Measuring and benchmarking the quality of two different organizational ways in delivering infant vaccination.

The aim of this study was the quality of service evaluation of two different organizational ways in delivering infant vaccination according to a Regional Vaccination Plan. Eleven vaccination centres were selected in two Local Health Units (ASLs) belonging to the Regional Health Service of the Lazio Region, Italy. The services offering paediatric vaccinations for children under three years of age, delivered without an appointment (VACP) or with the need for an appointment (VACL), were investigated. The quality aspects under evaluation were communicational efficiency, organisational efficiency and comfort. Subjective data were collected from different stakeholders and involve the elicitation of best and worst feasible performance conditions for the ASLs when delivering VACP/VACL services. Objective data consists in the observation of current performances of the selected vaccination centres. Quality scorecards were obtained from the combination of all data. Benchmarking between VACP and VACL, i.e., two different organisational ways in delivering infant vaccination, can be performed as a result of the probabilistic meaning of the evaluated scores. An expert of vaccination services, i.e., a virtual combination of patients, doctors and nurses, claims the quality of service delivery of the ASLs under investigation with probability 78.03% and 69.67% for VACP and VACL, respectively. In other words, for short, the quality scores of the ASLs were 78.03% for VACP and 69.67% for VACL. Furthermore our results show how to practically improve the current service delivery. The QuaVaTAR approach can result in improvements of the quality of the ASLs for the two different ways of delivering paediatric vaccinations in a simple and intuitive way.

[The plan for prevention of obesity of ASL RMB, Italy]. / Prevenzione dell'Obesità: l'esperienza del piano attuativo aziendale per la prevenzione dell'obesità in una ASL romana.

Lazio District, by pointing out the guidelines of the "Obesity and Overweight for Lazio District Plan" (DGR no1166, 23/12/05), enacts the "National Prevention Plan 2005-2007". The Public Health Service for Food and Nutrition has been the main player of the Plan; the District and Department of Health of the District had a technical and organizational support role. Within the development of the Plan for prevention of obesity of ASL RMB, a technical multidisciplinary group was constituted and three more programs were developed, all of them were dedicated to promotion and support of breast-feeding, prevention of obesity and overweight in childhood and adulthood. The educational activity concerning promotion and support of breast-feed ing actively involved operators from consultory rooms and hospital staff from ASL. The reports about nutritional surveillance allowed a careful analysis of the service conditions and priorities. Special criticality facets have been pointed out such as the high prevalence of overweight (31%) and obesity (7%), the habit of skipping breakfast, a low fruit and vegetables consumption, a generally sedentary lifestyle and, during the intervention, the parents' low involvement. In geriatric age cases, a high malnutrition risk both for overnutrition and undernutrition was found in the elderly groups that were checked; the diets' nutritional density as well as the physical activity aspect recover an important role in the intervention planning. Moreover the discussions with catering companies were an important aspect in order to make several target groups aware. The globally considered experience highlighted positive elements of mobilization, consensus, reorientation of activities and resources, giving proof of the significance of integration concerning specifical aims of different company services. Nevertheless, the carrying on of such activities needs resource investments in the specifical area and enlargement of activities especially for the multisector-based efforts.