Context

X is a hospital, focused on children healthcare. In the last years, X Hospital went in crisis under
different points of view: different causes such as the lack of doctor’s motivation, the always less
investments in qualification and training and inadequate infrastructures brought the hospital in a
situation of a decreasing capacity to offer competitive medical services, with all the
consequences that it bring.

As linked project, it can be mentioned "Doing more does not mean doing better, choosing wise
Italy", it is a project launched by Slow Medicine, that aims to encourage the dialogue between
doctors and other health professionals.
The project is based on the assumption of responsibility of doctors and other health professionals
in the choices of care and on the participation of patients and citizens, and is implemented
through in order to reinstate a proper workflow, a cooperation environment, a high quality of life
both for doctors and patients and high services standards.
In practice, it is carried out through a dialogue and comparison with Scientific Societies and
Italian Professional Associations regarding diagnostic tests, treatments and procedures that,
according to the available scientific knowledge, do not bring significant benefits to most of the
patients to whom they are prescribed, but can, on the contrary, expose them to risks.
All this brings less complaint numbers and to decrease the number of deaths while increasing
the quality of care. 1 2

1
https://choosingwiselyitaly.org/progetto/

2
https://choosingwiselyitaly.org/documenti/
 Justification

The less X Hospital capacity to offer competitive medical services is due to different causes.
First of all, doctors lack motivation in their job, and this bring demoralization and conflicts in the
work, that influence the quality and the competitivity of the hospital services. It is directly linked
with the fact where the hospital does not invest in training and qualifications programs.
Very relevant is the not fulfilment of performance criteria set by the Ministry of Health, that have
as consequence the reduction of the financial allocations and bonus from the Ministry of Health.
Furthermore, hospital infrastructure is quite inadequate for the dimension and the numbers of the
X hospital.

The main effects of the less capacity to offer competitive medical services are 3.
The number of hospital-related deaths and complaints has increased, and this surely harm to the
hospital visibility.
Moreover, the number of doctors who choose to work for this hospital is decreasing, taking
always fewer young doctors, and demoralizing the entire staff.
In addition, more attractive conditions are offered by other hospitals, that bring a lot of patients
choosing other hospitals.

The entire project needs to be implemented as quick as possible, because… I don’t know the
details because is very important to implement it now

This project will help to reach the objective of the funding programme of i mproving the hospital’s
capacity to offer competitive medical services to its existing patients as well as new patients and
fulfilling the performance criteria set by the Ministry of Health
 Beneficiaries

Beneficiaries are those stakeholders that will gain something from the project. They can be
divided in direct beneficiaries, indirect beneficiaries and target group.

There will follow the categorizing of beneficiaries of the hospital X rehabilitation.

Direct beneficiaries

- Doctors who want to work in another hospital

Doctors who want to work in another hospital are 60% of the total doctors, 45% of them are aged
from 35 to 60 and 20% of them are men. They want improvement of budget, more medical
supply and more services in the hospital, as well as to be motivated.

- Human Resources Manager of Hospital “X”

Human Resources plays a key role in the project, its aim is well trained doctors, staff motivation
and the hospital fully equipped with medical supply, as well as fewer complaints.

- Patients and their families

Patients and their families are one of the most important beneficiaries of the hospital
rehabilitation.
70% of the total number of patients are children.
Their aim is to have a higher health care standard with quality services. A particular attention
must go to children’s services and care, with specialized pediatric doctors who treat the children
according to their needs.
Moreover, is of the first importance families and patient’s aim of fewer deaths and more attention
to grave cases in the hospital.
Indirect beneficiaries

-Ministry of Health I am not sure that it is indirect

Ministry of health is involved for its financial help to the project.

Its aim is a good and competitive efficiency of the X Hospital, with improvement and development
of hospital services, and this will bring the hospital to fulfil the Ministerial standards.

