il "Modello di Analisi della Appropriatezza organizzativa dei ricoveri ospedalieri per elenchi normativi di Procedure" finalizzato a ben definire le componenti costitutive del ricovero ospedaliero ed in grado di dimostrare come dalla loro intersezione possa derivare l'indicazione alla modalità assistenziale più appropriata. Approvato in Puglia con deliberazione di Giunta n. 834 del 27 maggio 2008, attualmente in sperimentazione al Ministero della Salute
Sinergie tra norma UNI e Linee guida CNT (Centro Nazionale Trapianti)postaSimo
Presentazione a supporto dell'intervento di Letizia Lombardini, CNT - Centro Nazionale Trapianti, Membro del Gruppo di lavoro UNI/CT 044/SC 04/GL 04 “Sale criobiologiche” al webinar SICUREZZA PER LE SALE CRIOGENICHE: ECCO LA UNI 11827" del 20 ottobre 2021
Sinergie tra norma UNI e Linee guida CNT (Centro Nazionale Trapianti)postaSimo
Presentazione a supporto dell'intervento di Attilio Cortellini, Membro del Gruppo di lavoro UNI/CT 044/SC 04/GL 04 “Sale criobiologiche” al webinar "SICUREZZA PER LE SALE CRIOGENICHE:ECCO LA UNI 11827" del
Sinergie tra norma UNI e Linee guida CNT (Centro Nazionale Trapianti)postaSimo
Presentazione a supporto dell'intervento di Letizia Lombardini, CNT - Centro Nazionale Trapianti, Membro del Gruppo di lavoro UNI/CT 044/SC 04/GL 04 “Sale criobiologiche” al webinar SICUREZZA PER LE SALE CRIOGENICHE: ECCO LA UNI 11827" del 20 ottobre 2021
Sinergie tra norma UNI e Linee guida CNT (Centro Nazionale Trapianti)postaSimo
Presentazione a supporto dell'intervento di Attilio Cortellini, Membro del Gruppo di lavoro UNI/CT 044/SC 04/GL 04 “Sale criobiologiche” al webinar "SICUREZZA PER LE SALE CRIOGENICHE:ECCO LA UNI 11827" del
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
This article is all about what AI trends will emerge in the field of creative operations in 2024. All the marketers and brand builders should be aware of these trends for their further use and save themselves some time!
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
It's part of a Data Science Corner Campaign where I will be discussing the fundamentals of DataScience, AIML, Statistics etc.
Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
basics – to make it quicker and easier, without sacrificing
the vital ingredients for success.
“If you’re looking for some real-world guidance, then The Six Step Guide to Practical Project Management will help.”
Dr Andrew Makar, Tactical Project Management
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
This article is all about what AI trends will emerge in the field of creative operations in 2024. All the marketers and brand builders should be aware of these trends for their further use and save themselves some time!
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
It's part of a Data Science Corner Campaign where I will be discussing the fundamentals of DataScience, AIML, Statistics etc.
Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
basics – to make it quicker and easier, without sacrificing
the vital ingredients for success.
“If you’re looking for some real-world guidance, then The Six Step Guide to Practical Project Management will help.”
Dr Andrew Makar, Tactical Project Management
Beginners Guide to TikTok for Search - Rachel Pearson - We are Tilt __ Bright...
MAAP - Modello di Analisi della Appropriatezza organizzativa dei ricoveri ospedalieri per elenchi normativi di Procedure - ARESS Puglia
1. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri ospedalieri
per elenchi normativi di Procedure
Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri ospedalieri
per elenchi normativi di Procedure
3. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
• L'APPROPRIATEZZA PROFESSIONALE
• L’APPROPRIATEZZA ORGANIZZATIVA
4. •
• “POSSONO ESSERE DEFINITI "INAPPROPRIATI" I CASI TRATTATI IN REGIME DI RICOVERO ORDINARIO O IN DAY HOSPITAL CHE LE STRUTTURE SANITARIE
POSSONO TRATTARE IN UN DIVERSO SETTING ASSISTENZIALE CON IDENTICO BENEFICIO PER IL PAZIENTE E CON MINORE IMPIEGO DI RISORSE”.
Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
5. •
• “POSSONO ESSERE DEFINITI "INAPPROPRIATI" I CASI TRATTATI IN REGIME DI RICOVERO ORDINARIO O IN DAY HOSPITAL CHE LE STRUTTURE SANITARIE
POSSONO TRATTARE IN UN DIVERSO SETTING ASSISTENZIALE CON IDENTICO BENEFICIO PER IL PAZIENTE E CON MINORE IMPIEGO DI RISORSE”.
Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
APPROPRIATO
SETTING ASSISTENZIALE MIGLIORE O IDENTICO
BENEFICIO CON MINORE IMPIEGO DI RISORSE
8. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
•• DELIBERAZIONE N.90 DEL 22 GENNAIO 2019: LINEE GUIDA “ORGANIZZAZIONE DELLE ATTIVITA’ PER
LA VERIFICA DELLA APPROPRIATEZZA DELLE PRESTAZIONI SANITARIE IN REGIONE PUGLIA"
11. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
•
• PATOLOGIA
• CONDIZIONI CLINICHE
• COMPLESSITÀ DELLE PROCEDURE
•
• ETÀ, DISTANZA DALLA RESIDENZA
14. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
•
•
•
•
•
•
• SEVERITÀ CLINICA
• RISCHIO DI MORTE
15. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
• SI DEFINISCONO A “CRITICITÀ MINIMA”
• I RICOVERI CON
SEVERITÀ CLINICA =1
E
RISCHIO DI MORTE =1
• SONO QUESTI (CON CONDIZIONI CLINICHE BUONE) L’OGGETTO DEL NOSTRO
STUDIO.
• SI DEFINISCONO A “CRITICITÀ MINIMA”
• I RICOVERI CON
SEVERITÀ CLINICA =1
E
RISCHIO DI MORTE =1
• SONO QUESTI (CON CONDIZIONI CLINICHE BUONE) L’OGGETTO DEL NOSTRO
STUDIO.
• SI DEFINISCONO A “CRITICITÀ MINIMA”
• I RICOVERI CON
SEVERITÀ CLINICA =1
E
RISCHIO DI MORTE =1
• SONO QUESTI (CON CONDIZIONI CLINICHE BUONE) L’OGGETTO DEL NOSTRO
STUDIO.
16. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
• AD OGNI PROCEDURA, IN FUNZIONE DELLA COMPLESSITÀ, RISCHIO DI COMPLICANZE,
DIFFICOLTÀ DI ESECUZIONE E/O INVASIVITÀ, UTILIZZANDO UN CRITERIO DI SCELTA
PRUDENZIALE, È STATO ASSEGNATO UN SETTING ASSISTENZIALE DI RIFERIMENTO.
• SI SONO PRODOTTE QUINDI 4 LISTE NORMATIVE PROCEDURALI:
SULLA BASE DI STUDI PRODOTTI DA ALTRI ENTI ED ISTITUZIONI ED IN COLLABORAZIONE CON I REFERENTI REGIONALI
DELLE SOCIETÀ SCIENTIFICHE DELLE MAGGIORI DISCIPLINE, SONO STATE ANALIZZATE TUTTE LE PROCEDURE CONTENUTE
NELLA VERSIONE 2002 (E, A SEGUIRE, DEL 2007) DELLA ICD 9 CM
-LISTA “A”: procedure eseguibili in ricovero ordinario;
-LISTA “B”: procedure eseguibili in ricovero di 0-1 g.
-LISTA “C”: procedure eseguibili in day-hospital/day-surgery;
-LISTA “D”: procedure eseguibili in regime di assistenza ambulatoriale.
17. SULLA BASE DI STUDI PRODOTTI DA ALTRI ENTI ED ISTITUZIONI ED IN COLLABORAZIONE CON I REFERENTI REGIONALI
DELLE SOCIETÀ SCIENTIFICHE DELLE MAGGIORI DISCIPLINE, SONO STATE ANALIZZATE TUTTE LE PROCEDURE CONTENUTE
NELLA VERSIONE 2002 (E, A SEGUIRE, DEL 2007) DELLA ICD 9 CM
Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
• AD OGNI PROCEDURA, IN FUNZIONE DELLA COMPLESSITÀ, RISCHIO DI COMPLICANZE,
DIFFICOLTÀ DI ESECUZIONE E/O INVASIVITÀ, UTILIZZANDO UN CRITERIO DI SCELTA
PRUDENZIALE, È STATO ASSEGNATO UN SETTING ASSISTENZIALE DI RIFERIMENTO.
