RISULTATI RICERCA

BackgroundPatient journey mapping is widely considered a helpful tool to enhance the patient experience by supporting practitioners in the provision of patient-centered care. PurposeThe ultimate goal of this paper is to introduce an all-encompassing framework that integrates the experientialdimension of care into the major phases of the patient journey, as well as identify how different patterns of behavior may influence the therapeutic path. MethodologyThe analysis is divided into two parts. The first involves the theory adaptation of a marketing framework to healthcare in the context of the Experience Economy.The second consists of the theoretical conceptualization of a patient journey map called the “Snail Model”. FindingsThe results show how the interaction between health literacy and involvement may unearth four typologies of patients: resigned, informed, expert, and responsible. Furthermore, the following stages of the patient journey are identified: i) health communication policies and prevention programs; ii) health service access and diagnostic process; iii) patient involvement and therapeutic adherence; iv) doctor-patient communication failure and therapeutic non-adherence. Practice implicationsIt is crucial for practitioners to adopt an experiential standpoint when providing care. The theories presented in this study should assist them in clustering patients according to their behaviors, as well as monitoring the effectiveness of the patient journey. ConclusionThe NHS should ensure effective prevention programs, equal access to healthcare, and adherence to treatments.Overall, patient involvement is essential to improving the quality of care and the whole patient experience.

La gestione del personale amministrativo nel Sistema Sanitario Nazionale (SSN) italiano è una sfida critica spesso trascurata. Tuttavia, in un contesto di imminenti pensionamenti e rivoluzioni tecnologiche, è pressante la necessità di attrarre personale più giovane, qualificato e digitalmente competente, ridefinendo il profilo amministrativo verso una gestione più efficiente e innovativa. Questo studio offre la prima analisi del personale amministrativo nel contesto del SSN, al servizio di una efficace attività di pianificazione dei fabbisogni. Il contributo propone metriche di benchmarking a livello interaziendale e nel confronto tra unità operative amministrative e ne mostra una possibile applicazione in un’azienda sanitaria.

This paper proposes, implements and routinises a strategic management control system (MCS) as a means of stimulating the managerialisation of small organisations. To this end, this paper develops a single case study based on a small Italian residential care home. The tool employed entailed significant organisational, operational and cultural changes. Thus, careful analysis of the nature and economic and financial consequences of this process are needed. This control system also aims to become a reporting and communication tool to inform stakeholders of the organisation’s behaviour, results and economic and social responsibilities. This paper utilises an interventionist approach, and its value lies in its practical implications, which contribute to a reduction in the gap between theory and practice.

Negli ultimi anni, il contesto sanitario italiano è soggetto a profondi cambiamenti e trasformazioni, determinati sia dall’evoluzione delle esigenze della popolazione, sia dalle sfide imposte dalla pandemia, che hanno accelerato l’adozione di innovazioni tecnologiche.In particolare, le Aziende Sanitarie Locali (ASL) sono chiamate a rimodulare e ridefinire i modelli organizzativi di Assistenza Territoriale. Questi cambiamenti hanno un impatto sui diversi elementi del contesto sanitario italiano, anche rispetto alle comunità di professionisti, che si devono interrogare sui nuovi ruoli e sulle nuove opportunità di servizio rispetto ai bisogni dei pazienti.In linea con le indicazioni ministeriali, DGR n. 643 del 2022, è stato approvato il documento denominato “Linee Guida generali di programmazione degli interventi di riordino territoriale della Regione Lazio in applicazione delle attività previste dal Piano Nazionale di Ripresa e Resilienza (PNRR)...”, che si inserisce nel quadro delle azioni di transizione digitale previsti dalla Missione 6 Salute.Su tali stimoli, l’ASL di Latina ha avviato fin dal 2023 i relativi processi di organizzazione e ri-organizzazione, descritti nel presente contributo.Sull’analisi organizzativa di tale modello di intervento sulla Sanità Territoriale Laziale, sono state sviluppate alcune considerazioni sia di sistema sia operative, tutte finalizzate all’evidenziazione di pratiche disponibili per futuri confronti.

