FINDINGS

Figure 11. Type of operational units of the directors involved in the survey

The age of the responding directors, the majority (68%) belongs to the "More than 60 years old"

group and 74% of respondents have a directive experience of at least 10 years.

Section 2

It represents the central part of the study and is designed to measure the degree of diffusion of co-production practices in the areas detected by the previous review.

Question #1, intends to detect the extent to which the complex operating unit involves patients / citizens to increase the perceived quality of the service. 37% of respondents gave an answer of 3

"quite", while 8% answered both "completely" and "in no way".

1. Medical 40%

2. Surgical 24%

3. Diagnostics 8%

4.

Prevention 6%

5. Other 21%

No answer 1%

1. Medical 2. Surgical 3. Diagnostics 4. Prevention 5. Other No answer

Figure 12. Degree of involvement of patients / citizens in order to increase the perceived quality of the service

Question #2 investigates the extent to which patients/citizens are involved to increase patient safety.

Also in this question the evaluation extremes have very close percentages: 11% "in no way" and 12% "completely". 28% (53 users) assigned the central rating of 3 "quite". Question #3, is aimed at understanding the extent to which the operating unit involves patients / citizens to identify ways to break down barriers to access services; in this answer the not at all constitutes 15% and the almost not at all, represented by (2) represents 26% as well as (3), so there is a shift more towards the non-existence of this strategy.

Through question #4 it is understood to what extent patients / citizens are involved to identify ways to eliminate the differences in therapeutic treatment of the patient: 30% of the answers are represented by the central judgment (3), while the "a little" 20% and the "very" represent 19%, however the "in no way" prevails with 15% compared to the "completely" with 12%. Question #5 investigates the involvement of patients/citizens for the design of support programs for vulnerable patients; this question was answered as follows: 28% attributed the rating "very" (4), those who answered "completely" (10%) were in the minority compared to the opposite score "in no way"

with 14%.

1 In no way 8%

2 A little 20%

3 Quite 37%

4 Very 26%

5 Completely

8%

No answer 1%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

Figure 13. Degree of involvement of patients / citizens in order to identify ways to eliminate the differences in therapeutic treatment of the patient

Question #6 intends to measure the involvement of patients/citizens in the redesign of care pathways for chronic patients: the central assessments represent about the same population, who expressed (2) is 20%, who expressed (3) 23%, who expressed (4) 25%, mostly the "in no way" with 15% compared to "completely" with 10%.

Question #7 aims to understand the extent to which the complex operating unit involves patients/citizens in the design of services: as in the previous one, we have the central assessments representing about the same population, who expressed (2) is 22%, who expressed (3) 27%, who expressed (4) 21%, mostly the "in no way" with 19% compared to "completely" with 8%.

Question #8 measures the involvement of patients/citizens in the development and evaluation of care protocols; this response was the one with the highest percentage of "in no way" (21%) compared to all the previous ones, followed by a neutral response of (3) with 26% followed by

"very" (4) and 22% by "a little" (2), 20% while only 8% is represented by "completely".

1 In no way 15%

2 A little 20%

3 Quite 30%

4 Very 19%

5 Completely 12%

No answer 4%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

Figure 14. Degree of involvement of patients / citizens of development and evaluation of care protocols

Question # 9 notes the degree of involvement of patients / citizens for the identification of possible desired therapeutic outcomes; even in these evaluations the "in no way" represents a high percentage (19%) compared to all the previous ones, followed by a neutral response of (3) "quite"

with 26% followed by and "a little" (2) 24%, "very" (4) 21% while the lowest rating is represented by the "completely" with only 6%.

Figure 15. Degree of involvement of patients / citizens for the identification of possible desired therapeutic outcomes 1 In no way

21%

2 A little 20%

3 Quite 26%

4 Very 22%

5 Completely 8%

No answer 3%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

1 In no way 19%

2 A little 24%

3 Quite 26%

4 Very 21%

5 Completely 6%

No answer 4%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

The last question of this section, #10, the degree of involvement of patients / citizens in the design of diagnostic, therapeutic, assistance pathways: "in no way" and "completely" are very close, respectively with 16% and 15%. The "very" (4) and the central "quite" rating (3) represent 24%

each, while the "a little" is represented by 18%; to this question it seems that the answers of adoption this practice are greater than those of non-adoption.

Figure 16. Degree of involvement of patients / citizens in the design of diagnostic, therapeutic, assistance pathways

Section 3

This section investigates the extent to which patient engagement strategies are widespread within Italian public healthcare organisations. This section consists of 5 questions on how to engage the review.

Question #1 measure by which the operating unit implements meetings with advisory committees of patients and family members. 40% of respondents said that "a little" (20%) and "very" (20%) involve patients and family members in advisory committees, 27% respond (3) "quite" while only 9% "completely".

Question #2 intends to investigate the extent to which the operating unit is involved in meetings with patient representatives and patient advocacy organizations.

This question records the following answers: as in the previous one, 40% of respondents said that

"in no way" (20%) and "a little" (20%) have taken this action; the majority (27%) who say they have adopted "quite", 18% "very" and 10% "completely".

