[A critical analysis of the degree of care humanization in the Hospitals of the Provincia Romana San Giovanni di Dio Fatebenefratelli (FBF)]. / Valutazione del grado di Umanizzazione: una indagine critica condotta negli Ospedali della Provincia Romana Fatebenefratelli.

In the Hospitals of the Ordine della Provincia Romana San Giovanni di Dio Fatebenefratelli (FBF) (consisting of four hospitals located in three Italian regions) Patient Centeredness has always been considered a central point. In 2015, the Central Hospitals' Health Direction decided to use a check-list for the evaluation of the degree of Patient Centered Care Facilities, drawn up by the National Agency for Regional Health Services (Age.Na.S) during the 2010 Research Project "Experimentation and transfer of organizational empowerment models for evaluating and improving the quality of health services." The aim of the work was to measure the "Patient Centered Care degree" of the FBF structures by means of the Age.Na.S. check-list in order to identify effective and sustainable improvement measures, and to evaluate the applicability and the critical points of the questionnaire. The check-list was divided into four areas: care systems oriented at citizen's respect and centrality; physical accessibility, liveability and comfort of the places of care; access to information, simplification and transparency; care of the relationship with the patient and the citizen. The four areas were divided into 12 sub-areas, 29 criteria and 144 items with sub-items (248 questions), defined as quantitative or qualitative variables allowing for an evaluation of observed reality. Some items from different areas have been grouped into Focus and Operational Units (UU.OO./Facilities). The results of the Age.Na.S. study were used to compare the results obtained in the Roman Province FBF structures with the national ones. The Medical Directors and the responsible of FBF Quality Systems completed the cheek-list. A working group within the Central Hospitals' Health Direction analysed the data and processed the results, using the same scores provided by Age.Na.S.. The analysis of the results was divided into three levels. Focus and UU.OO./Facilities scores were calculated based on Age.Na.S. INDICATIONS: The distinction into three levels of analysis allowed for a thorough study of results, from the evaluation of the areas to the items. By comparing the results, the overall final value (range 6-6.5) and single area scores are close to the national average for beds number category in all the FBF hospitals. The most critical criteria, recurring in different levels are: 1.1.2 (Activities/projects to promote sociability and continuity with the outside world); 3.2.3 (Content and accessibility of the website); 4.1.2 (Training and support to the staff for the care of the relationship with the patient) and 4.2.3 (Training of the front-office staff), which had a < 4 score in at least three hospitals and generally achieve a value below the national average (level II and III of analysis). The analysis was extremely useful for detecting positive and negative aspects in the structures under examination. It also permitted to plan improvement measures based on set priorities and objective criteria, aimed at enforcing organizational empowerment models for improving the quality of patient-focused health services. However, during the compilation we found difficulties related to the applicability of the questionnaire. Indeed some questions, while having the same impact on the overall score, are less relevant, considering the patient centrality as main aim. It would be desirable that Age.Na.S. considers in a future survey the observations from hospitals joining previous investigations, in order to facilitate the use of the questionnaire and to improve this tool, which proved to be highly effective.

[The social responsibility report drafting in healthcare facilities. Experiences in Fatebenefratelli's Hospitals]. / La redazione del Bilancio Sociale nelle strutture sanitarie. Esperienza negli ospedali Fatebenefratelli.

Medical facilities have the duty to report, in a transparent, comprehensive and integrated manner, their performance, not only in relation to the services provided directly but also in relation to the interest of the various stakeholders and the economic and social benefits for the community. The Social Report is not only a communication tool related to corporate social responsibility but also the initial basis for acquiring social legitimacy, and serves the role of "social accounting" of the activities of an organization, with respect to its mission and institutional role. In healthcare, it can contribute to achieving the fundamental objectives of the healthcare system, in the financial area (fair financing), and also in the medical (outcomes) and ethical-social areas.

[Italian Decree D.lgs 231/2001--"Regulations regarding administrative responsibilities of corporate bodies of Companies and Associations including those not legally recognized"--an organizational model for the healthcare area]. / Contesto normativo D.lgs 231/2001 "Disciplina della Responsabilità amministrativa delle persone giuridiche delle Società e delle Associazioni anche prive di riconoscimento giuridico". Un modello organizzativo per l'Area Sanitaria.

Healthcare organizations must implement organizational and management models of regulation and control systems for effectively preventing possible administrative torts by personnel. We define an organizational management and control model for healthcare organizations, based on the legal dispositions of Decree n.231/2001. The model identifies critical points in the administrative and healthcare services delivery processes that are at high-risk of violations to the code. Its primary aim is to prevent torts by the personnel and safeguard the organization at the same time.