• SI SONO PRODOTTE QUINDI 4 LISTE NORMATIVE PROCEDURALI:
SULLA BASE DI STUDI PRODOTTI DA ALTRI ENTI ED ISTITUZIONI ED IN COLLABORAZIONE CON I REFERENTI REGIONALI
DELLE SOCIETÀ SCIENTIFICHE DELLE MAGGIORI DISCIPLINE, SONO STATE ANALIZZATE TUTTE LE PROCEDURE CONTENUTE
NELLA VERSIONE 2002 (E, A SEGUIRE, DEL 2007) DELLA ICD 9 CM
-LISTA “A”: procedure eseguibili in ricovero ordinario;
-LISTA “B”: procedure eseguibili in ricovero di 0-1 g.
-LISTA “C”: procedure eseguibili in day-hospital/day-surgery;
-LISTA “D”: procedure eseguibili in regime di assistenza ambulatoriale.
• AD OGNI PROCEDURA, IN FUNZIONE DELLA COMPLESSITÀ, RISCHIO DI COMPLICANZE,
DIFFICOLTÀ DI ESECUZIONE E/O INVASIVITÀ, UTILIZZANDO UN CRITERIO DI SCELTA
PRUDENZIALE, È STATO ASSEGNATO UN SETTING ASSISTENZIALE DI RIFERIMENTO.
• SI SONO PRODOTTE QUINDI 4 LISTE NORMATIVE PROCEDURALI:
18. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
LEGENDA
DOTT. F. DOTT. A. DOTT. D. DOTT. T. DOTT. V.
ORD ORD 0-1
CHIRURGIA
GENERALE
CHIRURGIA
VASCOLARE
CHIRURGIA
VASCOLARE
CARDIOCHI
RURGO
CARDIOCHI
RURGO
DH/DS AMB
ELENCO DEI CODICI DI PROCEDURE INTERVENTISTICHE
COD. ICD9CM 1996 - 2002
INTERVENTI SUL SISTEMA CARDIOVASCOLARE (35-39)
3849 Resezione di vene dell'arto inferiore con sostituzione DS DS DS ORD
ORD 0-1
ORD ORD
ORD
385 Legatura e stripping di vene varicose ORD 0-1 ORD 0-1
DH/DS
ORD 0-1 ORD 0-1 ORD 0-1
3850 Legatura e stripping di vene varicose, sede non specificata AMB DS DS/ORD 0-1
ORD 0-1 ORD 0-1
DH/DS DH/DS DH/DS
ORD 0-1
3851 Legatura di vene varicose intracraniche ORD ORD ORD
ORD
3852 Legatura di altre vene varicose del capo e del collo ORD ORD ORD ORD
ORD
3853 Legatura e stripping di vene varicose dell'arto superiore AMB DS DS
ORD 0-1
DH/DS DH/DS DH/DS
ORD 0-1
3855 Legatura di vene varicose toraciche ORD ORD ORD ORD
ORD
3857 Legatura di vene varicose addominali ORD ORD ORD ORD
ORD
3859 Legatura e stripping di vene varicose dell'arto inferiore AMB DS DS
ORD 0-1 ORD 0-1
DH/DS DH/DS DH/DS
ORD 0-1
delegato
regionaleS.I.
C.V.E. (SOC.
ITALIANA
CHIRURGIA
VASCOLARE
e
ENDOVASC
OLARE)
S.I.C.C.H.
SOCIETA'
ITALIANA DI
CHIRURGIA
CARDIACA
S.I.C.C.H.
SOCIETA'
ITALIANA DI
CHIRURGIA
CARDIACA
MIX MIN.+
PIEMONTE+ CONF.
STATO REG.+
SPECIALISTI
(criterio
cautelativo) -
NORMALIZZATO
SU INDICAZIONI
AGGIORNATE AL
29/02/2008
MINISTERO
DELLA
SALUTE
ELENCO
gennaio 2005
REGIONE
PIEMONTE
ELENCO
ottobre 2004
CONFERENZA
STATO REGIONI
ELENCO agosto
2002
COORD.
NAZ. ACOI
(ASS.
CHIRURGHI
OSPED.
ITALIANI)
S.I.C.V.E.
(SOC.
