Come organizzare l’assistenza del paziente per di percorsi cura. L’esperienza presso la Fondazione Policlinico Universitario «Agostino Gemelli».

[Autom. eng. transl.] Process management and clinical care pathways (PCA) are winning tools for improving quality within each healthcare organization, in compliance with the logic of clinical governance. As one of the largest Italian hospitals, which has made patient centrality one of the fundamental themes of its mission, it has linked to its recent reorganization the activation of a management management model for pathways dedicated to health problems (from diagnosis at follow-up), which operate according to the logic of process management? How did this experience place this structure in a reference role at national level? The manual is conceptually divided into two sections. After a brief introduction on the need today, in the Italian and international context, to base the assistance on sustainable logics of patient centrality and appropriate care based on evidence of efficacy, the manual proposes: - an operational and flexible tool capable of support the management and operators of public and private health companies operating within the Italian National Health Service in all phases of the implementation of PCAs from their introduction into the company, to implementation, monitoring up to revision and methodological approach at the base of the instrument itself. This tool is based on a rigorous model defined at the end of a dedicated Doctoral Project, which allowed its conceptualization. Starting from this framework, a six-stage methodological approach is defined: selection of the health problem; construction of the multidisciplinary working group; analysis of the actual path and the reference path; description of the objective path; PCA implementation; monitoring and audit. Particular attention was paid to methods that support change management and improve the quality of care. Each of the crucial phases is flanked, in an agile way, by examples / experiences drawn from management in the University Hospital “A. Gemini ”, within a single health organization for the management of a specific health problem. Strengths of the results achieved derive from the fact that the tool is configured: - As a non-static but flexible operational support, able to adapt to any business context - Not specific for hospital structures, but applicable in all care settings - Non-prescriptive in none of its phases - deriving from the integration between literature and field experience The disciplinary area of reference is the organization and health policies. The editorial proposal is aimed at a wide audience. It is configured as: 1. methodological guide for the application of the proposed operational tool. In this sense, it addresses the management of public and private health structures operating within the National Health Service who are interested in implementing PCAs for the management of health problems 2. support tool in the context of degree courses at UCSC and other national universities and in postgraduate and managerial training.