THE SELF-EVALUATION SYSTEM OF THE HPH PROJECT IN TUSCANY: FIRST RESULTS Authors: Fabrizio Simonelli, Caterina Teodori, Maria José Caldés Pinilla, Katalin Majer Regional Co-ordinating Centre of the HPH Network of Tuscany A. Meyer University Children’s Hospital, Florence (Italy)

About the self-evaluation system... I. Short introduction to the context II. Objectives III. Target group and methodology IV. Ad hoc evaluation tools and outcomes V. Next steps and conclusions

I. Short introduction to the context: LOCAL HEALTH UNIT LOCAL HOSPITAL UNIT  the first results have been presented on the occasion of the 7th Italian Conference of Turin (21-22th of November 2003).  the HPH Network of Tuscany, co-ordinated by the A. Meyer University Children’s Hospital, has started up a process of self-evaluation, involving all the 16 Local Health and Hospital Units belonging to its network;

I. Short introduction to the context The self-evaluation system is based on: a systematic calendar of annual meetings:  in the single Health and Hospital Units  with the Co-ordinators of the single inter-corporate projects allows :  to confront the data concerning the years 2002 and 2003  to evaluate the advancing of the HPH project  to identify its strengths and criticism

II. Objectives: Objectives of the self-evaluation system:  to define an annual evaluation process of the level of development of the HPH project in Tuscany  to monitor the development of the single corporate and inter-corporate projects

III. Target group and methodology:  Target group: the whole HPH Network of Tuscany  Methodology: - definition of ad hoc evaluation tools aligned with the standards individuated by the international Working Group; - collective evaluation in the Local Health and Hospital Units and with the Co-ordinators of the inter-corporate projects; - decoding, analyses and graphical elaboration of the results; - general report of network.

IV. Ad hoc evaluation tools and outcomes A system composed by:  a set of 13 standards - single corporate HPH projects  a scheme of steps - for the measurement of the development of the single inter-corporate projects  a scheme for the monitoring of the existing difficulties/excellencies.

Set of 13 standards

 It has been attributed a ‘weight’ to every standards, using the evaluation scale of the model of the European Foundation for Quality management: 0 = NOT INITIATED 33 = SOME PROGRESSES 66 = CONSIDERABLE PROGRESSES 100 = COMPLETELY REACHED  Finally the data have been elaborated statistically.

Outcomes 3 types of outcomes: AVERAGES OF THE STANDARDS YEARS 2002 AND 2003 CORPORATE AVERAGES YEARS 2002 AND 2003 b) Scheme of steps for show the differences: INTERCORPORATE PROJECTS YEARS 2002 AND 2003 a) Radar-diagrams for show the differences: c) Scheme for show: EXISTING DIFFICULTIES/EXCELLENCIES YEAR 2003

STATUTE TC/CO-ORDINATOR BUDGETING PRIZE-GIVING SYSTEM QUALITY SYSTEM TRAINING SYSTEM COMUNICATIONSYSTEM TERRITORIAL OPERATIVE UNITS TERRITORIAL HEALTH SERVICES LOCALASSOCIATIONISM INTERNAL VISIBILITY EXTERNAL VISIBILITY CHRONO-PROGRAMME A ) AVERAGES OF THE STANDARDS 2002/2003

A) CORPORATE AVERAGES 2002/2003 LHU PISA HOSPITAL PISA LHU AREZZO LHU EMPOLI HOSPITAL CAREGGI LHU VIAREGGIO LHU PISTOIA LHU FIRENZE LHU GROSSETO LHU PRATO HOSPITAL SIENA LHU SIENA LHU LUCCA HOSPITAL MEYER LHU LIVORNO LHU MASSA E CARRARA

B) DEVELOPMENT LEVEL OF THE INTER- CORPORATE PROJECTS /2003 Safety Humanisation Smoke-free Hospital Comfort/Reception Pain-free Hospital Intercultural Hospital Census of experiences Working programme (selection of priorities) HPH Projects Evaluation of outcomes Dissemination of results; Exportation of the project Project development 100% 66% 33%

C) DIFFICULTIES / EXCELLENCIES

Conclusions and next steps  Next steps: - refinements of the evaluation system, before starting the meetings of the year 2004  Conclusions: - the self-evaluation system seems quite well-grounded and sensible for the systematic evaluations of the HPH project in Tuscany; (further refinements will be needed) - a group of operators ‘culturally and operatively leading’ is consolidating, together with the need to give a local ‘phisyognomy’ to the regional network; - the system, allowing the comparison between the situations of the Local Health and Hospital Units, appears to be ‘pressing’ for the attention of the local management and the health professionals. indicators of measurement!!!