1. Health Promoting Hospitals Veneto Region Network........ Veneto Region Network 13 th International Conference on HPHs - Dublin, May 18-20, 2005 PATIENT CENTRED HOSPITAL ADMISSION: the HPH Project of Veneto Region Network Anna Maria Rinolfi Health Social Local Trust n.18 Rovigo (Italy) Health Promoting Hospitals Veneto Region Network

2. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 2 NORTH- EAST OF ITALY 4.5 MILLIONS OF INHABITANTS MAIN TOWN VENICE 18,364 Km 2 Veneto Region

3. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 3 HOSPITALS: 9 Hospitals of the Network were involved 1. Hospital of Feltre 2. Hospital of Schio 3 Hospital of Thiene 4. Hospital of Chioggia 5. Hospital of Este 6. Hospital of Monselice 7. Hospital of Trecenta 8. Hospital of Rovigo 9. Hospital of Bussolengo THE PROJECT ACTIONS: 1. Survey on 1,684 inpatients 2. Interventions (on the basis of survey results)

4. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 4 THE SURVEY Objectives To evaluate the type of admission received within 48 hours since the hospitalization To analyse the admission modalities To assess mood, sensitiveness and need of company To survey the waits for a suitable admission

5. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 5 THE SURVEY THE SURVEY INSTRUMENT The operative instrument chosen for the analysis was a questionnaire, submitted to the patients within 48 hours since the hospitalization, both in case it was planned or it was a urgent hospitalization.

6. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 6 The questionnaire aims to evaluate: 1. Information received by patients about: -1.1 their health state -1.2 the diagnosis and the examinations they were going to have -1.3 The ward organization THE SURVEY 2. Staff manners perceived by patients (courtesy) 3. Patients needs and expectations

7. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 7  N.1,684 inpatients  56% female, 44 % male  Average age : 56 years  41% were older than 65 years  71% no more 8 years of school  26 % First hospital admission Characteristics of the sample THE SURVEY

8. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 8 The mood, the information, the Hospital organization didn’t cause a problem, due to the fact these inpatients had already experienced a hospitalization! As a matter of fact experiences are not alike………………… Therefore we wondered:

9. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 9 MOOD DURING THE ADMISSION: Only the 36% of users declare their mood is peaceful/quiet during the admission The others: unpeaceful worried very worried Main results

10. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 10 …..this highlights the data we already know about the users: frailty during the hospital admission

11. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 11 It is natural and understandable that users are worried about their health conditions, but this situation suggests to consider their mood and to communicate with them so that to calm them KEY ASPECT OF A GOOD CARE

12. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 12 1.1 The Information about health state Who gives this information ?

13. 1. Who gives health state information ? By an ambulance doctor 1,2% By an emergency care unit doctor 20,4% By a ward doctor 47,7% By a specialist 17% Others (GPs,F-a) 3,0% By a nurse 5,6% By a relative 1,6% nobody 3,5% Hospitals Doctors 83, 3 % 96,6 % Received information

14. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 14 1. The Information about health state Was this information given respecting patients privacy ? Was it conprehensible for the patients ?

15. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 15 Main results 96,4% of people received information about their health conditions according to privacy, while the 96% received them in a simple and understandable way

16. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 16 1.2 The Information about diagnosis and the examinations How was it given in a prompt way ? 1.3 The information about ward organization

17. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 17 Comparing the three types of information received: 1. YES Information regarding the health conditions 96,5% (83,3% hospital doctors) 2. Information regarding the therapies YES 84,9% NO 15,1% 3. Organizational information of the Ward YES 49,7% NO 50,3%

18. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 18 Generally, the INFORMATION level is good, even if it is centred on the main issues concerning the health conditions, examinations, therapies. POOR INFORMATION CONCERNING THE OPERATIVE PACES OF WARDS AND ORGANIZATION, WITHIN 48 HOURS SINCE THE HOSPITALIZATION

19. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 19 WHY is there POOR information regarding the organizational aspects? Hypothesis: a)The operators provide these information after 48 hours… b) Personnel consider these information not very important and think they are passed among the inpatients by word of mouth.

20. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 20 ALSO THE ORGANIZATION INFORMATION ARE IMPORTANT, PARTICULARLY IF WE CONSIDER THAT MOST OF INPATIENTS ARE ELDERLY (difficult adaptability to a new place)

21. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 21 2 Staff Manners KINDNESS: YES among the 97% of the inpatiens

22. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 22 3 Patients needs and expectations NEED OF A PERSON CLOSE TO THEM: YES 70,2% 28,8% OF INPATIENTS DIDN’T HAVE THIS NEED ONLY THE 1% WASN’T ALLOWED

23. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 23 WHAT DOES A PATIENT EXPECT from the Hospital Admission? We surveyed the expectations through the expression of one’s own opinion ALL THE RATE LEVELS ARE HIGHER THAN THE REAL SATISFACTION OF NEED

24. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 24 SUPPLIED WAIT Kindness 97% 99.7% Information about the health conditions 91,9% 98,8% Organization information 49,7% 86,3% KINDNESS= very important ORGANIZATIONAL ASPECTS = less important

25. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 25 Conclusions Patients consider the hospital admission a tricky moment The information they wait for, are a true RIGHT: 1. to know their health conditions, examinations and possible operations 2. to receive this kind of information by the DOCTOR WHO RECEIVE THEM

26. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 26 Information should be given by a qualified person, who knows the hospitalization causes and the disease conditions This should happen: DURING THE HOSPITALIZATION

27. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 27 To receive simple, understandable and respectful to privacy information To receive information regarding a Ward customs and its organization Other surveyed needs: Where possible, to have a relative nearby Kind and available operators

28. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 28 What are we going to do? PLANNED INTEVENTIONS A: To include “Admission” in the planning of doctors/nurses training activities B: To do meetings with the Wards personnel C: To define specific “Ward protocols” so that to include in the ordinary medical procedure the admission modalities of patients

29. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 29 D: duly updated ward posters, - as well as in hotels - containing the main information regarding food timetable, meetings with doctors and other daily activities But never forget the importance of a direct spoken information

30. Health Promoting Hospitals Veneto Region Network 13 th International Conference on Health Promoting Hospitals, May 18-20 2005, Dublin 30 TO CARRY OUT THE PREMISES FOR A GOOD AND EFFECTIVE ADMISSION IS EQUAL TO CONTRIBUTE TO THE PATIENT’S WELL-BEING: 1:be able to receive a “new-inpatient” in one’s own life experience 2:allow the free expression of options, values, human needs, according to times and expressive modalities