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Volumes and results will be used to evaluate the structures for the purpose of the reorganization. The decisive elements (great novelty of the document) for the reorganization of the hospital network are the volumes of activities for specific processes and the appropriateness of hospitalizations and services. The reference measurements and estimates are those of the PNE Agenas. Within 6 months from the issue of the regulation, the threshold values for specific activity volumes, correlated to the best outcomes, and thresholds for outcome risks, will be defined by a commission composed of the Ministry of HealthRegions. In any case, the regulation identifies for the three-year period 2013-2015 (see text) some minimum thresholds for the volume of activity (for example at least 100 annual cases of heart attacks or at least 150 bypass operations) and the risk outcome thresholds (for example at least 60 % of femur surgery on over 65s within 48 hours)urgent care san antonio.
On the basis of these criteria, the Regions will have to implement the procedures for the conversion and accreditation of the hospital network.
General quality standards: clinical governance applies
The regulation highlights the need to promote and activate organizational standards according to the clinical governance model in order to guarantee assistance centered on people’s needs. Within 6 months from the issue of the regulation, the guidelines within which the hospital structures decline the dimensions of clinical governance must be established.
Standards for basic and first level
aids The standard is constituted by the documented and formal presence of systems or activities of: Clinical risk management; Evidence Based Medecine and Health Technology Assessment; Continuous evaluation and improvement of clinical activities; Health documentation, communication, information and participation of the citizen / patient; Continuous staff training.
Standards for level II principals
In addition to guaranteeing what is foreseen for level I structures, they play the role of promoting and developing methods, tools and programs to be disseminated and made available to other level I or II structures.General organizational, structural and technological standards: administrative staff maximum 7% of the total. In hospitals, the percentage ratio between the number of staff in the administrative role and the total number of staff cannot exceed 7%. Each structure is obliged to respect, with periodic checks, the contents of the national and regional guidelines in force on the quality and safety of structures. Finally, a complete computerization of procedures and services should be promoted, including the management of relationships with patients and caregivers for online monitoring and advice.
Specific standards for high specialty
For the structures that provide services in acute hospitalization, the definition of specific standards will be elaborated by a working group made up of the Ministry, Agenas, Regions and PA, within 12 months of the issue of this document.