2' min read
2' min read
Crowded emergency rooms, congestion, boarding, i.e. patients waiting for admission after emergency treatment. These are images we have become accustomed to, not related to seasonal difficulties such as flu or particular health emergencies, but a symptom of a more complex problem, as often happens in healthcare. The solution is certainly not to be found in speeding up patient visits, which would be disadvantageous to everyone, but requires a different and new organisation of the hospital as a whole and of the relations between the hospital and the territory, changing, for example, the methods of discharge.
The new pre-discharge area of the San Luigi Gonzaga Hospital in Orbassano in the province of Turin, the first in Piedmont and among the first in Italy, meets this need. A new ward with twelve beds, active seven days a week, 24 hours a day.
This is a space dedicated to all patients who, having completed their course of treatment and fulfilling all requirements for discharge, are waiting to return home or to an out-patient facility. These are all patients who have already been stabilised and diagnosed in the emergency room, often not self-sufficient even temporarily, who no longer need constant medical observation, but are entrusted to the assistance of nurses to conclude their pathway within the hospital. In fact, guarding the new ward are, not the doctors, but the nurses of Dipsa, the Health Professions Directorate, in close collaboration with the Health Directorate and the St. Louis Medical Area Department: in case of need, the doctors of the ward from which each patient comes are immediately involved.
"The activation of a nurse-managed pre-departure area," comments Davide Minniti, general director of the Aou San Luigi Gonzaga, "responds to the need to rationalise the use of beds according to the real health demand of patients, an increasingly valuable resource in times of overcrowding in the Dea and the hospital, as it makes places available for patients with acute pathologies, taking in patients who have completed their active treatment and are awaiting discharge.
The trial is based on international literature sources, including the British Medical Journal, according to which the presence of a pre-discharge area limits boarding in the emergency department by reducing the number of patients who stay in the Ps for more than six hours by around 10%. The new department makes it possible to limit this phenomenon, concretely reducing the time during which the patient is ready to be admitted elsewhere or to be discharged, but waits for the necessary bureaucratic process to be completed.