1 In no way 16%

2 A little 18%

3 Quite 24%

4 Very 24%

5 Completely

15%

No answer 3%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

Question #3 aims to understand the extent to which the operating unit is involved in internal meetings to share critical issues that have arisen in the service delivery phase together with patients / citizens. As in the previous two answers, the "in no way" (22%) and "a little" (20%) represent a large portion of respondents; "quite" represents 26% of respondents, while "very" represents 23%

which is the highest value so far detected, while "completely" 5% is the lowest so far .

Figure 17. Degree of involvement of patients / citizens in internal meetings to share critical issues that have arisen in the service delivery phase

Question #4 aims to measure the degree to which the complex operating unit is involved in moments of patient training together with internal professionals so that patients / citizens can have a voice in the organisation.

The most frequent answer to this question is "a little" (29%) followed by "in no way" 26%; “quite”

(22%) and “very” (14%) are less frequent, always stable the reduced representativeness of the

"completely" (5%).

1 In no way 22%

2 A little 20%

3 Quite 26%

4 Very 23%

5 Completely 5%

No answer 4%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

Figure 18. Degree to which the operating unit is involved in moments of patient training together with internal professionals so that patients / citizens can have a voice in the Hospital

Question #5 aims to understand the extent to which the complex operating unit uses technologies for the involvement of patients / citizens. As in the previous one, the most frequent answer to this question is "rarely" (31%), followed by sometimes (24%), "never" 21%, often 15% and constant always 5%.

Figure 19. Degree of use of technologies for the involvement of patients / citizens.

1 In no way 26%

2 A little 29%

3 Quite 22%

4 Very 14%

5 Completely 5%

No answer 4%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

1 In no way 21%

2 A little 31%

3 Quite 24%

4 Very 15%

5 Completely 5%

No answer 4%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

Section 4

This section aims to understand the use of technologies for co-production purposes.

Through Question #1 it is requested to indicate the extent to which the complex operating unit uses technologies to collect information relevant to the design of services. The most frequent answer to this question is represented by the "a little" with 34% and “quite” 29%, the extremes "in no way"

for 17% and “completely” with 5%.

Question #2 is aimed at understanding the extent to which the complex operating unit uses technologies to increase interactions with patients/citizens receiving services; the majority of respondents answered this question "a little" (32%), followed by 29% "quite". 18% answer that this action never takes place and while 4% answer that it always happens.

Question #3 intends to investigate how much the complex operating unit uses technologies to increase the level of patient/citizen involvement; even this action seems to be not widespread, given by the most frequent response "a little" (31%), "quite" 29%, in no way 20%. Very (12%) and Completely (4%) they represent only 16% of the population.

Question #4 aims to understand how much the complex operating unit uses technologies to share decision-making processes on the articulation and delivery of services. At this answer there is the highest value of the "in no way" (27%); the most frequent response is “a little” (32%) and “quite”

(28%). The lowest values are also recorded of “completely” (3%) and “very” (7%).

Figure 20. Degree of use of technologies to share decision-making processes on the articulation and delivery of services.

1 In no way 27%

2 A little 32%

3 Quite 28%

4 Very 7%

5 Completely

3% No answer

3%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

Section 5

This section requires the degree of agreement of the participants with some statements regarding the use of tools in support of co-production strategies of public value.

Question #1 intends to investigate whether in the last 5 years, health literacy improvement activities have been implemented in the organisation aimed at external stakeholders.

The most frequent answer is "quite" 27%, then "a little" 26%, "in no way" 20% while “very” 17%

and “completely” (5%) present only 22% of respondents.

Question #2 aims to understand if in the last 5 years, health literacy improvement activities have been implemented in the organisation aimed at internal stakeholders. To the answers in these questions we see an “very” value of 20%, “completely” is always poorly represented with a 5%, “a little” and “quite” both 27% and “in no way” 17%.

Figure 21. Implementation of Health literacy improvement activities in the Hospital aimed at internal stakeholders in the last 5 years

Question #3 aims to investigate whether the survey participants believe that the performance measurement systems in place detect the perspective of the patient / citizen for internal purposes.

1 In no way 17%

2 A little 27%

3 Quite 27%

4 Very 20%

5 Completely

5% No answer

4%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

The most frequent answer to this question is given by 30% of “a little”, followed by “quite” 25%,

“In no way” 19% and “completely” 3%.

Question #4 aims to understand the degree of agreement of the participants that the performance measurement systems in place provide useful information for the patient/citizen. The most frequent answer to this question is given by 30% “quite”, followed by “a little” 24%, “very” the 21% who record in this answer its highest value and “completely” stable the reduced representativeness of 3%

ever.

Question #5 wants to understand the degree of agreement with the statement that the involvement of patients / citizens in the definition of the mode of delivery of services leads to innovation. The majority of respondents gave an answer (3), “quite”; 23% of these (4) "very", followed by 18% of

"in no way" and 4% “completely”.

Question #6 asks if the complex operational unit has a good degree of autonomy in the involvement of citizens / patients: the most frequent answer is always the central (3) with 31%, 22% report "a little" (2), 20% “very”, 15% “in no way” and only 6% "completely".

Figure 22. Degree of autonomy in the involvement of citizens / patients of the operational unit

1 In no way 15%

2 A little 22%

3 Quite 31%

4 Very 20%

5 Completely 6%

No answer 6%

1 In no way 2 A little 3 Quite 4 Very 5 Completely No answer

Nel documento UNIVERSITA’ DEGLI STUDI DI PARMA (pagine 76-87)