Il performance management nei Dipartimenti di salute mentale (DSM) : proposta di un cruscotto multidimensionale e prospettive di implementazione

Il tema della misurazione e della valutazione delle performance delle attivit\ue0 sanitarie \ue8 oggi centrale non solo a livello aziendale ma anche a livello di singole partizioni organizzative. Dipartimenti, distretti, unit\ue0 operative sono chiamate a sviluppare sistemi e strumenti di performance management basati sulle proprie esigenze informative, allo scopo di supportare il middle management a migliorarne la gestione e orientare i comportamenti dei clinici. Questo lavoro di ricerca propone un cruscotto di valutazione delle performance costruito per i Dipartimenti di Salute Mentale, che mira a superare i gap riscontrati in letteratura e nell\u2019applicazione pratica di sistemi di performance management destinati a tale tipologia di dipartimenti. La definizione e la validazione del cruscotto ha, inoltre, coinvolto esperti del settore tramite focus group. Nelle conclusioni sono discussi le prospettive e i limiti dell\u2019applicazione del cruscotto multidimensionale.Performance management in Mental Health Departments: a proposal for a multidimensional dashboard and considerations for implementation. Performance management is a central topic for health care sector, not just at corporate level but also for each organizational unit. Clinical directorates, healthcare districts, and clinical units must develop performance management systems and tools based on their peculiar needs of data and information in order to support middle managers' decisions, and orient clinicians' behaviors. This research proposes a multidimensional dashboard for Mental Health Departments. The proposal aims to overcome literature gaps and failures in implementation of performance management tools in this sector. The definition and validation of the multidimensional dashboard have involved several experts through a series of focus group. In conclusion, the authors discuss prospects and limits for implementation of this multidimensional dashboard

Care across all phases of schizophrenia and initiation of treatment: discrepancy between routine practice and evidence. The SIEP-DIRECT'S Project.

AIMS: To evaluate the quality of psychiatric care in Italian community-based services and the discrepancy between real practices and NICE recommendations for the treatment of schizophrenia concerning the elements common to all phases of care and the first episode of psychosis. METHODS: Data concerning 14 indicators on common aspects of care in all phases and 11 indicators concerning psychosis onset, drawn from NICE Recommendations, were collected in 19 Departments of Mental Health. RESULTS: An optimistic attitude seems to prevail in the staff in all phases of care, while remarkable discrepancies between service practice and recommendations have been found in relation to systematic assessment, availability of informative leaflets and support to relatives. Concerning the treatment of first episode, a lack of specific services and differentiated activities, and paucity of practices based on specific guidelines has been detected. However, Italian community based services proved to have a good capacity to provide help quickly to those seeking help for a psychotic onset, to maintain regular contact with them in the subsequent year, and provide pharmacological treatment reasonably in line with the scientific evidence. Instead, little specific support is provided to the relatives. CONCLUSIONS: The results show critical points concerning capacity of assessment and treatment standardization, in all aspects of care and specifically in the treatment for the first episode. Differentiation of activities specifically dedicated to the patients at their first episode should be promoted as well as strategies to support relatives in a more specific way