Forecasting national and regional level intensive care unit bed demand during COVID-19: The case of Italy.

Given the pressure on healthcare authorities to assess whether hospital capacity allows properly responding to outbreaks such as COVID-19, there is a need for simple, data-driven methods that may provide accurate forecasts of hospital bed demand. This study applies growth models to forecast the demand for Intensive Care Unit admissions in Italy during COVID-19. We show that, with only some mild assumptions on the functional form and using short time-series, the model fits past data well and can accurately forecast demand fourteen days ahead (the mean absolute percentage error (MAPE) of the cumulative fourteen days forecasts is 7.64). The model is then applied to derive regional-level forecasts by adopting hierarchical methods that ensure the consistency between national and regional level forecasts. Predictions are compared with current hospital capacity in the different Italian regions, with the aim to evaluate the adequacy of the expansion in the number of beds implemented during the COVID-19 crisis.

Hospital safety climate and safety behavior: A social exchange perspective.

BACKGROUND: Safety climate is considered beneficial to the improvement of hospital safety outcomes. Nevertheless, the relations between two of its key constituents, namely those stemming from leader-subordinate relations and coworker support for safety, are still to be fully ascertained. PURPOSE: This article uses the theoretical lens of Social Exchange Theory to study the joint impact of leader-member exchange in the safety sphere and coworker support for safety on safety-related behavior at the hospital ward level. Social exchange constructs are further related to the existence of a shame-/blame-free environment, seen as a potential antecedent of safety behavior. RESEARCH DESIGN: A cross-sectional study including 166 inpatients in hospital wards belonging to 10 public hospitals in Italy was undertaken to test the hypotheses developed. METHODOLOGY: Hypothesized relations have been analyzed through a fully mediated multilevel structural equation model. This methodology allows studying behavior at the individual level, while keeping into account the heterogeneity among hospital specialties. FINDINGS: Results suggest that the linkage between leader support for safety and individual safety behavior is mediated by coworker support on safety issues and by the creation of a shame-free environment. PRACTICAL IMPLICATIONS: These findings call for the creation of a safety climate in which managerial efforts should be directed not only to the provision of new safety resources and the enforcement of safety rules but also to the encouragement of teamwork and freedom to report errors as ways to foster the capacity of the staff to communicate, share, and learn from each other.

How are organisational climate models and patient satisfaction related? A competing value framework approach.

Patient satisfaction has become an important indicator of process quality inside hospitals. Even so, the improvement of patient satisfaction cannot simply follow from the implementation of new incentives schemes and organisational arrangements; it also depends on hospitals' cultures and climates. This paper studies the impact of alternative models of organisational climate in hospital wards on patient satisfaction. Data gathered from seven public hospitals in Italy are used to explore this relationship. The theoretical approach adopted is the Competing Value Framework which classifies organisations according to their inward or outward focus and according to the importance assigned to control vs. flexibility. Results show that both a model stressing openness, change and innovation and a model emphasising cohesion and workers' morale are positively related to patient satisfaction, while a model based on managerial control is negatively associated with patient satisfaction.