Il modello di rete Hub & Spoke: fattori critici di successo e barriere organizzative

Journal title MECOSAN
Author/s Angelo Rosa, Giuliano Marolla, Giovanni Gorgoni
Publishing Year 2019 Issue 2018/107 Language Italian
Pages 24 P. 33-56 File size 360 KB
DOI 10.3280/MESA2018-107003
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Nowadays, National Health Systems must face two great issues: first, to pursue care objectives through equity & equality of access to safe and high quality healthcare services, second, to optimize resource use through high-level efficiency. Among the different organizational models suggested to face these aspects, most national health systems have opted for Network Models. In Italy, the D.M. 70 of 2 April 2015 "Regulation defining the qualitative, structural, technological and quantitative standards related to hospital assistance" identifies Hub & Spoke as the main reference model for Hospital networks and assigns the Regions full autonomy to define implementation strategies and operational methods. The objective of the study is to identify criticities and barriers perceived by the stakeholders involved in the organizational change. Through the implementation of the Delphi Technique, we have elaborated new, relevant results to suggest to policy makers.

Keywords: Hub & Spoke, Healthcare integrated network, D.M. 70, April 2015, Delphi Method, Critical Success factor and Barriers.

  1. Shaw S., Rosen R., Rumbold B. (2011). What is integrated care? An overview of integrated care in NHS. Nuffield Trust. Smith H.K., Harper P.R., Potts C.N. (2012). Bicriteria efficiency/equity hierarchical location models for public service application. Journal of the Operational Research Society, 64(4): 500-512.
  2. Switzer A.J., Demaerschalk B.M., Xie J., Fan L., Villa K.F., Wu E.Q. (2013). Cost-Effectiveness of Hub-and-Spoke Telestroke Networks for the Management of Acute Ischemic Stroke From the Hospitals’ Perspectives. Circulation: Cardiovascular Quality and Outcomes, 6(1): 18-26.
  3. Taber R. (1991). Knowledge Processing with Fuzzy Cognitive Maps. Expert Systems with Applications, 2(1): 83-87.
  4. Valentijn P.P., Boesveld I.C., Van der Klauw D.M., Ruwaard D., Struijs J.N., Molema J.J.W., Bruijnzeels M.A., Vrijhoef H.J.M. (2015). Towards a taxonomy for integrated care: a mixed-methods study. International journal of integrated care, 15(1): None.
  5. Valentijn P.P., Schepman S.M., Opheij W., Bruijnzeels M.A. (2013). Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. International Journal of Integrated Care, 13: 655-79.
  6. World Health Organization (2016). Integrated care models: an overview. Copenhagen: WHO Regional Office for Europe.
  7. Zhalechiana M., Ali Torabib S., Mohammadic M. (2018). Hub-and-Spoke network design under operational and disruption risks. Transportation Research Part E, 109: 20-43.
  8. Goodwin N. (2008). Diagnostic delays and referral management schemes: how “integrated” primary care might damage your health. International Journal of Integrated Care, 8(4).
  9. Govindarajan V., Ramamurti R. (2013). Delivering world-class health care, affordably. Harvard Business Review, 91(11): 117-22.
  10. Harper M.G., Asselin M., Kurtz A.C., Macarthur S.K., Perron S. (2012). Research priorities for nursing professional development: A modified e-Delphi study. Journal for Nurses in Staff Development, 28(3): 137-142.
  11. Keeney S., Hasson F., McKenna H. (2006). Consulting the oracle: Ten lessons from using the Delphi technique in nursing research. Journal of Advanced Nursing, 53: 205-212.
  12. Lega F. (2001). Organizzazione, strategia e gestione dei dipartimenti ospedalieri nelle aziende sanitarie multi ospedale: proposta, analisi e discussione di possibili assetti di riferimento. Organizzazione Sanitaria, 1: 2-17.
  13. Lega F., Mauri M., Prenestini A. (2010). L’ospedale tra presente e futuro. Milano: Egea. Lewis R., Rosen R., Goodwin N., Dixon J. (2010).
  14. Where next for integrated care organizations in the English NHS?. London: The King’s Fund. Linstone H.A., Turoff M. (1975). The Delphi Method: Techniques and Applications. Boston, MA: Addison-Wesley.
