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      COVID-19: yesterday, today and tomorrow. The quality of COVID-19 management and the evaluation of the “Health” chapter of the Recovery Plan

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          Summary

          Introduction

          The COVID-19 pandemic represented an unprecedented challenge for the healthcare world and the introduction of a new stronger and believable project plays a fundamental role for the quality of work and the provision of qualitative care.

          Aim

          The survey provided by Italian Association for the Quality of Health and Social Care (ASIQUAS) aims to examines the impact of “Health” chapter included in the Recovery Plan, through the assessment of management quality of the COVID-19 pandemic.

          Methods

          Starting from a literature review, in September 2021, a web-based survey has been conducted and administered by e-mail. It has been taken into account measures widely used by different healthcare structures in order to analyze the projects implemented in the face of pandemic and to evaluate the new real possibility to invest funds in new healthcare structures and projects.

          Results

          The survey consists of 19 multiple choices and respondents were from different types of structures, including regional departments and regional health agencies (1.4%), universities, research centers and scientific hospitalization and treatment institutes (IRCCS) (11%), hospitals and university polyclinics (34.2%), Local Health Authorities (39.7%), socio-health organizations and Others (13.7%). The pandemic has highlighted many vulnerabilities at both hospitals and territorial level. The major weaknesses revealed by the survey are mainly due to the lack of support from new staff units and poor availability of specific training tools for COVID-19 procedures. The Recovery Plan is still unclear with a lot of concern about the implementation and many limits of diffusion.

          Conclusions

          It becomes essential to guarantee a new effective and interoperative model of integration. Today we can start more aware for the implementation of a system closer to everyone’s needs, making shortcomings the new strength and starting point.

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          Most cited references25

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          A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being

          Background Health and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and, in the challenge to control the virus, have directly faced its consequences. Supporting their psychological wellbeing continues, therefore, to be a priority. This rapid review was carried out to establish whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis. Methods We undertook a rapid review of the literature following guidelines by the WHO and the Cochrane Collaboration’s recommendations. We searched across 14 databases, executing the search at two different time points. We included published, observational and experimental studies that reported the psychological effects on HSCWs during the COVID-19 pandemic. Results The 24 studies included in this review reported data predominantly from China (18 out of 24 included studies) and most sampled urban hospital staff. Our study indicates that COVID-19 has a considerable impact on the psychological wellbeing of front-line hospital staff. Results suggest that nurses may be at higher risk of adverse mental health outcomes during this pandemic, but no studies compare this group with the primary care workforce. Furthermore, no studies investigated the psychological impact of the COVID-19 pandemic on social care staff. Other risk factors identified were underlying organic illness, gender (female), concern about family, fear of infection, lack of personal protective equipment (PPE) and close contact with COVID-19. Systemic support, adequate knowledge and resilience were identified as factors protecting against adverse mental health outcomes. Conclusions The evidence to date suggests that female nurses with close contact with COVID-19 patients may have the most to gain from efforts aimed at supporting psychological well-being. However, inconsistencies in findings and a lack of data collected outside of hospital settings, suggest that we should not exclude any groups when addressing psychological well-being in health and social care workers. Whilst psychological interventions aimed at enhancing resilience in the individual may be of benefit, it is evident that to build a resilient workforce, occupational and environmental factors must be addressed. Further research including social care workers and analysis of wider societal structural factors is recommended. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10070-3.
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            General practice and primary health care in Denmark.

