What we found out

Project objectives Tweet

The Covid-19 pandemic has highlighted numerous critical issues in healthcare systems, including poor healthcare practices due to structural and managerial inefficiencies. One of the most severe problems is the lengthening of waiting lists for specialist visits, diagnostic tests, and surgical procedures. This situation has had direct consequences on patients' health, worsening untreated conditions and increasing the risk of complications.
Our project aims to:
* Reduce waiting times for essential healthcare services.
* Ensure equitable access to care, prioritizing the most vulnerable patients.
In conclusion, our project seeks not only to address the issue of waiting lists but also to transform the healthcare system into a more sufficient model.

Foreseen activities

Activities included in the project:
1. Purchase of advanced healthcare machinery and equipment to improve healthcare services and reduce waiting lists. Among the equipment
purchased are:
• Cardio CT (advanced CT for cardiac examinations)
• Angio-OCT with integrated fluorescein angiography (for ophthalmological diagnoses)
• Operating microscope for ENT
• 20 anesthesia machines (one for each operating room)
• 5 C-arms (radiological machines for vascular surgery and cardiac implants)
• Portable radiology machines for hospital departments
• For more details and the relevant amount, please see the report attached.

2. Administrative and technical management of the project, including:
• Drafting of tender specifications and sending to purchasing offices
• Purchase and tender award procedures
• Delivery and testing of equipment
• Maintenance of acquired technologies

3. Monitoring and impact on the healthcare system:
• Verification of the use of new technologies in the various departments
• Evaluation of the impact on the reduction of waiting lists waiting period
• Involvement of the office responsible for data analysis

Dates of the project:
• February 2023: Publication of the call for proposals and opening of applications
• March-December 2023: Conduct of tenders; Purchase, delivery and installation of equipment; Testing and operational start-up; Final reporting to the Campania Regional Authority
• December 31, 2023: Official end of the project
• 2024: Monitoring of impact and evaluation of results

The project was carried out in a very short time for the public administration (less than one year), with logistical and procedural difficulties due to regulatory constraints on procurement.

Project origin

The project was born following a public call published by the Campania Regional Authority in February 2023, aimed at using the residual funds of the 2014-2020 ERDF. The "AO dei Colli" participated in the call with the obligation to complete all the purchasing, testing and payment procedures by 31 December 2023.
The conception and implementation of the project involved various internal structures of the "AO dei Colli". Clinical Engineering had a central role in the technical management of the project, dealing with the writing of the tender specifications, support for the purchase and testing of the equipment.
Because of the limited timeframe of the tender, strict requirements have been applied on behalf of the "AO dei Colli" for suppliers to take part in the project.

Beneficiaries

No groups have been excluded from the definition of the project. Of course, decisions were taken mainly at an administrative and technical level, without a clear direct involvement of patients in the planning phase. However, they are the final beneficiaries of the project once it gets implemented.

Context

The project was funded to respond to the need to reduce healthcare waiting lists in the Campania Region, particularly aggravated by the post-COVID period. The pandemic has caused the closure of operating rooms and clinics, making it urgent to upgrade and boost technology to recover from the delays. For this reason, it was decided to invest in various equipment, both for the outpatient and surgical sectors, in order to optimize healthcare services.

The intervention was carried out under the 2014-2020 ERDF, a European funding program. The project was launched with very tight deadlines: the call for proposals was published in February 2023, and all the procedures for purchasing, delivering and testing the equipment had to be completed by December of the same year.

At the moment, the "AO dei Colli" is monitoring the opportunities to submit new funding proposals in the upcoming months.

Progress

The status of the project appears positive, with all payments and reporting completed by December 31st, 2024. There are no pending payments, although there were inconsistencies with the information provided by the OpenCoesione website, which indicated payments still pending. The project focused on the purchase of advanced healthcare technologies, such as a cardio CT, an ENT microscope and anesthesia equipment, mainly intended for the hospitals of the "AO dei Colli". More details are available in the report attached. These technologies were distributed among various departments of the Monaldi, Cotugno and CTO hospitals, improving diagnostic and surgical capacity, with a positive impact on waiting lists, although precise analytical data on their reduction are not available yet.

The information comes from Mr. Giaconia, Head of the Clinical Engineering dept. at the "AO dei Colli" that has dealt with the implementation of the project.

Results

As commented by Mr. Giaconia, the project has brought decisive results, both in terms of modernization of hospital technologies and improvement of healthcare performance. The main results include:
1. Purchase and installation of new technologies: Advanced devices have been acquired that have enhanced several hospital departments. These include, among others, the Cardio CT for the Monaldi hospital, which allows more precise diagnoses in cardiac pathologies, and the Angio-OCT with integrated fluorescein angiography for ophthalmology, which has improved the diagnosis and treatment of eye diseases. Operating microscopes have also been installed for ENT, which have optimized the quality of surgical operations, and anesthesia equipment and C-arms for surgical departments, improving the efficiency of operations.
2. Impact on efficiency and performance: New technologies have had a direct impact on the efficiency of departments, particularly in operating rooms. The use of microscopes and anesthesia equipment has helped reduce waiting times for surgical interventions, increasing productivity and improving the quality of services.
3. Improvement of waiting lists: Thanks to new technologies, surgical interventions have increased, significantly reducing waiting times for patients, particularly in the vascular, orthopedic and ENT departments.
4. Benefits for the quality of healthcare: New equipment has had a positive impact on the quality of services. Cardio CT and Angio-OCT have allowed for more accurate diagnoses, while new technologies in the operating room have improved the precision and effectiveness of operations, increasing the overall level of care and reducing the margins of error.
5. Overall assessment: The general feeling detects a very positive impact in terms of improving healthcare performance and operational efficiency, even though complete data on the long-term effectiveness of the technologies are not yet available.

Risks

Nowadays, waiting lists still tend to be pretty long in the healthcare sector and, consequently, financing only a part of the healthcare facilities is not enough to improve the general healthcare situation in Campania.

Investigation method

How was the information collected?

• Web research
• Interview with the users and/or final beneficiaries of the intervention

Mr. Giaconia, Head of the Clinical Engineering dept. at "AO dei Colli", has been interviewed during a videocall and has provided our team with the information and material contained in this report. Please see the transcript, pictures and report attached.

Interview requests have also been sent to the following people:
•Health Director at “Azienda dei Colli”
•General Director of the Coordination of the Regional Health System
•General Director at “ASL Napoli 1 Centro”
•Health Director at “ASL Napoli 1 Centro”
•Acting Procurement Manager at “Azienda dei Colli”
However, no response has been received in the cases mentioned above.

A further method of investigation has consisted in conducting a survey in the local community so as to investigate the sentiment and experiences related to the waiting lists in the healthcare sector. It was both a paper survey and an online survey via Google Forms, so as to reach a wider target. Please see the fac-simile attached.

Main questions

The main two questions asked to the interviewees in our survey were:
1.What was the longest waiting time for a visit and at which hospital?
(Question addressed to employees, teachers, school staff, university students)
2.Have you noticed any improvement or worsening in the post-Covid waiting lists?
(Question addressed to employees, teachers, school staff, university students)

Main answers

Here are the two main answers provided by the interviewees:
1.Waiting time: 1 year
Hospital structure: Betania Hospital
Summary of the answer: The interviewee reported having to wait a year for a visit at Betania Hospital, highlighting how the long waits caused delays in the diagnosis and treatment of the health problem.
2.Waiting time: 2 months
Hospital structure: Ospedale del Mare
Summary of the answer: Another interviewee stated that the wait for a visit at Ospedale del Mare was two months, a shorter time than in other cases but still significant, especially for those who need urgent check-ups.