COVID-19 emergency: from a general hospital to a covid hospital in one week, an Italian experience.

Abstract: Aim of this letter is to describe the reconversion process of our general hospital, in just one week, into a COVID-19 Hospital. The working strategy allowed to quickly find the spaces, identify the working group, reshape the hospital organizational structure, redesign the flows and patient/health workers pathways. The hospital provided for a progressive activation of COVID-19 beds following the philosophy of the intensity of care. The main results were on management, flows, PPE and hygiene areas. Although some problems came out in the beginning, this fast hospital reconversion model may be replicated in the future to face similar epidemic or pandemic outbreaks.

Quality improvement of medical records through internal auditing: a comparative analysis.

INTRODUCTION: The systematic evaluation of the quality of medical records is crucial. Nevertheless, even if the improvement of medical records quality represents a priority for every health organization, it might be difficult to realize.This is the first study to assess the efficacy of internal audit as a tool to improve the quality of medical records in hospital setting. METHODS: The program was carried out in a third level teaching hospital. Trained ad hoc evaluation teams carried out two retrospective assessments of quality of medical records using a random sampling strategy. The quality assessment was performed using a 48-items evaluation grid divided into 9 domains: General; Patient Medical History and Physical Examination; Daily Clinical Progress Notes; Daily Nursing Progress Notes; Drug Therapy Chart; Pain Chart; Discharge Summary; Surgery Register; Informed Consent. After the first evaluation of 1.460 medical records, an audit departmental program was set up. The second evaluation was carried out after the internal auditing for 1.402 medical records. RESULTS: Compared to the first analysis, a significant quality amelioration in all the sections of the medical chart was shown with the second analysis, with an increase of all the scores above 50%. The differences found for each section of medical records between the first and second analysis are all significant (p<0.01). CONCLUSIONS: Internal audits are not just measurement activities but a necessary activity to support the organization in achieving its objectives and assessing the quality of clinical care and maintaining high quality professional performance.

Factors influencing quality of life for disabled and nondisabled elderly population: the results of a multiple correspondence analysis.

Objectives. The aim of our study is to examine the role of some factors (sociodemographic patterns, social relationship support, and trust in healthcare actors) on structure of quality of life among the Italian elderly population, by stratifying according to presence or absence of disability. Methods. Using data of the Italian National Institute of Statistics (ISTAT) survey, we obtained a sample of 25,183 Italian people aged 65+ years. Multiple Correspondence Analysis (MCA) was used to test such a relationship. Results. By applying the MCA between disabled and nondisabled elderly population, we identified three dimensions: "demographic structure and social contacts," "social relationships," "trust in the Italian National Health Services (INHS)." Furthermore, the difference in trust on the INHS and its actors was seen among disabled and non-disabled elderly population. Conclusions. Knowledge on the concept of quality of life and its application to the elderly population either with or without disability should make a difference in both people's life and policies and practices affecting life. New domains, such as information and trusting relationships both within and towards the care network's nodes, are likely to play an important role in this relationship.

[To be in rapport with patients: the valence and significance of social skills in nursing]. / Rapportarsi ai pazienti: valenza e significato delle abilità sociali nel nursing.

In four wards of a large specialized orthopedic hospital in Bologna a self-administered questionnaire has been distributed to 34 nurses and 70 patients to investigate on one side, the representation which nurses have of patients' needs and the difficulties met in their work, on the other side the representation which patients have of the care they receive and of the difficulties they have in their relationship with nurses. Nurses give principal importance to those activities which contribute to the development of a good relationship with the patients. There is however a clear gap between the degree of awareness of the principles and their implementation, possibly as a consequence of the work organization. Some model situations are examined and discussed (e.g. the time allowed for dialogue, which is confined to ten minutes).