Models for institutional and professional accreditation of haemophilia centres in Italy

Abstract

The Health Commission of the Conference between the Italian State and Regions recognized the need to establish an institutional accreditation model for Haemophilia Centres (HCs) to be implemented by 21 Regions in order to provide patients with haemophilia and allied inherited coagulations disorders with high and uniform standards of care. The Italian National Blood Centre, on behalf of the Commission, convened a panel of clinicians, patients, experts, representatives from Regions and Ministry of Health. The agreed methodology included: systematic literature review and best practice collection, analysis of provisions and regulations of currently available services, priority setting, definition of principles and criteria for the development of recommendations on the optimal requirements for HCs. The result was the formulation of two recommendations sets. Two sets of recommendations were produced. The first concerns regional policy planning, in which the following aspects of comprehensive haemophilia care should be considered for implementation: monitoring and auditing, multidisciplinary approach to clinical care, protocols for emergency management, home treatment and its monitoring, patient registries, drug availability and procurement, recruitment and training of health care professionals. The second set concerns the accreditation process and lists 23 organizational requirements for level 1 HCs and 4 additional requirements for level 2 HCs. These recommendations help to provide Italian Regional Health Authorities with an organizational framework for the provision of comprehensive care to patients with inherited coagulation disorders based on current scientific evidence.

Accreditation and Quality in the Italian National Health Care System: a 10 years long review

“…Italian accreditation system aims to achieve harmonised quality standards across Regions and to implement continuous certified improvement efforts [38].…”

Comprehensive care for haemophilia: A literature review for improving institutional cooperation

“…Finally, some articles suggested the 'systemic care' view (n=4). Pritchard and Page [50], as well as Calizzani et al [51], translated this view in terms of 'multi-level care'. Specifically, Pritchard and Page [50] pointed out that CC should involve a variety of actors (e.g., organisations, institutions, community agencies, governments) working together in the continuum of care; in other words, it should fully reflect the broader healthcare system through a vertical integration process.…”

“…Specifically, Pritchard and Page [50] pointed out that CC should involve a variety of actors (e.g., organisations, institutions, community agencies, governments) working together in the continuum of care; in other words, it should fully reflect the broader healthcare system through a vertical integration process. In parallel, Calizzani et al [51] recommended that the principles underlying haemophilia CC should be considered for implementation within local policy planning and organisational frameworks. Differently, Hacker et al [52], as well as Grogan et al [53], interpreted the 'systemic care' view in terms of 'bottom-up care'.…”