8. Gazzetta Ufficiale della Repubblica italiana. DM 71 – Modelli e standard per lo sviluppo dell’Assistenza Territoriale nel Servizio Sanitario Nazionale.
9. McLaney, E., Morassaei, S., Hughes, L., Davies, R., Campbell, M., Di Prospero, L.. A framework for interprofessional team collaboration in a hospital setting: Advancing team competencies and behaviours. Healthc Manage Forum. 2022 Mar;35(2):112-117. doi: 10.1177/08404704211063584. Epub 2022 Jan 20. PMID: 35057649; PMCID: PMC8873279.
10. Langlois, S. Collective competence: Moving from individual to collaborative expertise. Perspect Med Educ 9, 71–73 (2020). https://doi.org/10.1007/s40037-020-00575-3.
11. As.I.Qu.A.S. (“Associazione Italiana per la Qualità dell’Assistenza Sanitaria e Sociale”). Available from: https://www.asiquas.it/
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14. De Kock, J.H., Latham, H.A., Leslie, S.J. et al. A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health 21, 104 (2021). https://doi.org/10.1186/s12889-020-10070-3
15. Cicchetti A., Di Brino E. Analisi dei modelli di risposta al Covid-19 in Italia: Report ALTEMS 2020, Università Cattolica del Sacro Cuore (Milano). Available from: https://altems.unicatt.it/altems-INSTANT%20REPORT%20ALTEMS%20ANNUALE%20-%202020_finale.pdf
16. Lasalvia, A., Amaddeo, F., Porru, S., Carta, A., Tardivo, S., Bovo, C., Ruggeri, M., Bonetto, C. Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy. BMJ Open. 2021 Jan 17
17. Hoogendoorn, ME., Brinkman, S., Bosman, RJ., Haringman, J., de Keizer, NF., Spijkstra, JJ. The impact of COVID-19 on nursing workload and planning of nursing staff on the Intensive Care: A prospective descriptive multicenter study. Int J Nurs Stud. 2021 Sep;121:104005. doi: 10.1016/j.ijnurstu.2021.104005. Epub 2021 Jun 21. PMID: 34273806; PMCID: PMC8215878.
18. Tsonis, O., Diakaki, K., Gkrozou, F., Papadaki, A., Dimitriou, E., Paraskevaidis, M., Kyrgiou, M., Paraskevaidis, E., Paschopoulos, M., Tsapakis, EM., Siafaka, V. Psychological burden of covid-19 health crisis on health professionals and interventions to minimize the effect: what has history already taught us? Riv Psichiatr. 2021 Jan-Feb;56(2):57-63. doi: 10.1708/3594.35763. PMID: 33899826.
19. De Kock, JH., Latham, HA., Leslie, SJ., Grindle, M., Munoz, SA., Ellis, L., Polson, R., O'Malley, CM. A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health. 2021 Jan 9;21(1):104. doi: 10.1186/s12889-020-10070-3. PMID: 33422039; PMCID: PMC7794640.
20. Piano Nazionale di Ripresa e Resilienza, available from: https://www.governo.it/sites/governo.it/files/PNRR.pdf
21. Filippini, T., Vinceti, SR. Italian National Recovery and Resilience Plan: a Healthcare Renaissance after the COVID-19 crisis? Acta Biomed. 2021 Nov 17;92(S6):e2021463. doi: 10.23750/abm.v92iS6.12339. PMID: 34787594; PMCID: PMC8851004
22. Plan National de Relance et de Résilience, available from:
https://www.economie.gouv.fr/files/files/directions_services/plan-de-relance/PNRR%20Francais.pdf
23. Denmark's Recovery and Resilience Plan, available from:
https://en.fm.dk/media/18774/denmarks-recovery-and-resilience-plan-accelerating-the-green-transition_web.pdf
24. Plan the Recuperación,transformación y resiliencia, available from:
https://www.lamoncloa.gob.es/temas/fondos-recuperacion/Documents/160621-Plan_Recuperacion_Transformacion_Resiliencia.pdf.
