From health care services to healthcare profiling within the COVID-19 emergency : the role of the health quality impact assessment inside the local health unit

Abstract

Purpose: The work considers the application of the quality of the care profile in hospital care, trying to obtain an overview of the resources used in the entire emergency management process in order to understand the information necessary for setting up improvement of activities. The analysis, combines theoretical reflections and empirical evidence relating to the treatment of the COVID-19 virus, develops the approach in question within the complex process of establishing a more effective and efficient care path. Design/Methodology/Approach: The choice of the field survey, is based on the qualitative method and in particular through the use of the case study, finds justification with the study objective and with the nature of the phenomenon investigated. This method lends itself to the need to observe the phenomena being analyzed in the environment of natural manifestation, even in the presence of other variables such as, the peculiarity of the managerial approach of the structure being investigated. Taking into account the current lack of knowledge on the subject being analyzed (COVID-19), the research is also based on a study of exploratory cases. Exploratory studies are appropriate when the understanding of the phenomenon under analysis from a theoretical (clinical) point of view is still in the embryonic stage. More generally, case studies are aimed at understanding complex organizational phenomena. The investigation concerns the Alfa Hospital in Calabria, selected as a study unit on the basis of some considerations. From a territorial point of view it operates in a vast provincial area. The strong focus on share capital is an important element in relation to the issue of quality as it represents a meta-condition for starting efficiency and planning processes. In addition, from an organizational point of view, the Company participated as a partner in projects on issues relating to emergency management. The Company is the regional reference hospital, DEA II level, regional HUB headquarters and COVID-19 Center. It is the reference point of the SPOKE centers, ensuring the highly specialized functions related to the emergency / urgency, coordinating the activity of the networks at local-regional and national level. Findings: The research focuses on the collection of data that represent the effort made by the Company in the construction of a theoretical-practical framework that acts as a reading key for the interrelation of emergency management with the Company's specific organizational-management model within the path concerning the provision of health services and the related care profiles having as central inspiring logic the centralization of the patient. Practical Implications: Consistent with what happened in other sectors of the Public Administration, where the process of change has as its objective the search for efficiency and efficacy, in Italy there is growing awareness that an efficient, effective and fair health service must be considered a critical success factor for the economic and social development of the country. The health system is at the center of great attention, having to demonstrate that it is adequately using the constantly decreasing resources available to it, in the face of a growing demand for health. Originality/value: The need for a growing orientation towards performance and the use of programming tools in the healthcare sector has been consolidated in the overall process of public administration corporatization. In this context, pathologies characterized by the length of care paths and high complexity in terms of treatment and complications must be considered. These pathologies are important in epidemiological terms, absorbed resources and potential for improvement from the point of view of intervention policies, public health services and efficiency.