The main gain of the Minister of health is the fulfil of the Ministerial
 Objectives

General objectives:
1) To improve the hospital’s capacity to offer competitive medical services to its existing patients
as well as new patients
2) To fulfil the performance criteria set by the Ministry of Health
Specific objectives:
1) More than 20% of patients treated in the pediatric section within 2 years because the hospital
X will improve their treatment system by the end of the project.
2) To help the local orphanage treat the children (providing it with medical equipment and
qualified doctors).
3) More than 35% of home treatment urgencies within 1 year
 Activities

1. Prepare qualifying training for existing doctors

We will organize qualifying training course for doctors with the aim of implementation and
requalification of their competences and acquiring new skills and we will give attention in team
ideal, with the aim to create a new environment.
The training course is funded through 3000 euros. It is a course that requires active participation
on the part of the trainees. The course is aimed at all doctors who have a low income in terms of
work.
The first step will be to understand the needs and skills to be implemented in the doctors
participating in the course through a list of participants and their needs. (there are 20 participants
divided into two different groups)
The course, within the hospital pole, will take place through theoretical meetings to update on
new technologies and safer techniques, training activities with support, participation in research
programs and organization of documentation, through reading of scientific texts, presentation of
papers, participation in improvement groups, analysis of clinical cases, participation in care
trials. doctors will be able to practice first-hand the new knowledge through the practice of on-
the-job training thanks to the use of new teaching methodologies acquired;
We will create through a stimulating and innovative teaching, a training climate of comparison,
mutual knowledge, and cohesion of the group, so as to favor an increase in work motivation.
Some of the practices used are 360° Evaluation and storytelling.

Duration: The course lasts 8 months, 10 hours per month

Deliverables: List of participants, Agenda of meeting, attendances list, surveys
Person who is responsible: Training Manager, project assistant, project manager.

M1 M2 M3 M4 M5 M6 M7 M8 Partner
who is
responsible
Activity 1 TM
PP, P1
 2. Recruit specialised doctors in the fields we lack them:

1. The objectives of this activity are: the elimination of costs due to excessive
turnover, the possibility of better monitoring the needs and the organizational
structure
2. In the first step we will collect important data through Job analysis and job
description, therefore a first phase of analysis
3. the second measurement step in which the goal will be to start recruitment by
collecting applications and analyzing them through the screening of resumes,
4. The last step is to finally choose, following selection interviews with the head of
the department, interviews, assessments and practical tests, the new hospital staff

Duration: 1 month
Deliverables: Report, Critical incidents
Partner who is responsible: recruiter HR
Deliverables: surveys, questionnaires, interviews, weekly and monthly meetings.

M1 M2 M3 M4 M5 M6 M7 M8 Partner who
is
responsible

Activity 2 R
 3. Find the construction firm that will renovate the hospital:

The economic resources to start the renewal and implementation process are: 60,000 euros for
new machinery and 15 thousand euros for the renovation of hospital spaces, in particular the
pediatric one, as sources of verification. The enterprise needed It will be a company competent in
the production of biomedical machinery; Another company will take care of the structural
dynamics, implementing the spaces making them more effective and organized.
The first step will be to enter into an agreement with an enterprise that will take care of the
reconfiguration of the spaces and the installation of the machinery, Showing our project we will
organize better how to concretize the renewal

Duration: 8 months, by the end of the project

Partner who is responsible: representatives from the Ministry of Health, Project Manager, Project
Assistant
Deliverables: Agreements, Reports, List of activities, Researches…

M1 M2 M3 M4 M5 M6 M7 M8 Partner who
is
responsible

Activity 2 PP, P1
M
 4. Find external funds from campaigns, fundraising, etc.

Hospital X does not rely only on internal sources of funding, given by the hospital itself, but also
from external sources including hospitals, regional and state funds, which through tenders,
adhere to the implementation of Hospital X.
Funding is mainly given by the Ministry of Health, which through several promotion campaigns,
will promote the new hospital.
We will open a fundraising campaign to obtain investments from privates.

Duration: 8 months, by the end of the project

Partner who is responsible: representatives from the Ministry of Health, Project Manager, Project
Assistant
Deliverables: Agenda of meetings, Agreements, Report, Researches…

M1 M2 M3 M4 M5 M6 M7 M8 Partner who
is
responsible

Activity 4 PP, P1
F

RISKS:
- the funds from the Ministry of Health won’t increase by 15% in the next 3 years.
- the number of patients who choose our hospital won’t increase
 Results

1) The infrastructure of the hospital will reach international standards by the end of the project
through the implementation of infrastructures, machines, remodulation of spaces used

2) The pediatric section will be 90% modernised within one year.