Resource allocation criteria in a hospital.

INTRODUCTION: Allocate fixed resources among competing users is a challenge in terms of hospital management in order to obtain the best performance considering strategic objectives. In order to address this need, a system of evaluation in an important research and teaching hospital was designed. This study describes resource allocation criteria in a hospital focusing on the evaluation system and its developed application methodology. METHODS: The indicator system allows the strategic management to rapidly detect the priorities in the evaluations of the Strategic, Organizational, Managerial, Economic, Research and Qualitative conditions of each unit. The chosen indicators are expressed with three numerical values, (1 indicating critical status, 2 acceptable conditions and 3 a good operational situation). RESULTS AND DISCUSSION: The adopted evaluation system considered different thematic areas: Strategic, Organizational, Managerial, Economic, Research and Qualitative. In order to define each area, 3 fields of evaluation have been chosen. The indicators have been structured according to a pyramid system allowing creating a single indicator for each area for each unit. Furthermore, a single indicator has been fixed in order to facilitate a first consideration on whether to carry out or not closer examinations of the most critical units. This manuscript describes an attempt to define objective criteria for the allocation of scarce resources in order to achieve the hospital's strategic objectives. The indicators identified allow to obtain an overall score for each unit, which allows the management to prioritize the needs.

[Surgery for intractable epilepsy in a patient with encephalocele of the temporal lobe: a case report]. / Khirurgicheskoe lechenie farmakorezistentnoi épilepsii u patsientki s éntsefalotsele visochnoi doli (klinicheskoe nabliudenie i obzor literatury).

We describe a case of surgical treatment of intractable temporal epilepsy in a female patient with congenital middle cranial fossa encephalocele. We present clinical-anamnestic and neuroimaging data as well as the microscopic and macroscopic pictures of encephalocele. We analyze outcomes of surgery for this pathology, which have been reported in the literature. To date, there have been a few articles on this subject in the domestic literature. The development of neuroimaging techniques and a growing number of verified encephalocele cases promote the widespread use of surgery for treatment of intractable epilepsy. Congenital encephalocele should be considered in the differential diagnosis of intractable temporal epilepsy, and, if verified, surgical treatment is the method of choice in most cases.

A web-based incident reporting system: a two years' experience in an Italian research and teaching hospital.

BACKGROUND: A web-based incident reporting system (IRS) is a tool allowing healthcare workers to voluntary and anonymously report adverse events/near misses. In 2010, this system was introduced in a research and teaching hospital in metropolitan area in the North part of Italy, in order to detect errors and to learn from failures in care delivery. The aim of this paper is to assess whether and how IRS has proved to be a valuable tool to manage clinical risk and improve healthcare quality. MATERIALS AND METHODS: Adverse events are reported anonymously by staff members with the use of an online template form available in the hospital intranet. We retrospectively reviewed the recorded data for each incident/near miss reported between January 2011 and December 2012. RESULTS: The number of reported incidents/near misses was 521 in 2011 and 442 in 2012. In the two years the admissions were 36.974 and 36.107 respectively. We noticed that nursing staff made more use of IRS and that reported errors were basically related to prescription and administration of medications. CONCLUSIONS: Much international literature reports that adverse events and near misses are 10% of admissions. Our data are far from that number, thus meaning that a failure in reporting adverse events exists. This consideration, together with the high number of near misses in comparison with occurred errors, leads us to speculate that adverse events with serious consequences for patients are marginally reported. Probably the lack of a strong leadership considering IRS as an instrument for improving quality and operators' reluctance to overcome the culture of blame may negatively affect IRS.

[Investigation and comparison of behaviours of adults and children in swimming pools]. / Indagine conoscitiva e confronto dei comportamenti degli utenti adulti e bambini delle piscine.

The swimmers health's protection must be achieved through the implementation of structures that respect safety standards, the best management of the structures and the users'compliance with rules that minimize the potential risks to health, now clearly identified by the World Health Organization in specific guidelines and by the national and regional legislation. An anonymous questionnaire has been used in order to detect the level of knowledge of hygienic risks and the behaviour of costumers (adults and children) of swimming pool. Comparing the answers, statistically significant differences in the behaviours of adults and children were found in order to protect their own and others' health. In particular children do shower and go through footbath before entering the swimming pool more than adults (respectively 89.2% versus 77.4% and 89.2% versus 79.4%). No differences in the behaviours of the two groups were found in the use of dedicated footwear and caps. Children are predisposed to follow the rules because they are more loyal to duty, while adults comply with the rules only when it is clear the advantage to protect their health. This paper underline the importance of health education programs that can help people to understand the importance of adopting certain behaviours in order to prevent risks and promote health for the benefit of all.