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HealthPromotingHospitals
Veneto Region Network
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Veneto
Region
Network
13th International Conference on HPHs - Dublin, May 18-20 , 2005
PATIENT CENTRED HOSPITAL ADMISSION: the HPH Project of Veneto Region Network
Anna Maria Rinolfi
Health Social Local Trust n.18 Rovigo (Italy)
Health
Promoting
Hospitals
Veneto
Region
Network
13th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin2
HealthPromotingHospitals
Veneto Region Network
NORTH- EAST OF ITALY
4.5 MILLIONS OF INHABITANTS
MAIN TOWN VENICE
18,364 Km2
Veneto Region
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HOSPITALS: 9 Hospitals of the Network were involved
1. Hospital of Feltre2. Hospital of Schio3 Hospital of Thiene4. Hospital of Chioggia5. Hospital of Este6. Hospital of Monselice7. Hospital of Trecenta8. Hospital of Rovigo9. Hospital of Bussolengo
THE PROJECT
ACTIONS: 1. Survey on 1,684 inpatients
2. Interventions (on the basis of survey results)
13th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin4
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THE SURVEYObjectivesTo evaluate the type of admission received within 48 hours since the hospitalization
To analyse the admission modalities
To assess mood, sensitiveness and need of company
To survey the waits for a suitable admission
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THE SURVEY
THE SURVEY INSTRUMENT
The operative instrument chosen for the analysis was a questionnaire, submitted to the patients within 48 hours since the hospitalization, both in case it was planned or it was a urgent hospitalization.
13th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin6
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The questionnaire aims to evaluate:1. Information received by patients about:
-1.1 their health state-1.2 the diagnosis and the
examinations they were going to have
-1.3 The ward organization
THE SURVEY
2. Staff manners perceived by patients (courtesy)
3. Patients needs and expectations
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N.1,684 inpatients56% female , 44 %% maleAverage age : 56 years41% were older than 65 years71% no more 8 years of school
26 % First hospital admission
Characteristics of the sample
THE SURVEY
13th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin8
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The mood, the information, the Hospital organization didn’t cause a problem, due to the fact these inpatients had already experienced a hospitalization!
As a matter of fact experiences are not alike…………………
Therefore we wondered:
13th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin9
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• MOOD DURING THE ADMISSION:Only the 36% of users declare their
mood is peaceful/quiet during the admission
The others: unpeacefulworried
very worried
Main results
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…..this highlights the data we already know about the users:
frailty
during the hospital admission
13th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin11
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It is natural and understandable that users are worried about their health conditions,
but this situation suggests to consider their mood and to communicate with them so
that to calm them
KEY ASPECT OF A
GOOD CARE
13th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin12
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1.1 The Information about health state
Who gives this information ?
1. Who gives health state information ?
• By an ambulance doctor 1,2%• By an emergency care unit doctor 20,4%• By a ward doctor 47,7%• By a specialist 17%• Others (GPs,F-a) 3,0%• By a nurse 5,6%• By a relative 1,6%
• nobody 3,5%
Hospitals Doctors
83, 3 %
96,6 % Received information
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1. The Information about health state
Was this information given respecting patients privacy ?
Was it conprehensible for the patients ?
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Main results
96,4% of people received informationabout their health conditions according to privacy,while the 96% received them in a simple and understandable way
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1.2 The Information about diagnosis and the examinations
How was it given in a prompt way ?
1.3 The information about ward organization
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Comparing the three types of information received:
1. YES Information regarding the health conditions 96,5%
(83,3% hospital doctors)
2. Information regarding the therapies
YES 84,9% NO 15,1%
3. Organizational information of the Ward YES 49,7% NO 50,3%
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Generally, the INFORMATION level is good, even if it is centred on the main issues concerning the health conditions, examinations, therapies.
POOR INFORMATION CONCERNINGTHE OPERATIVE PACES OF WARDSAND ORGANIZATION, WITHIN 48 HOURS SINCE THE HOSPITALIZATION
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WHY is there POOR information regarding the organizational aspects?
Hypothesis:a) The operators provide these information after 48 hours…
b) Personnel consider these information not very important and think they are passed among the inpatients by word of mouth.
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ALSO THE ORGANIZATION INFORMATION ARE
IMPORTANT, PARTICULARLY IF WE
CONSIDER THAT MOST OF INPATIENTS ARE
ELDERLY(difficult adaptability to a new
place)
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2 Staff Manners
KINDNESS:YES among the 97% of the inpatiens
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3 Patients needs and expectations
NEED OF A PERSON CLOSE TOTHEM: YES 70,2%
28,8% OF INPATIENTS DIDN’THAVE THIS NEED
ONLY THE 1% WASN’T ALLOWED
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WHAT DOES A PATIENT EXPECT from the Hospital Admission?We surveyed the expectations
through the expressionof one’s own opinion
ALL THE RATE LEVELS ARE HIGHER
THAN THE REAL SATISFACTIONOF NEED
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SUPPLIED WAIT
Kindness 97% 99.7%Information about thehealth conditions 91,9% 98,8%Organization information 49,7% 86,3%
KINDNESS= very important ORGANIZATIONAL ASPECTS = less important
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Conclusions
Patients consider the hospital admission atricky moment
The information they wait for, are a true RIGHT: 1. to know their health conditions, examinations and possible operations2. to receive this kind of information by the DOCTOR WHO RECEIVE THEM
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Information should be given by a qualified person, who knows the
hospitalization causesand the disease conditions
This should happen:
DURING THE HOSPITALIZATION
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•To receive simple, understandable and respectful to privacy information
To receive information regarding a Ward customs and its organization
Other surveyed needs:
Where possible, to have a relative nearbyKind and available operators
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What are we going to do?PLANNED INTEVENTIONS
A: To include “Admission” in the planning of doctors/nurses training activities
B: To do meetings with the Wards personnel
C: To define specific “Ward protocols” so that to include in the ordinary medical procedure the admission modalities of patients
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D: duly updated ward posters, - as well as in hotels -containing the main information regarding food timetable, meetings with doctors and other daily activities
But never forget the importance of adirect spoken information
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TO CARRY OUT THE PREMISES FOR A GOOD AND EFFECTIVE ADMISSION IS
EQUAL TO CONTRIBUTE TO THE PATIENT’S WELL-BEING:
1:be able to receive a “new-inpatient” in one’s own life experience
2:allow the free expression of options, values, human needs, according to
times and expressive modalities