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Conoscere il passato per capire il presente e orientare il futuro 了解过去，了解现在，指导未来
Q4 Medicine
Mecosan
Pub Date : 2020-10-01 DOI: 10.3280/mesa2020-114001
E. Borgonovi
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引用次数: 0
Sfide manageriali Covid-19: next steps 新冠肺炎管理挑战：下一步行动
Q4 Medicine
Mecosan
Pub Date : 2020-06-01 DOI: 10.3280/MESA2020-113009
D. Vecchio, Mario, Longo, Francesco
Covid emergency provides to health care managers rapidly changing and challenging scenarios, where severe and impacting decisions have to be suddenly taken The paper discusses the next possible managerial steps: Covid pick overcoming, downsizing of Covid capacity and the implementation of separate clinical settings for Covid and Covid-free patients, the activation of a task force for immediate intervention for possible new outbreaks, the no-Covid waiting lists management There are also at least three permanent critical processes to tackle: building a collective narrative about the events in order to foster a new organizational identity, preparing some extra capacity for new picks and for service flexibility, managing litigations For each step and process, the paper discusses possible managerial challenges Copyright © FrancoAngeli
新冠肺炎紧急情况为卫生保健管理人员提供了快速变化和具有挑战性的情况，在这些情况下，必须突然做出严重和有影响的决定。论文讨论了下一步可能的管理步骤：新冠肺炎选择克服、缩小新冠肺炎能力以及为新冠肺炎和无新冠患者实施单独的临床环境，启动一个工作组，对可能出现的新疫情进行即时干预，无规定等待名单管理还有至少三个永久性的关键过程需要处理：建立关于事件的集体叙述，以培养新的组织身份，为新的选择和服务灵活性准备一些额外的能力，管理诉讼对于每一个步骤和过程，本文都讨论了可能的管理挑战版权所有©FrancoAngeli
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引用次数: 0
Ripartire dalle cure primarie: priorità e lezioni imparate alla luce della Pandemia Covid-19 从初级保健开始：新冠肺炎大流行背景下的优先事项和经验教训
Q4 Medicine
Mecosan
Pub Date : 2020-06-01 DOI: 10.3280/MESA2020-113026
E. Vendramini
Primary Care Management has been a pivotal issue in the national and international debate in the last years GP National contract has been focused on the introduction of managerial, organizational and clinical tools since early 2000 The paper is aimed at analysing the first implications of the pandemic and the lessons learnt This not just as a milestone for other issues in the future but to manage the needs of elderly people, mainly chronic patients Copyright © FrancoAngeli
初级保健管理是过去几年国内和国际辩论中的一个关键问题。自2000年初以来，全国全科医生合同的重点是引进管理、组织和临床工具。该文件旨在分析大流行的第一个影响和吸取的教训。这不仅是未来其他问题的里程碑，而且是管理老年人(主要是慢性病患者)的需求版权©FrancoAngeli
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引用次数: 0
Disuguaglianze della salute e conseguenze della pandemia 健康不平等和新冠疫情的后果
Q4 Medicine
Mecosan
Pub Date : 2020-06-01 DOI: 10.3280/MESA2020-113005
A. Gugiatti
The health emergency following the Coronavirus pandemic risks calling into question the importance of national and regional strategies to deal with inequalities in health and in health services The analysis of the environmental, social and economic determinants of health, on the other hand, is fundamental for tackling future choices in the health sector with greater balance Copyright © FrancoAngeli
冠状病毒大流行后的卫生紧急情况有可能使人们质疑国家和区域战略对解决卫生和卫生服务不平等问题的重要性。另一方面，对健康的环境、社会和经济决定因素的分析，是以更大的平衡应对卫生部门未来选择的基础版权所有©FrancoAngeli
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引用次数: 0
Dall'ospedale alla co-produzione collettiva: come attivare la comunità per il contrasto al Covid-19 从医院到集体合作生产：如何激活社区抗击新冠肺炎
Q4 Medicine
Mecosan
Pub Date : 2020-06-01 DOI: 10.3280/mesa2020-113032
D. Cepiku, F. Giordano, A. Magi, E. Aloisantoni