  15. Lloyd J., Wait S. (2005). Integrated Care: A guide for policymakers. London: Alliance for Health and the Future.
  16. Lo Scalzo A., Donatini A., Orzella L., Cicchetti A., Profili S., Maresso A. (2009). Italy: health system review. Health Systems in Transition, 11(6): 1-168.
  17. Mestre A.M., Oliveira M.D., Barbosa-Póvoa A.P. (2014). Location-allocation approaches for hospital network planning under uncertainty. European Journal of Operational Research, 240(3): 791-806.
  18. Moreno A., Schwamm L.H., Siddiqui K.A., Viswanathan A., Whitney C., Rost N., Zachrison K.S. (2018). Improved Spoke Hospital Performance: Results from the Massachusetts General Hospital Telestroke Network. Telemedicine and e-Health, 24(9).
  19. Moretti A. (2017). The Network Organization: A Governance Perspective on Structure, Dynamics and Performance. Palgrave Macmicllan.
  20. Moynihan B., Davis D., Pereira A., Cloud G., Markus H.S. (2010). Delivering regional thrombolysis via a Hub-and-Spoke model. Journal of the Royal Society of Medicine, 103: 363-369.
  21. Nardetto L., Giometto B., Moretto G., Mantoan D., Saia M. (2017). Hub-and-Spoke stroke network in the Veneto region: a retrospective study investigating the effectiveness of the stroke pathway and trends over time. Neurological Sciences, 38(12): 2117-2121.
  22. OECD (2015). Health at a Glance 2015: OECD Indicators. Paris: OECD Publishing.
  23. Porter M., Lee T. (2013). The strategy that will fix health care. Harvard Business Review, 91(10): 50-70.
  24. Portney L., Watkins M. (2009). Foundations of clinical research: Applications to practice. Upper Saddle River, NJ: Prentice Hall.
  25. Prenestini A. Carbone C., Giusepi I., Lega F., Flor L., Garbelli C. (2011). Logiche e modelli organizzativi per le reti ospedaliere: analisi di due casi aziendali. L’aziendalizzazione della sanità in Italia. Rapporto OASI 2011. Milano: Egea.
  26. Rastier F., Cavazza M., Abeillé A. (2002). Semantics for Descriptions. Stanford: CSLI.
  27. Salton G., McGill M.J. (1983). Introduction to Modern Information Retrieval. New York: McGraw-Hill.
  28. Armitage G.D., Suter E., Oelke N.D., Adair C.E. (2009). Health systems integration: state of the evidence. International Journal of Integrated Care, 9(2): None.
  29. Bensa G., Carbone C. Lega F. (2008). Le reti ospedaliere dei SSR: un’analisi comparativa. In: Anessi Pessina E., Cantù E. (a cura di). L’aziendalizzazione della sanità in Italia. Rapporto OASI 2008. Milano: Egea.
  30. Berry M.W., Castellanos M. (2007). Survey of Text Mining: Clustering, Classification, and Retrieval, Second Edition. Springer.
  31. Bertolini M. (2007). Assessment of Human Reliability Factors: A Fuzzy Cognitive Maps Approach. International Journal of Industrial Ergonomics, 37(5): 405-413.
  32. Carbone C., Prenestini A., Lega F., Garbelli C., Ceratti F., Troiano D. (2011). Organizzare la rete ospedaliera aziendale: costruzione e applicazione di un modello teorico. Mecosan, 78.
  33. Cuccurullo C., Pennarola G. (2017). Strategia e performance nelle aziende ospedaliere. Analisi, pianificazione e performance. Milano: Egea.
  34. Currie G., White L. (2012). Inter-professional Barriers and Knowledge Brokering in an Organizational Context: The Case of Healthcare. Organization Studies, 33(10): 1333-1361.
  35. Daskin M.S., Dean, L.K. (2004). Location of health care facilities. Handbook of OR/MS in health care: a handbook of methods and applications. Boston: Kluwer.
  36. D.M. 70 del 2 aprile 2015 “Regolamento recante definizione degli standard qualitativi, strutturali, tecnologici e quantitativi relativi all’assistenza ospedaliera”.
  37. Elrod J.K., Fortenberry J.L. (2017). The Hub-and-Spoke organization design: an avenue for serving patients well. BMC Health Services Research, 17(suppl 1).
  38. Featherstone I., Keen J. (2012). Do integrated record systems lead to integrated services? An observational study of a multiprofessional system in a diabetes service. International Journal of Medical Informatics, 81(1): 45-52.

Angelo Rosa, Giuliano Marolla, Giovanni Gorgoni, Il modello di rete Hub & Spoke: fattori critici di successo e barriere organizzative in "MECOSAN" 107/2018, pp 33-56, DOI: 10.3280/MESA2018-107003