Management of Healthcare Processes Based on Measurement and Evaluation: Changing the Policy in an Italian Teaching Hospital

Management of Healthcare Processes Based on Measurement and Evaluation: Changing the Policy in an Italian Teaching Hospital

Ulrich Wienand (Head of Research Innovation Quality and Accreditation Office, Ferrara University Hospital, Ferrara, Italy), Gabriele Rinaldi (Director-General, Ferrara University Hospital, Ferrara, Italy), Gloria Gianesini (Orthopaedics Unit, Ferrara University Hospital, Ferrara, Italy), Anna Ferrozzi (Management Engineer, Research Innovation Quality and Accreditation Office, Ferrara University Hospital, Ferrara, Italy), Luca Poretti (Founder and CEO, XPSoft.it, Ferrara, Italy), Giorgia Valpiani (Statistician, Research Innovation Quality and Accreditation Office, Ferrara University Hospital, Ferrara, Italy) and Adriano Verzola (Head of Performance Analysis and Programming Office, Ferrara University Hospital, Ferrara, Italy)
Copyright: © 2014 |Pages: 21
DOI: 10.4018/ijrqeh.2014040102
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Abstract

Clinical management and care outcome measures, which are now becoming mandatory in more and more countries, can influence the quality of care if they are relevant, evidence-based, carefully crafted and subjected to periodical quality review. Over a period of 13 years, a large Italian teaching hospital has used this framework to develop a performance measurement system, comprising a total of 768 internal and 67 external measures, with a view to improving service provision and accountability. The web-based performance measurement system does have a cost in terms of staffing and technological requirements, but the integration of the data it provides into the decision-making process can have a considerable impact on performance, and therefore quality of care.
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Background

The Ferrara University Hospital Trust is a public healthcare provider based at the “Sant’Anna” Hospital situated in the Emilia-Romagna region of northern Italy. It employs 2,628 members of staff, comprising 476 physicians, and trains graduate and post-graduate students from the affiliated University of Ferrara School of Medicine. The hospital itself houses 626 beds for inpatients and 85 for those receiving day-hospital care – in 2013 there were 19,406 admissions (excluding healthy newborns) and 7,029 day-hospital patients.

In the spring of 2001, the hospital performed a thorough self-audit, prompted by the sudden availability of theories and tools for self-assessment (EFQM, 1999a, 1999b). This process had its cultural background in 1997, when the Emilia-Romagna Regional Administration began putting together an accreditation system for healthcare structures and funding local Continuous Quality Improvement projects. It was also fuelled by the creation of new national databases to collect clinical data in various medical fields, namely the Joint Replacement Register, the ICU national database, the Heart Surgery Register (REAL), among others.

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