This short paper, starting from an analysis on how the Covid-19 pandemic is managed in Italy, aims at putting forward a proposal entailing an alternative approach The central thesis is that the focus of emergency management policies was – and still is – on hospitals, leaving the territory exposed We propose a community-based approach, similar to those effectively used in low-income countries to deal with global health problems Such a proposal, which has several clinical, social and economic benefits including capillarity, early detection and greater ownership, is discussed with key informants from public and non profit institutions at the forefront of the fight of Covid-19 in Italy Several conditions that enable co-production are identified including the existence of a well-functioning territorial medicine, trust and co-production management mechanisms A community co-production approach is applicable to other high-income countries with healthcare systems operating beyond maximum capacity Copyright © FrancoAngeli
这篇简短的论文从对新冠肺炎疫情在意大利如何管理的分析开始，旨在提出一个需要替代方法的建议。中心论点是，应急管理政策的重点过去是——现在仍然是——医院，让领土暴露在外，类似于低收入国家为应对全球健康问题而有效使用的提案。这一提案具有多项临床、社会和经济效益，包括毛细管作用、早期发现和更大的自主权，与意大利抗击新冠肺炎最前线的公共和非营利机构的主要信息提供者进行了讨论。确定了能够共同生产的几个条件，包括存在功能良好的领土药物，信任和合作生产管理机制社区合作生产方法适用于医疗系统超出最大容量运行的其他高收入国家版权所有©FrancoAngeli
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引用次数: 2
Tre conferme: direzioni, aziende, regioni 三个确认：方向、公司、地区
Q4 Medicine
Mecosan
Pub Date : 2020-06-01 DOI: 10.3280/mesa2020-113010
F. Lega, V. Petronella, A. Triarico, C. Nicora
The Covid-19 emergency has challenged both the institutional configuration of the Italian NHS and the management of health organizations and hospitals The political debate and media coverage have often highlighted the regionalization and the capacity of leaders of health organizations as limitations or causes of failures in managing the pandemic Vice versa, a more in depth and fact-based analysis of what took place in the last months shows how the management of health organizations and the supervision of health services at regional level were strengths in coping with the emergency This work illustrates why Italian NHS should invest more in consolidating the corporatization process of health organizations and the regional governance of health sector Copyright © FrancoAngeli
新冠肺炎紧急情况对意大利国家医疗服务体系的机构配置以及卫生组织和医院的管理提出了挑战。政治辩论和媒体报道经常强调，区域化和卫生组织领导人的能力是管理疫情的局限性或失败原因，反之亦然，对过去几个月发生的事情进行了更深入和基于事实的分析，表明了地区一级对卫生组织的管理和对卫生服务的监督在应对紧急情况方面的优势。这项工作说明了为什么意大利国家医疗服务体系应该加大投资，巩固卫生组织的公司化进程和卫生部门的地区治理版权所有©FrancoAngeli
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引用次数: 0
L'applicazione delle disruptive technology (DLT, blockchain, smart contract e token) alla gestione del rischio epidemiologico 颠覆性技术（DLT、区块链、智能合约和代币）在流行病风险管理中的应用
Q4 Medicine
Mecosan
Pub Date : 2020-06-01 DOI: 10.3280/MESA2020-113016
A. Nisio, F. Pellecchia
The work proposes the implementation of blockchain technology to encourage contrast to the spread of Covid-19 The need to overcome the lockdown phase and, at the same time, put in place useful tools to avoid the recurrence of widespread infections, obliges to use already existing and consolidated technologies, which allow, in the urgency of the decisions to be taken, to make compatible the recovery of the social and economic life, protection of individual rights and freedoms The proposal aims to digitize, streamline, deburocratise, speed up, improve procedures and processes aimed at easy and non-intrusive certification of “non-infected” subjects Copyright © FrancoAngeli
该工作建议实施区块链技术，以鼓励与Covid-19的传播形成对比。在克服封锁阶段的同时，制定有用的工具以避免再次发生大范围感染，有义务使用现有和综合技术，以便在需要作出紧急决定的情况下，与社会和经济生活的恢复相适应。该提案旨在数字化、精简、民主化、加速和改进程序和流程，旨在对“未感染”受试者进行简单和非侵入性的认证版权©FrancoAngeli
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引用次数: 0
Quando burocrazia è sinonimo di velocità: l'Huoshenshan di Wuhan, il Javits Center Emergency Hospital a New York e l'Ospedale Fiera di Milano 当官僚主义意味着速度:武汉的胡申山、纽约的贾维茨中心紧急医院和米兰的米兰市立医院
Q4 Medicine
Mecosan
Pub Date : 2020-06-01 DOI: 10.3280/MESA2020-113019
G. Valotti, D. Cristofoli, Alex Turrini