ITALIANA
CHIRURGIA
VASCOLARE
e
ENDOVASCO
LARE)
Esempio:
19. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
LEGENDA
DOTT. F. DOTT. A. DOTT. D. DOTT. T. DOTT. V.
ORD ORD 0-1
CHIRURGIA
GENERALE
CHIRURGIA
VASCOLARE
CHIRURGIA
VASCOLARE
CARDIOCHI
RURGO
CARDIOCHI
RURGO
DH/DS AMB
ELENCO DEI CODICI DI PROCEDURE INTERVENTISTICHE
COD. ICD9CM 1996 - 2002
INTERVENTI SUL SISTEMA CARDIOVASCOLARE (35-39)
3849 Resezione di vene dell'arto inferiore con sostituzione DS DS DS ORD
ORD 0-1
ORD ORD
ORD
385 Legatura e stripping di vene varicose ORD 0-1 ORD 0-1
DH/DS
ORD 0-1 ORD 0-1 ORD 0-1
3850 Legatura e stripping di vene varicose, sede non specificata AMB DS DS/ORD 0-1
ORD 0-1 ORD 0-1
DH/DS DH/DS DH/DS
ORD 0-1
3851 Legatura di vene varicose intracraniche ORD ORD ORD
ORD
3852 Legatura di altre vene varicose del capo e del collo ORD ORD ORD ORD
ORD
3853 Legatura e stripping di vene varicose dell'arto superiore AMB DS DS
ORD 0-1
DH/DS DH/DS DH/DS
ORD 0-1
3855 Legatura di vene varicose toraciche ORD ORD ORD ORD
ORD
3857 Legatura di vene varicose addominali ORD ORD ORD ORD
ORD
3859 Legatura e stripping di vene varicose dell'arto inferiore AMB DS DS
ORD 0-1 ORD 0-1
DH/DS DH/DS DH/DS
ORD 0-1
delegato
regionaleS.I.
C.V.E. (SOC.
ITALIANA
CHIRURGIA
VASCOLARE
e
ENDOVASC
OLARE)
S.I.C.C.H.
SOCIETA'
ITALIANA DI
CHIRURGIA
CARDIACA
S.I.C.C.H.
SOCIETA'
ITALIANA DI
CHIRURGIA
CARDIACA
MIX MIN.+
PIEMONTE+ CONF.
STATO REG.+
SPECIALISTI
(criterio
cautelativo) -
NORMALIZZATO
SU INDICAZIONI
AGGIORNATE AL
29/02/2008
MINISTERO
DELLA
SALUTE
ELENCO
gennaio 2005
REGIONE
PIEMONTE
ELENCO
ottobre 2004
CONFERENZA
STATO REGIONI
ELENCO agosto
2002
COORD.
NAZ. ACOI
(ASS.
CHIRURGHI
OSPED.
ITALIANI)
S.I.C.V.E.
(SOC.
ITALIANA
CHIRURGIA
VASCOLARE
e
ENDOVASCO
LARE)
Esempio:
A ciascuna procedura, viene associato il setting assistenziale
Più cautelativo tra quelli proposti dalle varie esperienze nazionali
21. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
•
•
•
•
FILTRI DI ESCLUSIONE PER FATTORI DI RISCHIO
22. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
• METODO APPRO
Il metodo APPRO è stato sviluppato presso l’Agenzia di Sanità Pubblica della Regione
Lazio allo scopo di individuare i ricoveri acuti a bassa complessità assistenziale e a
gravità minima. Il metodo esclude dall’analisi della inappropriatezza tutti i ricoveri che
ricadano in uno dei seguenti casi:
i. Ricoveri dimessi dalle discipline di psichiatria (codice 40), riabilitazione (codice
56), lungodegenza (codice 60), unità spinale (codice 28), neuroriabilitazione
(codice 75)
ii. Ricoveri con degenza oltre il valore soglia per il DRG specifico (outliers)
iii. Ricoveri in cui il paziente risulti deceduto o trasferito entro 5 giorni (campo
modalità di dimissione)
iv. Ricoveri di neonati (età <= 28 giorni)
v. Ricoveri non a carico del SSN (onere della degenza = 3,4)
Il metodo APPRO è stato sviluppato presso l’Agenzia di Sanità Pubblica della Regione
Lazio allo scopo di individuare i ricoveri acuti a bassa complessità assistenziale e a
gravità minima. Il metodo esclude dall’analisi della inappropriatezza tutti i ricoveri che
ricadano in uno dei seguenti casi:
i. Ricoveri dimessi dalle discipline di psichiatria (codice 40), riabilitazione (codice
