La formazione del personale come strumento di management nelle strutture sanitarie - The training as tool of management in healthcare

In 2004, the World Health Organization (WHO) embarked on a path of assimilation of knowledge in health care, focusing on patient safety and on skills of different professionals. In Italy, the Law 150/2009 takes up this topic underlining the need to boost productivity, efficiency and transparency in public administration from an evaluation of the performance of structures and also paying attention to qualifications and professional skills. To acquiesce to the demands of the Italian and international legislation, training has been identified as a pivotal tool in the management of healthcare organizations, especially considering the evolution of healthcare organization in recent decades. Training for management in the healthcare sector has evolved together with the evolution of health systems, showing changes in roles and responsibilities of each professional involved. The creation of expertise has become increasingly based not on traditional educational interventions but on more interactive training, such as role playing, simulations and problem-solving. The principles of andragogy are therefore fundamental elements in the continuing education of professionals, especially those involved in clinical governance. The training of adults is achieved through the spiral of formation starting from the evaluation of the real needs linked to population's health, to professionals' skills, to clinical and technological innovation and to organizational changes. For this purpose, in 2004 was implemented the project of Continuing Medical Education (CME), which includes the organized and supervised set of training activities, both theoretical and practical, in order to maintain an high and updated professionalism of workers in healthcare field. At the regional level, the CME activities are coordinated by the Regional Department of Health. These activities cover all aspects of Health, therefore, do not affect only the clinicians but also those who are managerial positions such as General Managers, Medical Directors and Managing Directors. For all these figures must be demonstrated, in the curriculum vitae, strong organizational and managerial skills in public health. In order to cover these training requirements have been activated, even collaborating with universities, several training courses. These courses have a duration of not less than 120 hours in a period of six months, and are focused on specific issues related to the management, according to Ministerial Decree dated August 1, 2000 (Discipline of the training courses for General Managers of Healthcare Organizations). What has been said for General Directors was introduced to the Medical Directors a few years earlier with the DPR 484/97 who imposed mandatory training courses for health managers to hold positions of complex structure and for career advancement. From the analysis conducted emerged regional differencesin the management training. Among the common and transversal in all regions themes, can be highlighted the skills in the economic-financial sector and in particular the ability to read the budget and the performance indicators of healthcare organizations and the updating according to technological developments. Given these differences, in conclusion, emerges also from case studies of existing projects of management education as facilities are necessary to control the training process, in accordance with the evolving structure of public administrations.