The correct setting to improve the quality of health care process: a retrospective study in Internal Medicine Department
The definition of the role of hospitals and communities in terms of the response to patients’ health care needs is essential in the Lombardy region health-care reform development (LR. 23/2015). The stratification of patients according to clinical severity and care complexity for adequate clinical he...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2018-12-01
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| Series: | Italian Journal of Medicine |
| Subjects: | |
| Online Access: | https://www.italjmed.org/index.php/ijm/article/view/1035 |
| _version_ | 1797427831408427008 |
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| author | Filomena Pietrantonio Paola Aperti Luca Tonoli Elaine Tyndall Orietta Meneghetti |
| author_facet | Filomena Pietrantonio Paola Aperti Luca Tonoli Elaine Tyndall Orietta Meneghetti |
| author_sort | Filomena Pietrantonio |
| collection | DOAJ |
| description | The definition of the role of hospitals and communities in terms of the response to patients’ health care needs is essential in the Lombardy region health-care reform development (LR. 23/2015). The stratification of patients according to clinical severity and care complexity for adequate clinical health care, is achieved by delineating care settings, staff standards, required technical equipment and crucial aspects of clinical pathways. An observational and retrospective study at Manerbio Hospital Internal Medicine Unit (IMU) was carried out to define: i) characteristics of IMU patients; ii) role of IMU physician in management of poly-pathological patients; iii) alternative organizational models. After a Literature review, clinical severity was defined by modifying early warning score, complexity and co-morbidities by cumulative illness rating scale (CIRS) and by intensity of care through care intensity index (IIA). All medical records of patients admitted in the first quarter of 2016 were analyzed. A total of 393 medical records were examined: 199 M/194 F, median age 81 years. Critical patients (requiring continuous monitoring using advanced equipment): 27% of the sample (10% with intensive care transfer criteria). Co-morbidity: between 5 and 6 active diseases for most of the sample; 53% with CIRS between 7 and 12. Elevated care intensity (IIA) was found in 46% of the sample, remaining constant throughout hospital stay. Medium stay: 9.35 days. 27% of IMU patients needs subintensive care. About a quarter of patients has unresolved social problems contributing to acute presentations in the emergency room. Agreement on appropriate links between hospital and community care structures is advisable to reduce hospital stay, adequately responding to patients’ needs. |
| first_indexed | 2024-03-09T08:49:31Z |
| format | Article |
| id | doaj.art-f667c003562e48d68bce220656fd649f |
| institution | Directory Open Access Journal |
| issn | 1877-9344 1877-9352 |
| language | English |
| last_indexed | 2024-03-09T08:49:31Z |
| publishDate | 2018-12-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Italian Journal of Medicine |
| spelling | doaj.art-f667c003562e48d68bce220656fd649f2023-12-02T14:43:24ZengPAGEPress PublicationsItalian Journal of Medicine1877-93441877-93522018-12-0112410.4081/itjm.2018.1035The correct setting to improve the quality of health care process: a retrospective study in Internal Medicine DepartmentFilomena Pietrantonio0Paola Aperti1Luca Tonoli2Elaine Tyndall3Orietta Meneghetti4Internal Medicine Unit, Manerbio Hospital, ASST-Garda, Manerbio (BS)Registered Nurse, Brescia University, Nursing School, BresciaNurse, UPS, Manerbio Hospital, ASST-Garda, Manerbio (BS)Medical Doctor, Villa Stuart, RomeInternal Medicine Unit, Manerbio Hospital, ASST-Garda, Manerbio (BS)The definition of the role of hospitals and communities in terms of the response to patients’ health care needs is essential in the Lombardy region health-care reform development (LR. 23/2015). The stratification of patients according to clinical severity and care complexity for adequate clinical health care, is achieved by delineating care settings, staff standards, required technical equipment and crucial aspects of clinical pathways. An observational and retrospective study at Manerbio Hospital Internal Medicine Unit (IMU) was carried out to define: i) characteristics of IMU patients; ii) role of IMU physician in management of poly-pathological patients; iii) alternative organizational models. After a Literature review, clinical severity was defined by modifying early warning score, complexity and co-morbidities by cumulative illness rating scale (CIRS) and by intensity of care through care intensity index (IIA). All medical records of patients admitted in the first quarter of 2016 were analyzed. A total of 393 medical records were examined: 199 M/194 F, median age 81 years. Critical patients (requiring continuous monitoring using advanced equipment): 27% of the sample (10% with intensive care transfer criteria). Co-morbidity: between 5 and 6 active diseases for most of the sample; 53% with CIRS between 7 and 12. Elevated care intensity (IIA) was found in 46% of the sample, remaining constant throughout hospital stay. Medium stay: 9.35 days. 27% of IMU patients needs subintensive care. About a quarter of patients has unresolved social problems contributing to acute presentations in the emergency room. Agreement on appropriate links between hospital and community care structures is advisable to reduce hospital stay, adequately responding to patients’ needs.https://www.italjmed.org/index.php/ijm/article/view/1035Clinic intensitycare complexityacute internal medicine caremodified early warning scorecumulative illness rating scale and care intensity index scores. |
| spellingShingle | Filomena Pietrantonio Paola Aperti Luca Tonoli Elaine Tyndall Orietta Meneghetti The correct setting to improve the quality of health care process: a retrospective study in Internal Medicine Department Italian Journal of Medicine Clinic intensity care complexity acute internal medicine care modified early warning score cumulative illness rating scale and care intensity index scores. |
| title | The correct setting to improve the quality of health care process: a retrospective study in Internal Medicine Department |
| title_full | The correct setting to improve the quality of health care process: a retrospective study in Internal Medicine Department |
| title_fullStr | The correct setting to improve the quality of health care process: a retrospective study in Internal Medicine Department |
| title_full_unstemmed | The correct setting to improve the quality of health care process: a retrospective study in Internal Medicine Department |
| title_short | The correct setting to improve the quality of health care process: a retrospective study in Internal Medicine Department |
| title_sort | correct setting to improve the quality of health care process a retrospective study in internal medicine department |
| topic | Clinic intensity care complexity acute internal medicine care modified early warning score cumulative illness rating scale and care intensity index scores. |
| url | https://www.italjmed.org/index.php/ijm/article/view/1035 |
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