            General practice is the corner stone of Danish primary health care. General practitioners (GPs) are similar to family physicians in the United States. On average, all Danes have 6.9 contacts per year with their GP (in-person, telephone, or E-mail consultation). General practice is characterized by 5 key components: (1) a list system, with an average of close to 1600 persons on the list of a typical GP; (2) the GP as gatekeeper and first-line provider in the sense that a referral from a GP is required for most office-based specialists and always for in- and outpatient hospital treatment; (3) an after-hours system staffed by GPs on a rota basis; (4) a mixed capitation and fee-for-service system; and (5) GPs are self-employed, working on contract for the public funder based on a national agreement that details not only services and reimbursement but also opening hours and required postgraduate education. The contract is (re)negotiated every 2 years. General practice is embedded in a universal tax-funded health care system in which GP and hospital services are free at the point of use. The current system has evolved over the past century and has shown an ability to adapt flexibly to new challenges. Practice units are fairly small: close to 2 GPs per unit plus nurses and secretaries. The units are fully computerized, that is, with computer-based patient records and submission of prescriptions digitally to pharmacies etc. Over the past few years a decrease in solo practices has been seen and is expected to accelerate, in part because of the GP age structure, with many GPs retiring and new GPs not wanting to practice alone. This latter workforce trend is pointing toward a new model with employed GPs, particularly in rural areas.
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              The Impact of COVID-19 on Healthcare Worker Wellness: A Scoping Review

              At the heart of the unparalleled crisis of COVID-19, healthcare workers (HCWs) face several challenges treating patients with COVID-19: reducing the spread of infection; developing suitable short-term strategies; and formulating long-term plans. The psychological burden and overall wellness of HCWs has received heightened awareness in news and research publications. The purpose of this study was to provide a review on current publications measuring the effects of COVID-19 on wellness of healthcare providers to inform interventional strategies. Between April 6–May 17, 2020, we conducted systematic searches using combinations of these keywords and synonyms in conjunction with the controlled vocabulary of the database: “physician,” “wellness, “wellbeing,” “stress,” “burnout,” “COVID-19,” and “SARS-CoV-2.” We excluded articles without original data, research studies regarding the wellness of non-healthcare occupations or the general public exclusively, other outbreaks, or wellness as an epidemic. A total of 37 studies were included in this review. The review of literature revealed consistent reports of stress, anxiety, and depressive symptoms in HCWs as a result of COVID-19. We describe published data on HCW distress and burnout but urge future research on strategies to enhance HCW well-being.
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                Author and article information

                Journal
                J Prev Med Hyg
                J Prev Med Hyg
                JPMH
                Journal of Preventive Medicine and Hygiene
                Pacini Editore Srl
                1121-2233
                2421-4248
                27 October 2022
                2022
                : 63
                : 3
                : E391-E398
                Affiliations
                [1 ] Associazione Italiana per la Qualità della Assistenza Sanitaria e Sociale (ASIQUAS)
                [2 ] Università Cattolica del Sacro Cuore, Campus di Roma
                [3 ] Fondazione Policlinico Universitario Agostino Gemelli IRCCS
                [4 ] Medicina Fisica e Riabilitativa, Università degli Studi di Firenze
                [5 ] DiSSE, Dipartimento di Scienze Sociali ed Economiche, Sapienza Università di Roma e LUISS Business School , Roma
                [6 ] Dipartimento delle Professioni Sanitarie, Istituto pediatrico Giannina Gaslini , Genova
                [7 ] Sezione Igiene, Università Politecnica delle Marche , Ancona
                Author notes
                Correspondence: Antonio Giulio de Belvis, Università Cattolica del Sacro Cuore, Campus di Roma, Roma, Lazio, Italy; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Via della Pineta Sacchetti, 217, Roma RM, 00168 Lazio, Italy. E-mail: antonio.debelvis@ 123456unicatt.it
                Article
                10.15167/2421-4248/jpmh2022.63.3.2604
                9648551
                36415297
                02d90a5b-d559-4b47-9473-33f645a8e8c4
                ©2022 Pacini Editore SRL, Pisa, Italy

                This is an open access article distributed in accordance with the CC-BY-NC-ND (Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International) license. The article can be used by giving appropriate credit and mentioning the license, but only for non-commercial purposes and only in the original version. For further information: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en

                History
                : 18 May 2022
                : 12 September 2022
                Page count
                Figures: 3, Tables: 3, Equations: 0, References: 37, Pages: 8
                Categories
                Covid-19 - Health Care Management

                covid-19,quality management,local health,digital healthcare,recovery plan

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