25. True numbers, available from: https://www.truenumbers.it/pnrr-europa/
26. PNRR e Parlamenti in Europa: i casi di Italia, Francia, Germania e Spagna Servizio Studi del Senato, March, 2021 DOC. Doc. XXVII, n. 18, available from: https://www.senato.it/service/PDF/PDFServer/BGT/01209487.pdf
27. Sanità e territorio, i servizi socio-sanitari dei comuni italiani. Available from: https://www.quotidianosanita.it/allegati/allegato6570262.pdf
28. “Gemelli a Casa”, il nuovo servizio di Assistenza Domiciliare del Policlinico Gemelli, Oct 30, 2019. Available from: https://www.policlinicogemelli.it/news-eventi/nasce-gemelli-a-casa-il-nuovo-servizio-di-assistenza-domiciliare-del-policlinico-gemelli/
29. Dalal, AK., Dykes, P., Samal, L., et al. Potential of an Electronic Health Record-Integrated Patient Portal for Improving Care Plan Concordance during Acute Care. Appl Clin Inform. 2019;10(3):358-366. doi:10.1055/s-0039-1688831.
30. de Belvis, AG. Lonoce, N., Banchieri, G., Di Stanislao, F. Implementazione di percorsi assistenziali come strumenti di miglioramento della qualità nelle Aziende Ospedaliere e Aziende Sanitarie Locali per far fronte alle epidemie di Covid-19. Rivista QA. 2021.
31. FNOPI estimates based on Oms/Istat/Eurostat data for the population of chronically ill/non-self-sufficient persons and the quantification of hospital staff according to EU regulations and international parameters.
32. Assist Inferm Ric. Nurses and the new reform: is there space and resources for nursing care? 2021 Apr-Jun;40(2):92-100. Italian. doi: 10.1702/3634.36147. PMID: 34180912.).
33. Eurostat database (data referring to the year 2017 or closer).
34. Data extracted on Mar 21, 2022 (ISTAT)
35. Nursing fact sheet, FNOPI (Federazione Nazionale Ordini Professioni Infermieristiche). Available from: https://www.fnopi.it/wp-content/uploads/2021/05/SCHEDA-INFERMIERI-12-maggio.pdf
36. Kjeld Møller Pedersen, John Sahl Andersen, Jens Søndergaard.General Practice and Primary Health Care in Denmark. The Journal of the American Board of Family Medicine Mar 2012, 25 (Suppl 1) S34-S38; DOI: 10.3122/jabfm.2012.02.110216
37. Weißenfeld, M.M., Goetz, K. & Steinhäuser, J. Facilitators and barriers for the implementation of telemedicine from a local government point of view - a cross-sectional survey in Germany. BMC Health Serv Res 21, 919 (2021). https://doi.org/10.1186/s12913-021-06929-9
38. Osservatorio Innovazione Digitale in sanità 2021: un mercato da 1,5 miliardi. Available from: https://www.zerounoweb.it/cio-innovation/pa-digitale/osservatorio-innovazione-digitale-in-sanita-2021-un-mercato-da-15-miliardi/
39. Anessi Pessina, E., Cicchetti, A., Spandonaro, F.,Polistena, B., D’Angela, D.,Masella, C.,Costa, G.,Nuti,S.,Vola, Vainieri, M.,Compagni, A., Fattore, G., Longo, F., Bobini, M.,Meda F.,Buongiorno Sottoriva, C. “Proposte per l’attuazione del PNRR in sanità: governance, riparto, fattori abilitanti e linee realizzative delle missioni”. https://altems.unicatt.it/altems-Proposte%2-0attuazione%20PNRR.pdf. May,2021.
40. Banchieri, G. “Nulla sarà come prima…a proposito del Pnrr in Sanità”. Quotidianosanità. Oct. 2021, available from: https://www.quotidianosanita.it/studi-e-analisi/articolo.php?articolo_id=99345
41. Goldberg, E.M., Lin, M.P., Burke, L.G. et al. Perspectives on Telehealth for older adults during the COVID-19 pandemic using the quadruple aim: interviews with 48 physicians. BMC Geriatr 22, 188 (2022). https://doi.org/10.1186/s12877-022-02860-8
42. Russo, L., Campagna, I., Ferretti, B. et al. What drives attitude towards telemedicine among families of pediatric patients? A survey. BMC Pediatr 17, 21 (2017). DOI 10.1186/s12887-016-0756-x
43. Panicacci, S., Donati, M., Lubrano, A., Vianello, A., Ruiu, A., Melani, L., Tomei, A., Fanucci, L. Telemonitoring in the Covid-19 Era: The Tuscany Region Experience. Healthcare (Basel). 2021 Apr 29;9(5):516. doi: 10.3390/healthcare9050516. PMID: 33946633; PMCID: PMC8145703
44. Capozzo R, Zoccolella S, Musio M, Barone R, Accogli M, Logroscino G. Telemedicine is a useful tool to deliver care to patients with Amyotrophic Lateral Sclerosis during COVID-19 pandemic: results from Southern Italy. Amyotroph Lateral Scler Frontotemporal Degener. 2020 Nov;21(7-8):542-548. doi: 10.1080/21678421.2020.1773502. Epub 2020 Jun 12. PMID: 32530314.
2. Fabiani, M. et al. Il case fatality rate dell’infezione SARS-CoV-2 a livello regionale e attraverso le differenti fasi dell’epidemia in Italia [The case fatality rate of SARS-CoV-2 infection at regional level, through the different epidemic phases in Italy] (2021).
3. Università Cattolica, Osservatorio Nazionale sulla Salute nelle Regioni Italiane. Il Covid non uccide ovunque allo stesso modo, differenze di quasi 5 volte tra alcune Regioni in Italia. https://www.osservatoriosullasalute.it/wpcontent/uploads/2020/12/FOCUS-COVID_dicembre.pdf.
4. Titolo V- Le regioni, le Province e i Comuni, available from: https://www.governo.it/it/costituzione-italiana/parte-seconda-ordinamento-della-repubblica/titolo-v-le-regionile-province-e-i
5. Banchieri, G. “Il PNRR e i distretti socio sanitari. Cosa Cambierà?”. Quotidianosanità.it. 2021.
6. Marino, D. Sanità territoriale e gestione della crisi da Covid-19: le regioni italiane e il caso Lombardia. 2020.
7. Geddes da Filicaia, M. A different territorial health is possible!. Epidemiol Prev. 2021 Nov-Dec.
8. Gazzetta Ufficiale della Repubblica italiana. DM 71 – Modelli e standard per lo sviluppo dell’Assistenza Territoriale nel Servizio Sanitario Nazionale.
9. McLaney, E., Morassaei, S., Hughes, L., Davies, R., Campbell, M., Di Prospero, L.. A framework for interprofessional team collaboration in a hospital setting: Advancing team competencies and behaviours. Healthc Manage Forum. 2022 Mar;35(2):112-117. doi: 10.1177/08404704211063584. Epub 2022 Jan 20. PMID: 35057649; PMCID: PMC8873279.
10. Langlois, S. Collective competence: Moving from individual to collaborative expertise. Perspect Med Educ 9, 71–73 (2020). https://doi.org/10.1007/s40037-020-00575-3.
11. As.I.Qu.A.S. (“Associazione Italiana per la Qualità dell’Assistenza Sanitaria e Sociale”). Available from: https://www.asiquas.it/
12. Lasalvia, A., Amaddeo, F., Porru, S., Carta, A., Tardivo, S., Bovo, C., Ruggeri, M., Bonetto, C. Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy. BMJ Open. 2021 Jan 17;11(1):e045127. doi: 10.1136/bmjopen-2020-045127. PMID: 33455940; PMCID: PMC7813385.
13. Shreffler, J., Petrey, J., Huecker, M.. The Impact of COVID-19 on Healthcare Worker Wellness: A Scoping Review. West J Emerg Med. 2020 Aug 17;21(5):1059-1066. doi: 10.5811/westjem.2020.7.48684.