We analyze how the same type of public intervention (the transformation of a convention center into a hospital for Covid-19 patients) has occurred in three different contexts (Wuhan, New York and Milan) We highlight which models has led to a timely and efficient public intervention aimed at fighting Covid-19 local epidemic The comparative analysis reveals that there is no single path to success: according to different contextual conditions, different factors are fundamental to ensure government timeliness and efficiency We argue that the same factors are important also in situations of “ordinary emergency”, which normally occurs as, physiologically, governments have to cope with unlimited needs and scarce resources availability Copyright © FrancoAngeli
我们分析了同一类型的公共干预（将会议中心转变为新冠肺炎患者医院）是如何在三种不同的情况下发生的（武汉、纽约和米兰）。我们强调了哪些模式导致了旨在抗击新冠肺炎本地流行病的及时有效的公共干预。比较分析表明，没有单一的成功途径：根据不同的背景条件，不同的因素是确保政府及时性和效率的基础。我们认为，在“普通紧急情况”下，同样的因素也很重要，这种情况通常发生在生理上，政府必须应对无限的需求和稀缺的资源可用性。版权所有©FrancoAngeli
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引用次数: 1
Applicazione e potenziamento del PIP (Pandemic Influenza Preparedness Framework) in ambito OMS: un'arma in più per affrontare le fasi successive al picco da Covid-19 世卫组织大规模流感准备框架的应用和增强:处理covi -19峰值后阶段的额外武器
Q4 Medicine
Mecosan
Pub Date : 2020-06-01 DOI: 10.3280/MESA2020-113002
S. Brunelli, C. Falivena, L. Anselmi
Pandemic Influenza Preparedness (PIP) Framework, developed by the World Health Organization, is the only existing framework to face a global pandemic crisis It is aimed to define a line of intervention which overcomes characteristics of health systems and allows the Member States at accessing to vaccines and other benefits Besides reviewing its evolution, this article attempts to explore whether – and how – PIP could support future political and economic challenges engendered by Covid-19 In the absence of a new global agreement, PIP may represent the first outline of a framework for reacting to the present pandemic crisis Moreover, a revised and more robust version of PIP may increase preparedness to future health crises Copyright © FrancoAngeli
大流行性流感防范框架由世界卫生组织制定，是面对全球大流行危机的唯一现有框架。该框架旨在确定一系列干预措施，克服卫生系统的特点，使会员国能够获得疫苗和其他利益。在没有新的全球协议的情况下，PIP可能是应对当前大流行危机框架的第一个纲要。此外，修订后的更加健全的PIP版本可能会加强对未来卫生危机的准备。版权©FrancoAngeli
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引用次数: 0
La gestione delle operations in tempo di crisi: le prime 10 lezioni apprese dalle Aziende Sanitarie 危机管理:卫生公司学到的前10个教训
Q4 Medicine
Mecosan
Pub Date : 2020-06-01 DOI: 10.3280/MESA2020-113020
M. Marsilio, A. Prenestini
Operations management is a central topic to address standardization issues, redesign of patient and medical supplies processes and flows with the aim of eliminating or reducing variability This work aims to contribute to the debate on hospitals’ ability to deal with the Covid-19 pandemic emergency The experiences of seven healthcare organizations located in the most affected Italian regions were analyzed: Lombardy, Emilia-Romagna, Piedmont and Tuscany There are six fundamental drivers managed by the healthcare organizations to tackle the crisis: i) the organizational structure and decision support systems;ii) hospital networks for the management of patient flows;iii) asset management and physical lay out;iv) the redesign of medical supplies flows;v) the skills of professionals;vi) new health technologies The analysis revealed 10 fundamental lessons to be learned for operations management, enabling the healthcare managers and professionals to plan the responses to the next phases of the pandemic Copyright © FrancoAngeli
运营管理是解决标准化问题的中心主题，重新设计患者和医疗用品流程和流程，以消除或减少变异性这项工作旨在促进关于医院应对新冠肺炎大流行紧急情况的能力的辩论。分析了意大利受影响最严重地区的七个医疗机构的经验：Lombardy、Emilia-Romagna、，皮埃蒙特和托斯卡纳医疗保健组织管理着应对危机的六个基本驱动因素：i）组织结构和决策支持系统；ii）用于管理患者流的医院网络；iii）资产管理和实物布局；iv）重新设计医疗用品流程；v） 专业人员的技能；vi）新的卫生技术分析揭示了运营管理需要吸取的10个基本教训，使医疗管理人员和专业人员能够计划应对疫情的下一阶段版权所有©FrancoAngeli
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