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Quality Management in Health Care:
doi: 10.1097/QMH.0b013e31829a6d55
Original Articles

Home Enteral Feeding: Analysis and Improvement of Organizational Models

Paccagnella, Agostino MD; Marcon, Maria Lisa PgDip; Rebuffi, Stefania PgDip; Garna, Antonella PHARMD; Mauri, Alessandra PSYCH; Maccari, Daniela PHARMD; Paiusco, Patrizia MD; Spinella, Nello MD

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Abstract

Aim: The purpose of this study was to analyze the organizational models of home enteral feeding used in 5 local health authorities (LHAs) in the Veneto region (Italy). By comparing these models with the main guidelines, the authors have attempted to determine the “minimum standards” to be adopted at an organizational level.

Materials and Methods: This 3-stage study analyzes procedures, precoded actions, and recordable processes. Stage 1: objectives were defined, work methods selected, and reference guidelines chosen. Stage 2: flowcharts were drafted to show the actions and work paths taken for the 5 LHAs. Stage 3: flowcharts were compared with data from the literature.

Results: The study shows that very different organizational models exist. For instance, by comparing organizational processes with the procedures prescribed by the guidelines, it can be seen that the mean percentages of actions taken by the 5 LHAs, for patients in both rest homes and nursing homes, rarely exceeds the threshold of 50% (on a scale from 0% to 100%).

Conclusion: This study shows that home enteral feeding is neither optimized nor uniform in the 5 LHAs and that standardized methods are not used for clinical monitoring.

© 2013Wolters Kluwer Health | Lippincott Williams & Wilkins

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