Redesigning service delivery for hypertensive patients: a methodological guideline to improve the management of chronic diseases.

Authors:
Adelaide Ippolito
Adelaide Ippolito
Federico II University Hospital
Napoli | Italy
Prof. Guido Iaccarino, MD, PhD
Prof. Guido Iaccarino, MD, PhD
Federico II University of Naples
Full Professor of Applied Medical Science and Technology
Cardiology
Napoli, Campania | Italy
Maddalena Illario
Maddalena Illario
University of Naples Federico II
Napoli | Italy

Transl Med UniSa 2014 Apr 24;9:7-17. Epub 2014 Apr 24.

Research and Development Board, Federico II University Hospital ; ITALY ; Translational Medical Sciences, Federico II University ; ITALY.

Best care is not necessarily the most expensive, but the most appropriate, and prevention is the most powerful tool to promote health. A novel approach might envision the reduction of hospital admittance (thus meeting a requirement from long term condition patients: they would rather not being hospitalized!) and the enforcement of peripheral (both on the territory and at home) assistance. In this direction, experiences of reshaping new service deliveries towards an integrated disease management, namely clinical pathways, can be observed in Europe and in different parts of the world. Aim of this paper is to provide a methodological guideline to support the management in planning clinical pathways, also outlining the main barriers limiting the process. In particular, we present the results of planning a clinical pathway at the Centre for Hypertension of the Federico II University Hospital (Naples, Italy). The case study showed that the introduction of a similar service impacts on the organisation of the structure. An analysis of organizational processes "as are" and the re-design of processes "to be" are necessary to integrate the clinical pathway into the actual activities.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4012379PMC

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April 2014
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