La gestione della conoscenza in ambito sanitario. Il caso di Swissmedic, l’Agenzia del farmaco svizzera

La gestione della conoscenza o knowledge management è l’insieme delle strategie e dei metodi idonei al fine di identificare, raccogliere, sviluppare, conservare e rendere accessibile e fruibile la conoscenza a favore di tutti coloro che lavorano in una determinata organizzazione. La gestione della conoscenza appare strategica per le organizzazioni che si trovano in un momento di rilevante cambiamento a causa dell’introduzione delle nuove tecnologie, quali il settore sanitario. La gestione della conoscenza può avvenire focalizzandosi in modo prevalente sulla parte legata ai processi e agli strumenti di information technology, oppure basandosi di più sugli aspetti socio-immateriali legati al capitale umano. Il presente lavoro vuole analizzare un caso pratico di costruzione di un modello di gestione della conoscenza in un ente pubblico appartenente al settore sanitario, Swissmedic, l’Agenzia del farmaco svizzera

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Riflessioni sull’impatto delle nuove tecnologie sul capitale intellettuale in ambito sanitario. Un caso di studio in chirurgia

Il ‘capitale intellettuale’, definito come la somma degli asset intangibili riconducibili al capitale umano, strutturale e relazionale presente in un’organizzazione, viene considerato sia dalla letteratura manageriale che da quella clinica quale una delle risorse maggiormente strategiche per gli enti sanitari. Il paper vuole analizzare l’impatto delle nuove tecnologie sul capitale intellettuale nel settore sanitario in generale, e nella chirurgia in particolare, attraverso l’analisi di un caso di studio riguardante l’introduzione di un nuovo strumento tecnologico in sala operatoria. Ne emerge come l’introduzione delle nuove tecnologie porti ad un’innovazione strategica dove i dati diventano l’elemento innovativo centrale. Tali dati risultano in grado di rivoluzionare non solo il lavoro e il ruolo del chirurgo, ma il valore aggiunto che viene creato per l’intera società in un’ottica di miglioramento delle condizioni di vita e well-being

Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Background: Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons' knowledge and perception of using AI-based tools in clinical decision-making processes. Methods: An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society's website and Twitter profile. Results: 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion: The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI

Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey

Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile. Results A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly. Discussion Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions