Program Team: 8 Local Health Units participating in the HPH NetProgram Team: 8 Local Health Units participating in the HPH NetProgram Team: 8 Local Health Units participating in the HPH NetProgram Team: 8 Local Health Units participating in the HPH Network of Friuli work of Friuli work of Friuli work of Friuli VeneziaVeneziaVeneziaVenezia Giulia (Italy)Giulia (Italy)Giulia (Italy)Giulia (Italy)

CoordinatingCoordinatingCoordinatingCoordinating Center HPH Network of Friuli Venezia Giulia: Aguzzoli Cristina,Center HPH Network of Friuli Venezia Giulia: Aguzzoli Cristina,Center HPH Network of Friuli Venezia Giulia: Aguzzoli Cristina,Center HPH Network of Friuli Venezia Giulia: Aguzzoli Cristina, Bertoli Marco, Giacomini Luisa, Calucci Bertoli Marco, Giacomini Luisa, Calucci Bertoli Marco, Giacomini Luisa, Calucci Bertoli Marco, Giacomini Luisa, Calucci FulvioFulvioFulvioFulvio

ParticipantsParticipantsParticipantsParticipants: Sara SANSON, Mario ROBOTTI, Anna DELLA VEDOVA Maria PERESSON, Daniele RIVA, Raffaele ZORATTI, Patrizia PORTOLAN, Virginio BEACCO, Silvia MASCI, Rossana CIANO, Luisa DUDINE, Stefano RUSSIAN, Livia BICEGO, Marco RIZZO, Carlo FAVARETTI

Health promoting healthcare in a changing world:Innovation in service provision, healthcare managem ent and health system design

Particular thanks to Dr.Carlo Favaretti , for his continuous supportand for his expert advice

Psychoemotional standards for self assessment in workplace: experience in Friuli Venezia Giulia HPH network

HEALTH PROMOTING HOSPITALS & HEALTH SERVICES Ospedali e Servizi Sanitari per la Promozione della Salute

HPH Una Rete dell’OMS

Regione Autonoma Friuli Venezia Giulia Speaker

Dr.Raffaele Zoratti

Medice,cura te

ipsum

IndexStress-distress

Resilience

Psycho-emotional well being

Self Assessment in 8 HealthServices Friuli Venezia Giulia Network

Results

Psycho-emotional standardsas training tool forimprovement plans

Management policy actions

Stress and distress

According to natural selection , if

you don’t succeed in getting

over the distress conflict - or

you are not able to accept the

temporary inability - you

perish ……

""""Life Life Life Life existsexistsexistsexists bybybyby maintainingmaintainingmaintainingmaintaining a a a a complexcomplexcomplexcomplex dynamicdynamicdynamicdynamic equilibriumequilibriumequilibriumequilibrium or or or or

homeostasishomeostasishomeostasishomeostasis, , , ,

whichwhichwhichwhich isisisis constantlyconstantlyconstantlyconstantly challengedchallengedchallengedchallenged bybybyby

intrinsicintrinsicintrinsicintrinsic or or or or extrinsicextrinsicextrinsicextrinsic adverseadverseadverseadverse forcesforcesforcesforces

or or or or StressorsStressorsStressorsStressors" (" (" (" (ChrousosChrousosChrousosChrousos, 1998). , 1998). , 1998). , 1998).

Cortisol levels during human aging predict hippocampal atrophy

and memory deficits

Sonia J. Lupien et al. Nature Neuroscience 1,

69 - 73 (01 May 1998)

Self Assessment and Improvement plans

PRIORITY: to Identify areas for well being at

work implementation

Serenity Prayer""""FatherFatherFatherFather, , , , givegivegivegive usususus couragecouragecouragecourage totototo changechangechangechange whatwhatwhatwhat

mustmustmustmust bebebebe alteredalteredalteredaltered, , , , serenityserenityserenityserenity totototo acceptacceptacceptaccept whatwhatwhatwhat

cannotcannotcannotcannot bebebebe helpedhelpedhelpedhelped, and the , and the , and the , and the insightinsightinsightinsight totototo knowknowknowknow

the one the one the one the one fromfromfromfrom the the the the otherotherotherother."."."."

Reinhold Niebhur, american theologian

The psychobiology of resilience

Although adverse environments are well known to be a risk factor for psychopathology, many individuals respond adaptively to such environments. There is growing interest in the underlying mechanisms involved in such resilience. Several cognitive-affective processes may be involved, and these may be mediated by particular neuronal circuits and neurochemical systems. This article summarizes some of the relevant work on the role of fear conditioning, reward processing, and social behavior in resilience.