56), lungodegenza (codice 60), unità spinale (codice 28), neuroriabilitazione
(codice 75)
ii. Ricoveri con degenza oltre il valore soglia per il DRG specifico (outliers)
iii. Ricoveri in cui il paziente risulti deceduto o trasferito entro 5 giorni (campo
modalità di dimissione)
iv. Ricoveri di neonati (età <= 28 giorni)
v. Ricoveri non a carico del SSN (onere della degenza = 3,4)
23. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
• METODO APPRO (ricoveri in psichiatria, ricoveri non acuti, neonati 0-28 gg.,
deceduti, trasferiti entro 5 gg., non a carico del S.S.R., Outliers)
• ETA’ 0-14 ANNI
• ETA’ ≥ 75 ANNI
• TIPO DI RICOVERO URGENTE
• MODALITA’ DI DIMISSIONE CONTRO PARERE DEI SANITARI
• MOBILITA’ ATTIVA EXTRAREGIONALE
24. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri
ospedalieri
per elenchi normativi di Procedure
•
•
•
•
• METODO APPRO (ricoveri in psichiatria, ricoveri non acuti, neonati 0-28 gg.,
deceduti, trasferiti entro 5 gg., non a carico del S.S.R., Outliers)
• ETA’ 0-14 ANNI
• ETA’ ≥ 75 ANNI
• TIPO DI RICOVERO URGENTE
• MODALITA’ DI DIMISSIONE CONTRO PARERE DEI SANITARI
• MOBILITA’ ATTIVA EXTRAREGIONALE
• METODO APPRO (ricoveri in psichiatria, ricoveri non acuti, neonati 0-28 gg.,
deceduti, trasferiti entro 5 gg., non a carico del S.S.R., Outliers)
• ETA’ 0-14 ANNI
• ETA’ ≥ 75 ANNI
• TIPO DI RICOVERO URGENTE
• MODALITA’ DI DIMISSIONE CONTRO PARERE DEI SANITARI
• MOBILITA’ ATTIVA EXTRAREGIONALE
31. Il MAAP Interattivo
Permette di entrare nel
merito del metodo e dei
dati, fino al dettaglio del
singolo ricovero.
Permette inoltre di
effettuare simulazioni.
33. Setting di ricovero
Ricoveri effettuati
Ricoveri analizzabili
Riclassificazione
MAAP
Trasformazione finale
Ricoveri eliminati dai
Filtri Fattori di Rischio
34. Setting di ricovero
Ricoveri effettuati
Ricoveri analizzabili
Riclassificazione
MAAP
Indicatori di trasformabilità
Trasformazione finale
Ricoveri eliminati dai
Filtri Fattori di Rischio
39. Un’altra modalità di
presentazione dei dati del
MAAP è il RIEPILOGATIVO.
Un’altra modalità di
presentazione dei dati del
MAAP è il RIEPILOGATIVO.
Costruisce una tabella di
tutte le possibili
trasformazioni sulla base
delle scelte effettuate
52. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri ospedalieri
per elenchi normativi di Procedure
Approccio metodologico: Dr. Gaetano A. Di Pietro
Progettazione software: Dott. Vito Petrarolo
53. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri ospedalieri
per elenchi normativi di Procedure
Approccio metodologico: Dr. Gaetano A. Di Pietro
Progettazione software: Dott. Vito Petrarolo
54. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri ospedalieri
per elenchi normativi di Procedure
E con il contributo di:
Dr. Luca Lorenzoni
Dott. Gaetano Grassi
Dott.ssa Elisabetta A. Graps
Sig.ra Beatrice Caffarella
Sig.ra Anna Salvatore
Dott.ssa Lucia Bisceglia
55. Modello di Analisi
dell’Appropriatezza organizzativa dei ricoveri ospedalieri
per elenchi normativi di Procedure
E con il contributo di:
Dr. Luca Lorenzoni
Dott. Gaetano Grassi
Dott.ssa Elisabetta A. Graps
Sig.ra Beatrice Caffarella
Sig.ra Anna Salvatore
Dott.ssa Lucia Bisceglia