Sistemi di programmazione e controllo nell’ospedale per intensità di cure: una review delle principali esperienze

Translated title of the contribution: [Autom. eng. transl.] Planning and control systems in the hospital by intensity of care: a review of the main experiences

Maria Lucia Specchia, Eugenio Anessi Pessina, Gualtiero Ricciardi, Silvio Capizzi, Andrea Poscia, E Lovato

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

[Autom. eng. transl.] INTRODUCTION: Over the last decade, healthcare organizations have been involved in profound processes of change in the organizational and institutional structure and profound interventions have been developed to review internal company operating processes, such as the implementation of clinical governance logics, adoption of Assisted diagnostic-therapeutic pathways (PDTA), adoption of models for treatment intensity. In particular, to experience the most profound changes, especially in terms of organizational set-ups, was the hospital that, in recent years, has been increasingly interested in the adoption of models based on the intensity of care that involve the hiring of patient needs as reference drivers on which to design the hospital organization, define PDTAs, organize logistics. A transformation in this sense necessarily implies a substantial redefinition of the hospital organization and therefore of the relative control programming systems, to be identified at the level of the paths that characterize the different areas of care intensity, rather than at the level of the areas themselves or at the Unit level operative. In fact, changes in organizational models and those in programming and control systems, in the light of the link between the organizational structure and operational mechanisms, must necessarily go hand in hand. In the hospital, due to the intensity of care, it varies: - the budgeting system, as the tools supporting the definition of the objectives and the actors involved are modified (production and consumption objectives vs. objectives linked to the path and process standards); - the control of permanent productive factors (PL, personnel, technologies, etc.), which is attributed to the new areas of care intensity; - the articulation of productive and economic responsibilities, which is identified at the path level. The objective of the study is to carry out a review of the literature on programming and control systems and on the methods of managing production factors in hospital structures organized by care intensity. MATERIALS AND METHODS: A review of the international and national scientific literature was conducted by querying the following databases: Pubmed, EconLit, Ebscho, Ovid. For the research strategy in scientific databases, specific research strings have been developed, including specific terms and potential synonyms. Further articles have been found with free terms, snowball strategy, reference list screening and analysis of gray literature. The research included scientific papers published starting in 2000 with the aim of analyzing programming and control systems and ways of managing production factors based on pathways / processes. RESULTS: From the initial 263 articles, 11 works were included in the review. The main strategies emerged from the analyzed works were: Activity Based Costing (ABC), Activity Based Management (ABM), Simplified Activity Based Costing (S-ABC), Time-Driven Activity-Based Costing (TDABC). The analysis of the included studies highlighted only a few examples of complete and concrete implementation of changes in the entire structure of the control system. In most cases, the realignment was only partial, resulting in a level of detection and accountability that does not completely replace the previous ones, but integrates them in part. A common element to all the experiences is the recognition of the importance of aligning new business planning and control systems with new organizational structures. The main limits for a complete implementation of the new programming and control systems based on pathways / processes are represented by resistance factors such as pol
Translated title of the contribution[Autom. eng. transl.] Planning and control systems in the hospital by intensity of care: a review of the main experiences
Original languageItalian
Title of host publicationAtti del 47° Congresso Nazionale della Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI)-Comunicazioni brevi
Pages250-251
Number of pages2
Publication statusPublished - 2014
EventCongresso Nazionale della Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI) - Riccione
Duration: 1 Oct 20144 Oct 2014

Conference

ConferenceCongresso Nazionale della Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI)
CityRiccione
Period1/10/144/10/14

Keywords

  • Health Management
  • Lean Thinking

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