[Process approach experience of university trust]. / L'importanza dell'approccio per processi: esperienza di una azienda universitaria.

This job has the scope to make to comprise the importance of the quality system applied to a complex organization describing the phases that have characterized the definition and the improvement of one organizational-managerial procedure for the prevention and the treatment of a problem of great importance in the within of the care process (ulcer pressure), demonstrating as the personnel involvement is one of change strategy used .

[Quality improvement: evolution and use of nursing records in a complex organization: the experience of Policlinico Umberto I of Rome - Italy]. / Miglioramento continuo della qualità: elaborazione ed applicazione della cartella infermieristica all'interno di un'organizzazione complessa. L'esperienza dell'azienda policlinico Unberto I di Roma.

Nursing documentation evolution is the result of an evolution of care and nurses like change of cultural and legislative type that has place, in way more growing, the patient to the center of nursing action. So it affirms that the nursing folder is the tool that allows to record, to plan, to appraise, to document and communicate patient care results, and of not smaller importance, to develop the search implementing nursing assistance turns to qualitative enhancement of the cares.

[Strategic planning: integration of training and quality. Experience at the Umberto I Polyclinic of Rome]. / Pianificazione strategica: integrazione fra formazione e qualità, l'esperienza dell'azienda policlinico umberto I di Roma.

This work shows how personnel involvement is one change strategy used in a complex organization making use of education and quality as main reorganization factors in a hospital system based on old management that didn't consider personnel as a strategy resource within a reorganizational change.

[Professional accreditation of emergency care services. Experience of the polyclinic "Umberto I" of Rome]. / L'accreditamento professionale dei servizi di Pronto Soccorso. Il percorso del Policlinico "Umberto 1o" di Roma.

Professional Accreditation can be seen as a Quality Improvement/Assurance Program for the delivery of Medical and Nursing Care, through organizational analysis to determine the level of compliance to specific criteria, correlated with satisfactory assistance processes. We report the experience of a professional accreditation process of an Emergency Department within a University Hospital in Rome, with high level assistance facilities. Voluntary interdisciplinary working groups were formed and working process was decomposed, as Quality Assurance Programs propose, so that critical points in each phase could be pointed out and hypothesis for improvements could be advanced for subsequent operative planning of changes. This method was used and applied to analyze the Emergency Department's "mission", clearing the goals of department, accordingly with the hospital's management mandate, and therefore permit the assessment of the level of compliance to quality indicators. Results of the different phases and critical analysis of all the steps are described.