We reached the conclusion that although there may be scope for improvement, this implementation is a step forward toward the goal of building a "solid bridge" between the scientific evidence and the final decision maker's choice.

(2018) Health technology assessment methods guidelines for medical devices : how can we address the gaps? The

This paper illustrates a study conducted into the managerial practices implemented to mitigate the consequences of a major fire emergency and to promptly restore normal business operations at a large pediatric hospital. Stemming from prior research on crisis response and recovery in critical infrastructures, this investigation demonstrates that factors such as the complexity of the underlying stakeholder networks, the vulnerability of the involved actors, and several temporal and spatial constraints, all contribute in hampering the intervention of crisis managers. In these situations, relying on consolidated best practices may enable more rapid response and more adequate recovery.This study adopts a qualitative approach to build a retrospective case study that highlights the crucial issues that healthcare crisis managers are requested to face when exposed to thorny work conditions: presence of numerous actors from the public and the private sector, involvement of organizations with contrasting interests, need for a balance among public health, cost containment and legitimacy, etc. The findings of the present investigation expand the theoretical knowledge on the dynamics that characterize crises occurring at critical infrastructures and provide practical recommendations for healthcare emergency managers to improve their response to, and recovery from, major fire emergencies.

Robotic surgery is a good clinical alternative to laparoscopic and open surgery (for many pediatric operations). However, the costs of robotic procedures are higher than the equivalent laparoscopic and open surgical interventions. Therefore, in the short run, these findings do not seem to support the decision to introduce a robotic system in our hospital.

BackgroundTo test the application of Business Process Management technology to manage clinical pathways, using a pediatric kidney transplantation as case study, and to identify the benefits obtained from using this technology.MethodsUsing a Business Process Management platform, we implemented a specific application to manage the clinical pathway of pediatric patients, and monitored the activities of the coordinator in charge of the case management during a 6-month period (from June 2015 to November 2015) using two methodologies: the traditional procedure and the one under study.ResultsThe application helped physicians and nurses to optimize the amount of time and resources devoted to management purposes. In particular, time reduction was close to 60%. In addition, the reduction of data duplication, the integrated event management and the efficient data collection improved the quality of the service.ConclusionsThe use of Business Process Management technology, usually related to well-defined processes with high management costs, is an established procedure in multiple environments; its use in healthcare, however, is innovative. The use of already accepted clinical pathways is known to improve outcomes. The combination of these two techniques, well established in their respective areas of application, could represent a revolution in clinical pathway management. The study has demonstrated that the use of this technology in a clinical environment, using a proper architecture and identifying a well-defined process, leads to real benefits in terms of resources optimization and quality improvement.