99236 - Modelli organizzativi e gestionali dell'assistenza in ambito ospedaliero e territoriale (BO1)

Learning outcomes

At the end of the module the student knows the main nursing care delivery models in different care settings. Identifies the main competences of other members of the nursing team and relates them to his/her own competences. Identifies the organisational principles of continuity of care, roles and system of responsibilities using the clinical governance approach.

Course contents

1. The healthcare system and organisational models of care

• Organisation of Healthcare Systems and the Italian National Health Service (Local Health Authorities, IRCCS – Scientific Institutes for Research, Hospitalisation and Healthcare)
• Meso-level organisational models for hospital–community integration (hospitals organised by intensity of care)
• Unit-level organisational models of care delivery (task-oriented, functional, sector-based, small-team, primary nursing, case management)
• Care delivery models in relation to the needs and expectations of patients, staff and services
• Shift work: regulatory framework and organisational models

2. Competencies, teamwork and professional accountability

• Professional profiles, roles and competencies
• Working within a multi-professional team: structure and strategies
• Assignment of care activities to other professional figures (healthcare assistants and nursing associates): criteria, verification tools, and the accountability of those assigning/delegating tasks

3. Care planning, quality and patient safety

• Quality of care: dimensions and reference models
• Designing and managing care on the basis of Nursing Outcomes (nursing-sensitive outcome indicators)
• Operational tools for care planning and documentation
• Handover and information transfer to ensure continuity of care: methodologies, settings, criteria for selecting essential data
• Determining care priorities and clinical decision-making processes: criteria for the deferability/non-deferability of interventions; models and tools supporting clinical decision-making
• Time management in nursing practice
• Compromised care: Missed Nursing Care and Unfinished Nursing Care

4. Innovation and emerging care scenarios

• Emerging care needs and patient frailty
• Digital health and artificial intelligence in nursing practice

Readings/Bibliography

Baldissera, A., Palese, A., & Saiani, L. (2001). Il lavoro a turno negli ospedali: Modelli organizzativi a confronto. Assistenza Infermieristica e Ricerca, 20(4), 220–229.

Federazione Nazionale degli Ordini delle Professioni Infermieristiche. (2023). Position statement: Sanità digitale. FNOPI.

Mesaglio, M., Vesca, R., Rossi, A., Narduzzi, B., Fregonese, F., Pestrin, R., Fadone, A., Cadorin, L., Bressan, V., & Palese, A. (2019). Guida operativa per la riprogettazione delle consegne tra turni. Assistenza Infermieristica e Ricerca, 38(4), 212–220. https://doi.org/10.1702/3273.32398

Palese, A., Lavia, B., Masala, O., Moretto, G., Pordenon, M., Santarossa, A., et al. (2008). Esiti sensibili alle cure infermieristiche: Analisi critica della letteratura. Assistenza Infermieristica e Ricerca, 27(2), 33–42.

Saiani, L., & Brugnolli, A. (2020). Trattato di cure infermieristiche (3ª ed.). Sorbona – Idelson-Gnocchi.

Teaching methods

 Frontal lecture

Individual study of clinical and methodological content in the clinical context

Discussion of cases in subgroups with presentation in plenary sessions

Interactive lecture with unfolding and exercises

Assessment methods

Learning assessment takes place through an oral examination, structured around two questions:

1. Knowledge and comprehension question: aimed at ascertaining the student's knowledge of the main models of nursing care delivery across different care settings, the organizational principles underlying continuity of care, and the roles and system of accountability.
2. Reasoning and application question: starting from an organizational problem, the student is required to identify the competencies of the different members of the care team, relate them to their own competencies, and propose a reasoned solution, drawing on the organizational principles acquired.

The examination is considered passed only if both questions receive at least a sufficient evaluation.

Assessment Grid

Essential knowledge of the content, with some minor inaccuracies or gaps; minimal but pertinent analysis of the organizational problem, with partial conceptual connections and a poorly articulated but coherent organizational proposal; technical-professional terminology used in a basic manner, with some imprecision. 18–19

Correct but not always complete knowledge of organizational models and clinical governance principles; adequate analysis of the problem, with generally correct conceptual connections and a simply reasoned organizational proposal; overall correct use of terminology, with clear exposition but some uncertainty. 20–23

Correct, complete, and well-organized knowledge of the required content; precise analysis of the problem, with effective connections between concepts and a well-reasoned and coherent organizational proposal; appropriate technical-professional terminology, with clear and fluent exposition. 24–26

Complete, in-depth, and fully relevant knowledge, with precise references to the principles of clinical governance; thorough and critical analysis of the problem, with articulated connections between the team's competencies and the student's own, and a well-reasoned and well-argued organizational proposal; command of technical-professional terminology, with fluent and precise exposition. 27–29

Complete, rigorous, and critically elaborated knowledge of organizational models and clinical governance; original and in-depth analysis of the problem, with conceptual connections of considerable critical depth, and an innovative organizational proposal, fully reasoned and argued with independent judgment; full command of technical-professional language, with rigorous, precise, and well-structured exposition. 30–30L

Teaching tools

Digital tools for innovative teaching.

Handouts and concept maps by the teacher

Office hours

See the website of Luisa Sist