Background: There still is reluctance among surgeons when it comes to using bedside US in their daily clinical practice, except for very specific fields.Generally, the decision-making process relies on imaging techniques (e.g. CT, MRI). This may lead to a latency of execution, and consequently to a delay in decision making.Objectives: The purpose of this study is to assess the economic impact of systematic and routine use of surgeon-performed point-of-care US (SP-POCUS) in the everyday activities of a surgical department, both for urgent and elective cases.Methods: We conducted a cost-benefit analysis comparing the incremental costs and savings of diagnostic strategies based on alternative procedures to bedside US. The dataset refers to 478 SP-POCUS performed at the General Surgery Department of Policlinico San Pietro (Bergamo, Italy) between January 2018 and February 2020. The alternatives to SP-POCUS were computed tomography (CT), X-ray (RX), magnetic resonance imaging (MRI), and US performed by the Radiologist.Per-exam costs, including personnel time expenditure, were calculated.Results: The economic evaluation revealed that the use of SP-POCUS allowed the hospital to generate €355 net savings per patient, mainly from avoided hospitalizations, fewer hospital days and hours of operating room.Extrapolating these results to a wider scenario, in a similar setting they could have represented a potential annual savings of more than €1.1 million for the Regional healthcare system in Lombardy, and more than €5.7 millions for the whole NHS in Italy.Conclusions: We provided evidence that SP-POCUS may generate important costs savings for health care providers, as it represents the most cost-effective initial diagnostic procedure compared to standard alternatives.The wide applicability of SP-POCUS could be obtained at rather negligible costs for investment in staff training.

L’articolo analizza lo stato di attuazione del DM 77/2022 nell’AUSL-IRCCS di Reggio Emilia, esaminando la riorganizzazione dei servizi sanitari territoriali attualmente in corso. Vengono esplorate le sfide e le soluzioni adottate in un territorio già orientato verso modelli integrati come Distretti e Case della Salute. Tra le azioni implementate dall’Azienda si evidenzia l’attivazione di setting di cura dedicati alla medicina di iniziativa, come Centrali Operative Territoriali e Ospedali della Comunità, la formazione del personale medico e sanitario, e il potenziamento dell’assistenza domiciliare.Tecnologie innovative, collaborazione multidisciplinare e multiprofessionale e coinvolgimento del terzo settore risultano essere elementi chiave per rispondere in modo integrato ai bisogni di salute e valorizzare i professionisti coinvolti. La chiave di lettura del caso va oltre l’attuazione del DM 77, comprendendo una transizione valoriale nella politica sanitaria per sviluppare un servizio pubblico più pronto ad affrontare le sfide contemporanee.

A luglio 2021, nell’Azienda USL Toscana Centro (Toscana, Italia), è stato attivato un progetto pilota per il processo di approvvigionamento di farmaci nel magazzino della distribuzione diretta dell’Ospedale Santo Stefano di Prato. L’obiettivo del progetto riguarda l’ottimizzazione delle giacenze di magazzino per ridurre i costi di gestione e il rischio di rotture di stock, tenendo conto della domanda e dei vincoli di spazio. L’approccio metodologico proposto si focalizza su un modello di gestione delle scorte standardizzato e facilmente applicabile per tutti gli operatori. I risultati ottenuti dopo sei mesi dall’applicazione hanno mostrato una significativa riduzione del valore di giacenza a fronte di un numero similare di ordini effettuati in urgenza.

