The experience of patients with diabetes with the use of telemedicine and teleassistance services during the COVID-19 pandemic in Italy: Factors associated with perceived quality and willingness to continue.

AIM: The purpose of this study is to investigate the individual and contextual determinants of the perceived quality (PQ) of the telemedicine and teleassistance (TMTA) services and the willingness to continue (WC) with them among patients with diabetes using TMTA services during the COVID-19 pandemic in one large region of Italy. METHODS: A structured survey was administered to patients with type 1 and 2 diabetes who used TMTA during the first wave of the COVID-19 pandemic. The questionnaire contained questions on TMTA service experience and participants' socio-demographic characteristics. Multiple regression models investigated the independent factors associated with PQ and WC. RESULTS: The final analysis included 569 patients with diabetes (54.7% female), with an average age of 58.1 years. TMTA services' PQ and WC were high. A higher education and being unemployed were factors associated with an increased WC. Older age was negatively related to PQ. Perceived support from TMTA service was positively associated with PQ and WC. Perceived increase in disease self-management was positively associated with PQ and WC. CONCLUSIONS: Our study identified several determinants of PQ and WC. These socio-demographic and TMTA-related factors should be considered in the implementation of care pathways integrating in-person visits with TMTA.

Process Control Charts in Falls Prevention: The Experience of the Local Healthcare Authority of Romagna, Italy.

Patient safety is a great concern of healthcare institutions and the correct reporting and management of adverse events is a key element for supporting safety improvement efforts. Patient falls are the most frequent adverse event in hospitals and often cause serious patient outcomes. In this work, we describe the experience of the Local Healthcare Authority of Romagna, Italy that, within the framework of a quality and safety improvement programme, designed, developed and implemented a desktop application for monitoring inpatient falls. A multidisciplinary team created a software tool based on R, an open source software for statistical computing that, appropriately combined with the existing hospital information system, is used to obtain Shewhart u-control charts for monitoring the monthly fall rates. The tool had been implemented in twenty nine hospital units. The results indicate that the proposed application gave a valuable contribution in the safety improvement activities. Its usefulness extended beyond the "safety problem" as it also enabled hospital managers to identify a number of critical issues in data collection. As a result, where necessary, improvement actions had been implemented. Furthermore, the use of open source software led to a considerable cost reduction and facilitated customization of the software tool.