14. De Kock, J.H., Latham, H.A., Leslie, S.J. et al. A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health 21, 104 (2021). https://doi.org/10.1186/s12889-020-10070-3
15. Cicchetti A., Di Brino E. Analisi dei modelli di risposta al Covid-19 in Italia: Report ALTEMS 2020, Università Cattolica del Sacro Cuore (Milano). Available from: https://altems.unicatt.it/altems-INSTANT%20REPORT%20ALTEMS%20ANNUALE%20-%202020_finale.pdf
16. Lasalvia, A., Amaddeo, F., Porru, S., Carta, A., Tardivo, S., Bovo, C., Ruggeri, M., Bonetto, C. Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy. BMJ Open. 2021 Jan 17
17. Hoogendoorn, ME., Brinkman, S., Bosman, RJ., Haringman, J., de Keizer, NF., Spijkstra, JJ. The impact of COVID-19 on nursing workload and planning of nursing staff on the Intensive Care: A prospective descriptive multicenter study. Int J Nurs Stud. 2021 Sep;121:104005. doi: 10.1016/j.ijnurstu.2021.104005. Epub 2021 Jun 21. PMID: 34273806; PMCID: PMC8215878.
18. Tsonis, O., Diakaki, K., Gkrozou, F., Papadaki, A., Dimitriou, E., Paraskevaidis, M., Kyrgiou, M., Paraskevaidis, E., Paschopoulos, M., Tsapakis, EM., Siafaka, V. Psychological burden of covid-19 health crisis on health professionals and interventions to minimize the effect: what has history already taught us? Riv Psichiatr. 2021 Jan-Feb;56(2):57-63. doi: 10.1708/3594.35763. PMID: 33899826.
19. De Kock, JH., Latham, HA., Leslie, SJ., Grindle, M., Munoz, SA., Ellis, L., Polson, R., O'Malley, CM. A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being. BMC Public Health. 2021 Jan 9;21(1):104. doi: 10.1186/s12889-020-10070-3. PMID: 33422039; PMCID: PMC7794640.
20. Piano Nazionale di Ripresa e Resilienza, available from: https://www.governo.it/sites/governo.it/files/PNRR.pdf
21. Filippini, T., Vinceti, SR. Italian National Recovery and Resilience Plan: a Healthcare Renaissance after the COVID-19 crisis? Acta Biomed. 2021 Nov 17;92(S6):e2021463. doi: 10.23750/abm.v92iS6.12339. PMID: 34787594; PMCID: PMC8851004
22. Plan National de Relance et de Résilience, available from:
https://www.economie.gouv.fr/files/files/directions_services/plan-de-relance/PNRR%20Francais.pdf
23. Denmark's Recovery and Resilience Plan, available from:
https://en.fm.dk/media/18774/denmarks-recovery-and-resilience-plan-accelerating-the-green-transition_web.pdf
24. Plan the Recuperación,transformación y resiliencia, available from:
https://www.lamoncloa.gob.es/temas/fondos-recuperacion/Documents/160621-Plan_Recuperacion_Transformacion_Resiliencia.pdf.
25. True numbers, available from: https://www.truenumbers.it/pnrr-europa/
26. PNRR e Parlamenti in Europa: i casi di Italia, Francia, Germania e Spagna Servizio Studi del Senato, March, 2021 DOC. Doc. XXVII, n. 18, available from: https://www.senato.it/service/PDF/PDFServer/BGT/01209487.pdf
27. Sanità e territorio, i servizi socio-sanitari dei comuni italiani. Available from: https://www.quotidianosanita.it/allegati/allegato6570262.pdf
28. “Gemelli a Casa”, il nuovo servizio di Assistenza Domiciliare del Policlinico Gemelli, Oct 30, 2019. Available from: https://www.policlinicogemelli.it/news-eventi/nasce-gemelli-a-casa-il-nuovo-servizio-di-assistenza-domiciliare-del-policlinico-gemelli/
29. Dalal, AK., Dykes, P., Samal, L., et al. Potential of an Electronic Health Record-Integrated Patient Portal for Improving Care Plan Concordance during Acute Care. Appl Clin Inform. 2019;10(3):358-366. doi:10.1055/s-0039-1688831.