Al fine di produrre un quadro sullo stato di attuazione, nell’anno di avvio, delle disposizioni contenute nel PNRR e nel DM 77/2022, FIASO ha organizzato una survey alla quale hanno aderito 74 Aziende sanitarie territoriali.Le varie strutture e i processi previsti dalla normativa (Case e Ospedali di Comunità, Centrali Operative ecc.) sono stati attivati in media da poco più della metà del campione. La tecnologia sembra diffusa per il teleconsulto, meno per il controllo dei pazienti da remoto. Tutti hanno attuato formazione degli operatori e campagne di informazione verso la popolazione. Lo stato di avanzamento dell’applicazione di quanto previsto dalla normativa risulta in fase avanzata solo nell’11% delle Aziende. Viene evidenziata una disomogeneità territoriale nell’attuazione del nuovo modello di presa in cura. La maggiore difficoltà è rappresentata dalla carenza dei professionisti.

European policies play a crucial role in helping farms and stakeholders in the agri-food sectors to proactively engage in digital and environmental transitions. Among them, the European Partnership for Innovation in Agriculture (EIP-AGRI), which was established in 2014, has proven significant in promoting sustainable production models and value chains in Europe. Operational Groups (OGs) within the Partnership provide “interactive innovation” platforms in which research institutions work with farmers, advisors, businesses, NGOs and other interest groups to co-create innovative solutions for agriculture and forestry as well as rural communities; the rationale is that when farmers and foresters are engaged in the process, the solutions are more likely to be based on their concrete reality and thus relevant.  While the benefits of the participatory, multi-actor and bottom-up approach of OGs have been widely acknowledged, little is known about the drivers and barriers influencing the process. This contribution explores their role in the wine sector, applying a mixed methods approach to analyse the perceptions of OG stakeholders from different Italian regions. Interviewees have been asked to what extent they believe the EIP-AGRI OGs serve as drivers of innovation and provide a network able to foster knowledge exchange, and what they perceive to be their barriers to innovation. By addressing this knowledge gap, this study will provide some insights and good practices to improve EIP-AGRI policies at regional, national and European levels.

The twin transition has great potential for the development of the wine sector, although its benefits for the valorisation of the Protected Designation of Origin (PDO) economy and at the quality districts level are not explored in depth either in the theoretical or empirical literature. The study aims to contribute to this knowledge gap from a strictly conceptual perspective, by investigating benefits and obstacles that Blockchain and digital technologies can have to favour the creation and implementation of a quality wine district towards a sustainable path. Based on the literature background and a case study approach, the Vermentino di Gallura PDO Quality District, this study discusses the prospects and hypotheses of introducing Blockchain technologies and other digital tools at district level and the challenges and opportunities for fostering its sustainable transition. Preliminary results suggest that this transition could benefit the local supply chain and its territory over different pillars of sustainability, although obstacles can be expected along the implementation path. Obstacles can be in various areas – among which are the breadth and variety of processes included within the boundaries of the digital transition and the inter-organizational nature of the twin transition.

Promoting a sustainable economy through the digital and ecological transition of companies is one of the challenges of our century. By improving processes along the agri-food supply chains and enhancing the data generated in every single area of the value chain, digital promises to reduce the ecological footprint of the agricultural sector. Thus, the aim of the research was to estimate the environmental impacts and the social cost of pollution of different agricultural systems to identify the weak point in the cultivation phase and propose more sustainable lines of intervention and alternatives in a green transition perspective. The study was carried out in Southern Italy and 46 cropping systems were analyzed and compared using the Life Cycle Methodology (LCA). Results showed that to date no farmers interviewed has adopted digital technologies. The comparison between cultivation systems highlighted the greater sustainability of those organic. Among the different systems, some by their nature cOULD be considered more sustainable than others (as olive and hazelnut systems) because linked to a cultivation characterized by a low use of resources and inputs. On the contrary, others presented greater impacts due to the use of considerable quantities of materials, above all support and covering structures (as in table grapes systems) or plastic containers (as in strawberry systems). In the systems that didn’t use many materials, the disaggregation of the impacts by agricultural operations showed that the greatest impacts were linked to the emissions of the fuels, especially during the harvesting phase, and to fertilization and disease control. Hence the need to spread the use of the LCA methodology to estimate impacts in agriculture, increase organic cultivation and intervene with modern digital and precision agriculture technologies to consume fewer resources, reduce waste, and improve the quality of life.

