Health Promoting Hospitals Veneto Region Network Health Promoting

Health Promoting Hospitals Veneto Region Network Health Promoting Hospitals PATIENT CENTRED HOSPITAL ADMISSION: the HPH Project of Veneto Region Network . Anna Maria Rinolfi Health Social Local Trust n. 18 Rovigo (Italy). . 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 13 International Conference on HPHs - Dublin, May 18 -20 , 2005 th Veneto Region Network

Veneto Region NORTH- EAST OF ITALY 18, 364 Km 2 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin Health Promoting Hospitals 4. 5 MILLIONS OF INHABITANTS MAIN TOWN VENICE Veneto Region Network 2

THE PROJECT Health Promoting Hospitals HOSPITALS: 9 Hospitals of the Network were involved 1. Hospital of Feltre 2. Hospital of Schio 3 Hospital of Thiene 4. Hospital of Chioggia 5. Hospital of Este 6. Hospital of Monselice 7. Hospital of Trecenta 8. Hospital of Rovigo 9. Hospital of Bussolengo ACTIONS: 1. Survey on 1, 684 inpatients 2. Interventions (on the basis of survey results) Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 3

Health Promoting Hospitals THE SURVEY Objectives To evaluate the type of admission received within 48 hours since the hospitalization To analyse the admission modalities To assess mood, sensitiveness and need of company To survey the waits for a suitable admission Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 4

THE SURVEY Health Promoting Hospitals THE SURVEY INSTRUMENT The operative instrument chosen for the analysis was a questionnaire, submitted to the patients within 48 hours since the hospitalization, both in case it was planned or it was a urgent hospitalization. 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 5 Veneto Region Network

THE SURVEY Health Promoting Hospitals aims to evaluate: 1. Information received by patients about: -1. 1 their health state -1. 2 the diagnosis and the examinations they were going to have -1. 3 The ward organization The questionnaire 2. Staff manners perceived by patients (courtesy) 3. Patients needs and expectations 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin Veneto Region Network 6

THE SURVEY Health Promoting Hospitals Characteristics of the sample v. N. 1, 684 inpatients v 56% female , 44 %% male v. Average : 56 years v 41% were older than 65 years v 71% no more 8 years of school v 26 % First hospital admission Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 7

Health Promoting Hospitals Therefore we wondered: The mood, the information, the Hospital organization didn’t cause a problem, due to the fact these inpatients had already experienced a hospitalization! As a matter of fact experiences are not alike………………… 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 8 Veneto Region Network

Health Promoting Hospitals Main results • MOOD DURING THE ADMISSION: Only the 36% of users declare their mood is peaceful/quiet during the admission The others: 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin unpeaceful worried very worried 9 Veneto Region Network

Health Promoting Hospitals …. . this highlights the data we already know about the users: frailty during the hospital admission Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 10

Health Promoting Hospitals It is natural and understandable that users are worried about their health conditions, but this situation suggests to consider their mood and to communicate with them so that to calm them KEY ASPECT OF A GOOD CARE Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 11

Health Promoting Hospitals 1. 1 The Information about health state Who gives this information ? Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 12

1. Who gives health state information ? • • By an ambulance doctor 1, 2% Hospitals By an emergency care unit doctor 20, 4% Doctors 83, 3 % By a ward doctor 47, 7% By a specialist 17% Others (GPs, F-a) 3, 0% By a nurse 5, 6% By a relative 1, 6% 96, 6 % Received information • nobody 3, 5% 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 13

Health Promoting Hospitals 1. The Information about health state Was this information given respecting patients privacy ? Was it conprehensible for the patients ? Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 14

Health Promoting Hospitals Main results 96, 4% of people received information about their health conditions according to privacy, while the 96% received them in a simple and understandable way Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 15

Health Promoting Hospitals 1. 2 The Information about diagnosis and the examinations 1. 3 The information about ward organization How was it given in a prompt way ? Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 16

Health Promoting Hospitals Comparing the three types of information received: 1. YES Information regarding the health conditions 96, 5% (83, 3% hospital doctors) 2. Information regarding therapies YES 84, 9% NO 15, 1% 3. Organizational information of the Ward YES 49, 7% NO 50, 3% 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin Veneto Region Network 17

Health Promoting Hospitals Generally, the INFORMATION level is good, even if it is centred on the main issues concerning the health conditions, examinations, therapies. POOR INFORMATION CONCERNING THE OPERATIVE PACES OF WARDS AND ORGANIZATION, WITHIN 48 HOURS SINCE THE HOSPITALIZATION Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 18

Health Promoting Hospitals WHY is there POOR information regarding the organizational aspects? Hypothesis: a) The operators provide these information after 48 hours… b) Personnel consider these information not very important and think they are passed among the inpatients by word of mouth. 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 19 Veneto Region Network

Health Promoting Hospitals ALSO THE ORGANIZATION INFORMATION ARE IMPORTANT, PARTICULARLY IF WE CONSIDER THAT MOST OF INPATIENTS ARE ELDERLY (difficult adaptability to a new place) 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin Veneto Region Network 20

Health Promoting Hospitals 2 Staff Manners KINDNESS: YES among the 97% of the inpatiens Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 21

Health Promoting Hospitals 3 Patients needs and expectations NEED OF A PERSON CLOSE TO THEM: YES 70, 2% 28, 8% OF INPATIENTS DIDN’T HAVE THIS NEED ONLY THE 1% WASN’T ALLOWED Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 22

Health Promoting Hospitals WHAT DOES A PATIENT EXPECT from the Hospital Admission? We surveyed the expectations through the expression of one’s own opinion ALL THE RATE LEVELS ARE HIGHER THAN THE REAL SATISFACTION OF NEED Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 23

Health Promoting Hospitals SUPPLIED Kindness Information about the health conditions Organization information WAIT 97% 99. 7% 91, 9% 49, 7% 98, 8% 86, 3% KINDNESS= very important ORGANIZATIONAL ASPECTS = less important Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 24

Health Promoting Hospitals Conclusions Patients consider the hospital admission a tricky moment The information they wait for, are a true RIGHT: 1. to know their health conditions, examinations and possible operations 2. to receive this kind of information by the 3. DOCTOR WHO RECEIVE THEM Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 25

Information should be given by a qualified person, who knows the hospitalization causes and the disease conditions Health Promoting Hospitals This should happen: DURING THE HOSPITALIZATION 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 26 Veneto Region Network

Health Promoting Hospitals • To receive simple, understandable and respectful to privacy information To receive information regarding a Ward customs and its organization Other surveyed needs: Where possible, to have a relative nearby Kind available operators Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 27

Health Promoting Hospitals What are we going to do? PLANNED INTEVENTIONS A: To include “Admission” in the planning of doctors/nurses training activities B: To do meetings with the Wards personnel C: To define specific “Ward protocols” so that to include in the ordinary medical procedure the admission modalities of patients Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 28

Health Promoting Hospitals D: duly updated ward posters, - as well as in hotels containing the main information regarding food timetable, meetings with doctors and other daily activities But never forget the importance of a direct spoken information Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 29

Health Promoting Hospitals TO CARRY OUT THE PREMISES FOR A GOOD AND EFFECTIVE ADMISSION IS EQUAL TO CONTRIBUTE TO THE PATIENT’S WELL-BEING: 1: be able to receive a “new-inpatient” in one’s own life experience 2: allow the free expression of options, values, human needs, according to times and expressive modalities Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18 -20 2005, Dublin 30