Governo delle medicazioni avanzate nella AUSL di Bologna: analisi di appropriatezza ed economicità
Valentina Valastro, Patrizia Falcone, Morena Borsari
Background: The governance of the Advanced Dressings (AD) is a recommended action from the Emilia Romagna region: the numberless medications on the marked represent an area of great development that absorbs considerable economic resources by the Local Health Units. AD are Medical Devices (DM) grouped into the National Classification of DM (CND) M0404. In the AUSL of Bologna, the governance project started in the year 2014 and shared with the professionals of the Pharmacy Service and of the Clinical Governance, and dressing specialists. The outcome was to identify the appropriateness criteria to improve both treatment outcomes and the cost/benefit ratio.
Materials and methods: Actions carried out in the year 2014:
Critical reading of information flow reports on DM
Analysis of corporate consumption data
Identification of areas with the highest spending impact
Detection of 33 operating units of ADI (Integrated Home Care) of the Department of Primary Cure
Actions carried out in the year 2015:
Creation of a Working multi-professional Group (WG) on dressing
Analysis of data sheets and scientific evidences
Optimization of AUSLBO’s Database
Processing / dissemination of regional / local reference documents and detailed consumption monthly reports
Audit Wound-Care by examining the activities carried out by operators and evaluating deviations of current clinical practice from the standard
Training courses for General practitioners about the treatment of “difficult wounds”.
Results: The tools and strategies implemented by the WG led to achieve the business budget fixed for 2015. In fact, a decrease in the trend up to the -10.3% after twelve months, for the CND M0404 was registered. This result represented a great contraction of spending compared to the previous year’s consumption. Regular meetings with ADI representatives allowed to identify critical issues and correcting them with timely actions.
Conclusions: This experience confirmed that organizational, managerial, relational and technical competences of the Hospital Pharmacist are essential in view of a clinical governance based on the appropriateness and the correct management of the economic resources in the hospital and territorial structures.
Key words: advanced dressings, audit, report, integrated home care, appropriateness, working multi-professional group