The importance of research and innovation is crucial for addressing the challenges posed by evolving climatic and environmental conditions, along with the urgent need to mitigate greenhouse gas emissions and to deal with unstable markets.To establish Sustainable Agri-Food Systems, in environmental, social, and economic terms, it is essential to ensure access to technologies that can reduce biological and market risks.The objective of this paper is to understand how different factors influence the innovativeness of organic farmers in the Marche region, in Italy, with a particular focus on the adoption of a digital tool, Decision Support System (DSS).The analysis, developed through the application of the SEM model to a sample of organic farmers, highlights the significant role of support services in facilitating the implementation of innovations. Therefore, it is important for policymakers, especially at the regional level, to define specific and coherent measures that incentivize the adoption of innovations.

This paper investigates how some factors affect the willingness to buy organic food on e-commerce platforms. Data have been collected using a web-based survey with 490 respondents. A factor analysis was used to analyze data and later to consider them in a Poisson Count Regression Model. The findings show that well-educated and high-income women are more willing to purchase organic food on e-commerce platforms than others.Moreover, other drivers, such as food quality attributes and people’s attitudes towards green consumption and digital channels, affect people’s willingness to buy organic food online. These results should be useful for experts dealing with organic food. Marketing campaigns should consider all the drivers affecting people’s willingness to purchase organic food online to target the market by designing communication content susceptible to generating the greatest appeal.

This paper presents the first results of marketing studies for the positioning of a new sustainable biobased plastic packaging for fresh food, as part of the research project “CItrus waste ReciCLing for added valuE products – CIRCLE” for improving the sustainability of the citrus processing production chain through the valorization of processing waste. The present study, conducted on Italian consumers, contributes to the flow of literature on consumer demand of sustainable food packaging, highlighting the preferences, concerns, and skepticism, the factors that explain behaviors, and the role of information on their choices. Findings may be of interest for firms and Public Institutions to promote circularity behaviors among citizens and to consolidate their ethical motivations through correct information and experience.

The paper explores the complex relationship between digital and ecological transitions, particularly focusing on their interdependence and potential to drive sustainability. It acknowledges that digitalization, while offering numerous benefits such as efficiency and scalability, does not inherently lead to sustainability. The text highlights three critical aspects influencing digitalization’s impact: the design of digital solutions, access to these solutions, and the complexity of systems integrating digital technologies. Challenges such as the risk of exacerbating inequalities and the necessity for comprehensive governance to mitigate negative effects are discussed. The paper also delves into the digital transition within the agri-food sector, emphasizing the contrast between conventional agriculture and agroecological approaches, which prioritize diversity and resilience. It argues that digital tools can support more sustainable and diverse agricultural practices if correctly aligned with ecological principles. Finally, the text calls for targeted innovation policies to ensure that digital transition contributes effectively to ecological goals, suggesting that a thoughtful and directed approach is essential for realizing the transformative potential of digitalization in fostering a sustainable future.

The study aims to recommend Islamic macroprudential policy instruments to support Indonesia’s staple agricultural sector financing. Delphi-ANP analysis method is used to determine the optimal Islamic macroprudential instruments, which result is supported by meta-analysis and optimum method findings.The results show that Islamic Agricultural Lending to Sector (IALTS) is the optimal instrument to support agricultural sector financing. According to the ANP and optimum method findings, an Islamic macroprudential instrument should meet three criteria i.e., it should be able to increase financing for the agricultural sector, prevent speculative short-term transactions, and internalize systemic risk. Experts emphasized that IALTS have met the criteria to support sustainable growth and stability in the agricultural sector financing. Meta-analysis reveals a positive and significant correlation between agricultural financing and agricultural productivity across countries, which supports the instrument of macroprudential implementation.The government should adopt measures to boost agricultural production through macroprudential policy tools, financing for agriculture from Islamic banks, and policies that ensure inclusive agricultural financing for the benefit of all levels of farmers.