1 HIV Patient s Journey Patient s journey methodology Con il supporto di:
2 ISTUD Foundation ISTUD Foundation is an independent business school that operates in Europe in the field of executive education, advanced lifelong learning and in the field of management research. As independent advanced centre of management research and training. Health and Healthcare conceives, designs and implements activities of organizational research and training for the development of individual professionals, whole teams or even their entire organizations. All this is aimed at advancing a healthcare system fully capable of responding to the patients real needs and to their frame of reference, and affordable from an economic point of view. This practice offers the healthcare sector its multidisciplinary competencies of training, organizational research and consulting.
3 Publications and research Medicina Narrativa Per una sanità sostenibile (2012) Le organizzazioni evolute in sanità Il sole 24 Ore sanità (2010) La composizione dell offerta socio-sanitaria per la persona con lesione midollare ISTUD INAIL Progetto A.L.M.A. Assistenza alle persone con Lesione Midollare: armonizzazione delle cure Per una qualità estesa delle cure: buone pratiche per i servizi domiciliari di ematologia ISTUD - AIL Le organizzazioni Aperte in sanità Il sole 24 Ore sanità (2006) Progetto SLANCIO: SLA Network delle Cure In Organizzazioni evolute ISTUD - AISLA
4 Patient s Journey approach The term 'patient journey' refers to the experiences and processes the patient goes through during the course of a disease and its treatment (BMJ 2011) Process mapping enables the reconfiguring of the patient journey from the patient s perspective in order to improve quality of care and release resources. (BMJ 2010)
5 Patient s journey in health care today On PubMed the search of "Patient's Journey" shows 185 references Most of the Patient's Journey developed in chronic diseases and conditions All publications highlight the benefits of the Patient's Journey construction to define the quality parameters and rationalization of the process of care Development of models of care and assistance geared to the centrality of the patient and the empowerment of citizens are gradually replacing the top down old business process reengineering AIFA supports dialogue and interaction with the patients Monitoring program on 105 new drug marked with black triangle : all patients can report adverse events becoming protagonists of pharmaco vigilance
6 Benefits of process mapping Picture of a patient pathway which is a complex process, undertaking the journey from a patient s perspective Overview of activities and collaboration among professionals during the course of treatment Identification and selection of the most critical activities to achieve the goals of care Definition of quality standards and optimization of the process of care Comparison of physician and patients perceptions about quality and management of care Less wastes for management of care (order versus chaos).
7 HIV Patient s Journey project: objectives build and validate the HIV patient's journey promote the use of Italian HIV Ministerial Guidelines during the patient s journey include the patient's experience in all phases of the journey identify most critical areas and their emotional impact to management define the skills and tools needed to optimize the management of HIV patient promote a new approach "illness centered" and not only «disease centered» in the management of HIV infection
8 HIV patient s journey: method Assessment Advisory meeting Sharing with patients Community Sharing with scientific Community Validation Advisory meeting Issue of Patient s Journey
9 Phase 1: assessment Scouting of relevant documentation (Guidelines, desk research, audio-visual materials) Define the Scientific Committee: Prof. Adriano Lazzarin, Prof. Massimo Andreoni. Define a board of medical specialists in infectious and tropical diseases (representative of main structures in the management of HIV over Italy) and representatives of the Associations (ANLAIDS, Nadir Onlus, Plus, NPS Italy Onlus) Sharing the project with a KOLs group Visit a Department of Infectious and Tropical Diseases to learn the basic knowledge of the therapeutic reference and context. Define an instrument for assessment (questionnaire)
10 Scientific commettee Prof. A. Lazzarin ; Prof. M.Andreoni HIV physicians: A Ammassari, Roma A Castagna, Milano S Rusconi, Milano AM Cattelan, Rovigo M Celesia, Catania G D Ettorre, Roma G Orofino, Torino Patients ans people associations: GM Corbelli, Anlaids M Errico, NPS S Marcotullio, NADIR S Pieralli, Plus Coordination commettee: MG Marini, (F.ISTUD) Milano L Reale, (F.ISTUD) Milano Advisory board
11 Phase 2: advisory meeting Advisory Meeting (14-15 Marzo) a Baveno, ISTUD Foundation Sharing the results of the Assessment Sharing the methodology of consensus building Mapping the journey of HIV patient (based on what actually happens) through flow chart. Analysis of the activities Identification of crtitical issues and additional proposals Reflection about the "ideal type" of journey but linked with the feasibility concept Preparation of a first draft of patient journey
12 Phase 3: sharing with patient s Community In NADIR annual seminar the draft of HIV Patient's Journey was presented. Goal was to collect comments and feedback from patient's experience on the various phases of the journey. ISTUD Foundation thereafter prepared a new proposal updated of HIV Patient's Journey including deeper the focus on «the living with» the condition
13 Phase 4: sharing with scientific community Italian Conference on AIDS and Retrovirus - ICAR, pre-course HIV patient s journey Presenting an updated proposal of prototype of HIV Patient's Journey in order to submit the instrument to the scientific community. Goal is to collect comments and feedback from the physician experience on the various phases of the journey, ISTUD Foundation will prepare a new proposal updated Patient's Journey including a deepening coming from the «physician s eye».
14 Phase 5: final advisory meeting Final Advisory meeting 29 May in Milan, ISTUD Foundation Objective: performing the final version of the HIV Patient's journey, bringing the final corrections and validate the document in preparation for the implementation on the national territory Patient s journey is not a rigid document but will require continuous revisitation to make it consistent with innovation of pathways of care
15 Flowchart - Symbology HIV patient s journey has been realized through the development of FLOW - CHART. Start / end of the flow Actions/activities Emotions decision-making that generates two possible paths Production / storage of a document Directions of the flow
16 HIV patient s journey: summary The inclusion in the structure of care Flow chart 1 The hospitalization Flow chart 4 The first visit Flow chart 2 The second visit Flow chart 3 Follow Up without treatment Flow chart 5 Follow Up with treatment Flow chart 6
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