Azienda Ospedaliera S. Camillo-Forlanini, Italy
Angelo Pochini since 2002 is a senior Lecturer at Sapienza University of Rome in the under and postgraduate degree of nursing. He has 21 years of experience in critical care, particularly cardiology. He has been head of the Nursing Cardiovascular and Center Heart Transplant, of' the Center of Kidney Transplant and the Integrated Area of Critical Care. Currently, he is in the bed management team.
Background: Th e downsizing of Italian hospitals, in terms of acute care beds, in facilities with a high level of specialization and with an emergency service leads to set up a bed management team, as new strategic and organizational model. Th e role of "facilitator of the process of admission" is held by a nursing coordinator especially in cases of emergency-urgency. Since 2008 this team, in the hospital San Camillo-Forlanini of Rome, an hospital of national importance, is " hub" of reference in the network of regional emergency for several major diseases: cardiovascular, neurovascular, as well as neurotrauma and severe polytrauma. Furthermore, it is a reference point for transplants such as heart, liver and kidneys. Currently, the Hospital serves and cares an area of almost 2,550,000 users the largest in the region. Today, six nursing coordinators, co-assisted by two physicians of the hospital management collaborate in the rationalization and optimization of hospital beds available for the needs of the emergency service, except for the pediatric unit. Method: Nursing coordinators, applying methodologies such as systemic analysis and path maximum reference are in charge of the entire path from admission to discharge or relocation to other health care facilities such as long-term care, post-acute, hospice or nursing home. Results: Bed management team contributed to the improvement of the results in terms of activity of wards/units of the emergency service, to decrease the number of patients with chronic diseases; furthermore there was an improvement in terms of collaboration between hospital and local health services/facilities in taking care of patients immediately aft er the acute phase. Conclusion: Th is organizational model making the centre of entire health system the patient generated a stronger attitude of health providers to collaborate