Ateneo - UPO

The course is designed for the student to acquire the knowledge and related practical skills of applying care organizational models in primary care and prevention. The first part of the course is aimed at presenting the complexity of organizational settings and the care and management specificities of the professions that contribute to the implementation of Health Public Management, so that the student begins to master the terminology and the main contents related to, in order to better read his or her own context of reference. The second part illustrates the peculiarities, opportunities and limitations of current or desirable care organizational models of hospital, territorial and preventive settings, referring to experiences from Italian regions and international contexts. The ability to design organizational changes is fostered by acquiring a method of sizing the activities of territorial contexts and choosing the appropriate care organizational model for the objectives.

Prerequisite:
Stefano Landi “L’amministrazione dell’azienda sanitaria – Gestione, organizzazione e bilancio”. Giappichelli editore, 2022.
Referenced texts:
Valeria Tozzi, Francesco Longo: “Management della cronicità. Logiche aziendali per gestire I nuovi setting sanitari finanziati dal PNRR”. Egea ed. 2023.
Milena Vaineri, Chiara Barchielli e Nicola Bellé “Modelli organizzativi e performance dell’assistenza infermieristica”. Ed Il Mulino, 2020.

To know and discuss:
- the perspectives and implications of Population Health Management in the development of care and organizational models;
- the characteristics, strengths and weakness factors of the organizational and care models currently in use in the community and hospital systems;
- the connotation of responsibility of the nurse and midwife in the different models;
- the contribution of technology and advanced skills in the reengineering of organizational and care models;
Identify and define:
- what are and which are the organizational and care models implemented to date in hospital and community settings;
- professional and technical models in relation to the person, outcomes, system complexity, and care pathways;
Analyze:
- the economic and social problems and dynamics that may impact the care system;
- the critical factors of the models currently in use in territorial and preventive facilities;
- the potential developments of nursing models in the current health care environment; and
- the new scenarios for community health care and new organizational models: Community Homes, Community Hospitals, Territorial Operations Centers
Use:
- a method of sizing services and configuring the professional care model.

Principles of administration of health care facilities (Management, organization and budgeting of companies).

Interactive frontal lesson. Presentations in MS-Power Point format and websites. Lecture-discussion with projection of audiovisuals, discussion of scientific works, group reports.

Tutorials: the formulation of a project in primary care and/or prevention.
Students with physical disabilities, Learning Disabilities or Special Education Needs can request specific services and tools via the Staff Sviluppo e Coordinamento Carriere e Servizi alle Studentesse e agli Studenti, consulting the University webpage: https://www.uniupo.it/en/services/services-students-physical-or-learning-disabilities.
Students with disabilities, learning disabilities or special education needs, once they have contacted the University Staff, can refer to the tutor in charge of the course to define the examination modalities, concerning academic aspects.

The profit exam is offered in a single session for the entire integrated course. Regarding the part of “Innovative Organizational and Care Models,” two open-ended questions and an exercise similar to that conducted in the classroom will be offered. In order to achieve a score of 30/30 cum laude, the student must still demonstrate excellent knowledge of all the topics covered in the course.

1 - Introduction to the concept of the Territory-Hospital-Territory (THT) system and existing organizational and care models. Population Health Management.
2 - Hospital care and organizational models: from the Emergency Room to inpatient care (brief mentions of the Tri.Co. method; Triage; See &Treat and Fast Track).
Ordinary hospitalization and short-cycle and/or planned hospitalization. The Bed Management System. Nursing-led operating units.
Hospital organization by intensity of care. Hub and spoke hospitals.
Hospital organizational care models: model by function (functional nursing), model by team (Team Nursing) and principles of Primary Nursing model.
Case Management (CM) as a "bridge" hospital/territory care model.
3 - Territorial care and organizational models: Territorial health care and the District. Initiative Medicine. Health Homes and Community Hospitals. The network of social and health services. Community building and engagement in health protection.
The ADI (integrated home care).
End-of-life care, palliative care, hospice: organizational reference models.
Continuity and transitional care CAVS (Continuity of Care) RSA (assisted living facilities). The Hospital/Territory integration system and protected discharges. Respite hospitalizations.
The family and community nurse. Outpatient Nursing. The nurse in the service pharmacy.
Territorial continuity of care models (Transitional Care Model), Nurse Led Care (NLC) and The Chronic care model (CCM).
The prevention system between needs analysis, planning and performance.
4 - Operations management tools for sizing territorial services according to Zazzera and Longo's model and assignment of the mandate for partial final evaluation.
5 - Two cases of care and organizational innovation of the hospital and the territory:
- Magnet hospital
- Kaiser permanent

Gender integration
In the course of the lectures, the contribution of gender to the profession of nursing, as a profession aimed at caring for people, will be addressed. Therefore, the influence of biological differences (defined by sex) and socio-economic differences (defined by gender) on the state of health and illness of each person will be discussed: according to the WHO, men and women often have different incidence, symptoms and also response to treatment, and have different responses to access to care, with significant gender inequalities. When describing work contexts, the lessons will mention the differences related to the world of work and its organisation, with all the different consequences that these situations have on gender differences.

In order to achieve knowledge and skills corresponding to the sufficiency level, the student is asked to demonstrate:
-Knowledge and understanding: the concept of care organizational model, taxonomic references and analysis of care and organizational models, the structure and activities of the health care system and chronicity management.
-Ability to apply knowledge and understanding: ability to apply the knowledge acquired during the course and understand the concepts of care organizational model and service models.
-Autonomy of judgment: ability to understand and interpret care organizational models and evaluate proposed models, as well as propose innovative models in relation to the evaluation of health public management objectives of health care companies.
-Communication skills: ability to expose concepts clearly, in both oral and written form, using appropriate scientific language.
-Learning skills: ability to use the knowledge acquired to participate in seminars and/or courses to further the subject.