30. de Belvis, AG. Lonoce, N., Banchieri, G., Di Stanislao, F. Implementazione di percorsi assistenziali come strumenti di miglioramento della qualità nelle Aziende Ospedaliere e Aziende Sanitarie Locali per far fronte alle epidemie di Covid-19. Rivista QA. 2021.
31. FNOPI estimates based on Oms/Istat/Eurostat data for the population of chronically ill/non-self-sufficient persons and the quantification of hospital staff according to EU regulations and international parameters.
32. Assist Inferm Ric. Nurses and the new reform: is there space and resources for nursing care? 2021 Apr-Jun;40(2):92-100. Italian. doi: 10.1702/3634.36147. PMID: 34180912.).
33. Eurostat database (data referring to the year 2017 or closer).
34. Data extracted on Mar 21, 2022 (ISTAT)
35. Nursing fact sheet, FNOPI (Federazione Nazionale Ordini Professioni Infermieristiche). Available from: https://www.fnopi.it/wp-content/uploads/2021/05/SCHEDA-INFERMIERI-12-maggio.pdf
36. Kjeld Møller Pedersen, John Sahl Andersen, Jens Søndergaard.General Practice and Primary Health Care in Denmark. The Journal of the American Board of Family Medicine Mar 2012, 25 (Suppl 1) S34-S38; DOI: 10.3122/jabfm.2012.02.110216
37. Weißenfeld, M.M., Goetz, K. & Steinhäuser, J. Facilitators and barriers for the implementation of telemedicine from a local government point of view - a cross-sectional survey in Germany. BMC Health Serv Res 21, 919 (2021). https://doi.org/10.1186/s12913-021-06929-9
38. Osservatorio Innovazione Digitale in sanità 2021: un mercato da 1,5 miliardi. Available from: https://www.zerounoweb.it/cio-innovation/pa-digitale/osservatorio-innovazione-digitale-in-sanita-2021-un-mercato-da-15-miliardi/
39. Anessi Pessina, E., Cicchetti, A., Spandonaro, F.,Polistena, B., D’Angela, D.,Masella, C.,Costa, G.,Nuti,S.,Vola, Vainieri, M.,Compagni, A., Fattore, G., Longo, F., Bobini, M.,Meda F.,Buongiorno Sottoriva, C. “Proposte per l’attuazione del PNRR in sanità: governance, riparto, fattori abilitanti e linee realizzative delle missioni”. https://altems.unicatt.it/altems-Proposte%2-0attuazione%20PNRR.pdf. May,2021.
40. Banchieri, G. “Nulla sarà come prima…a proposito del Pnrr in Sanità”. Quotidianosanità. Oct. 2021, available from: https://www.quotidianosanita.it/studi-e-analisi/articolo.php?articolo_id=99345
41. Goldberg, E.M., Lin, M.P., Burke, L.G. et al. Perspectives on Telehealth for older adults during the COVID-19 pandemic using the quadruple aim: interviews with 48 physicians. BMC Geriatr 22, 188 (2022). https://doi.org/10.1186/s12877-022-02860-8
42. Russo, L., Campagna, I., Ferretti, B. et al. What drives attitude towards telemedicine among families of pediatric patients? A survey. BMC Pediatr 17, 21 (2017). DOI 10.1186/s12887-016-0756-x
43. Panicacci, S., Donati, M., Lubrano, A., Vianello, A., Ruiu, A., Melani, L., Tomei, A., Fanucci, L. Telemonitoring in the Covid-19 Era: The Tuscany Region Experience. Healthcare (Basel). 2021 Apr 29;9(5):516. doi: 10.3390/healthcare9050516. PMID: 33946633; PMCID: PMC8145703
44. Capozzo R, Zoccolella S, Musio M, Barone R, Accogli M, Logroscino G. Telemedicine is a useful tool to deliver care to patients with Amyotrophic Lateral Sclerosis during COVID-19 pandemic: results from Southern Italy. Amyotroph Lateral Scler Frontotemporal Degener. 2020 Nov;21(7-8):542-548. doi: 10.1080/21678421.2020.1773502. Epub 2020 Jun 12. PMID: 32530314.