Stein DJ, CNS Spectr. 2009 Feb;14(2 Suppl 3):41-7.

essess

Personality Life styleLife styleLife styleLife style

Communication

RESILIENCE

MISSION AND VISION: aimsof organization

Decree withForce of law 81/2008Occupational physician programs

Awareness aboutdistress level and relaxationtechniques

Setting Smoke freeHealthy FoodWellness programs

ProceduresWhoWhatWhenWhy

ForumIntranetHouse organ

CommunicationTraining

MISSION AND VISION:individualdevelopment

Enjoy projectsHealthyworkplace

Life skillsTraining : PBL

ORGANIZATIVE LEVEL INDIVIDUAL LEVEL

Standard Management PolicyPromoting a Healthy WorkplaceFocus on psycho-emotional wellbeing

the evaluation in a flexible system , the resiliency o f the system and of the people -

1.4 The organization identifies the responsabilities for the health operators’ psycho-emotional well-being

1.5 Professional profile and job description

1.6 Communication within the company : accountability between the company and the operators.

4.4 Environment : safety4.5 Environment : comfort4.6 Environment : the balance-space4.7 Professional profile4.8 Human profile 4.9 Monitoring and updating4.10 Assessment of chronobiology,

care models and health impacts. The clinical risk managementand the relation with work-related stress.

2009 – 2010 Analysis

First step: � self assessment for Standard

1 “Management Policy “ and Standard 4 “PromotingHealthy workplace”+ “Psycho-emotional wellbeing standards”

� 8 Hospitals and HealthServices of Friuli Venezia Giulia HPH network

� the point of view of management area

Second step : self assessment in Assistential areaspsychiatric,oncologic patients

How self assessment works in our reality

yes partly no

ASS 2 13% 72% 16%

BENESSERE ST 1 Regione fvg

13%

72%

16%

25%19%

56%

25%

13%

63%

13%

56%

31%

19%

75%

6% 6%

25%

69%

50%

31%

19%

0%

10%

20%

30%

40%

50%

60%

70%

80%

ASS 2 ASS 1 AOPN AOUD CRO Burlo ASS 6

STANDARD 1 psychoemotional wellbeing 2010

yes

partly

no

ASS 2 20% 47% 33%ASS 1 60% 7% 33%AOPN 36,5% 23,5% 40%AOUD 7% 60% 33%CRO 40% 40% 20%Burlo 27% 33% 40%ASS 6 27% 53% 20%

20%

47%

33%

60%

7%

33%

36,5%

23,5%

40%

7%

60%

33%

40%40%

20%

27%

33%

40%

27%

53%

20%

0%

10%

20%

30%

40%

50%

60%

ASS 2 ASS 1 AOPN AOUD CRO Burlo ASS 6

STANDARD 4 psychoemotional 2010

yes

partly

no

N°Operators 31 december 2009 TOT = 15.608

ASS2= 2.079 AOUTS=3.011 BURLO= 763

ASS1= 1.309 AOUD= 3.896 CRO= 674

ASS6= 1.886 AOPN = 1.990

Operators 2010: - 409

SELF ASSESSMENT AS A TOOL FOR WELL BEING TRAINING

Training/Information 30 operators

MultiprofessionalManagers MD Nurses

Technicians

Identification of a DepartmentReferent forOrganizativeWellbeing

Identification of a DepartmentReferent forOrganizativeWellbeing

FIRST CYCLE

1-3 february 2011

SECOND CYCLE

1-3 march 2011

9 meetings – may-september 2010 in a Health Service 19 operators set up training on well-being analysis / improvement plans

1st SESSION- ORGANIZATIVE EMPOWERMENT

2nd SESSION- ENVIRONMENTAL EMPOWERMENT

3rd SESSION- INDIVIDUAL EMPOWERMENT Training/Information

30 operators

MultiprofessionalManagers MD Nurses

Technicians

RESULTS 2011: PRELIMINARY NEEDS

Operators of MANAGEMENT AREAdebriefing paths to face distress(4.10.2)Operators of SURGICAL AREAdebriefing paths to face distress (4.10.2)Operators of MEDICAL AREAempowerment communicationtarget medical doctors new employees (1.6.1)Operators of EMERGENCY AREAaccountability for improvement communicationbetween operators and HPH steering group(1.6.3)Operators of HEALTH SERVICES AREAempowerment on life skills (4.8.3) and debriefing paths(4.10.2)

Self Assessment STANDARD 1 and 4 and Pshyco-emotional wellbeing

2012 IMPLEMENTATION

EVERY SERVICE IS PUTTING IN ACTION A SPECIFIC PROGRAMStandard 1.4.2

TO RESUME…..RESILIENCE OF AN ORGANIZATION

PERSONALITY : Mission of Health Service1. From Plan to Action: Plan of Prevention 2010-2012 and

alliance with HPH network2. The committment of managers towards HPH : 3rd Regional

HPH Conference – 5 May 2011 –3. The commitment on annual planning goals 20124. The commitment of Coordinating Center : XV National

HPH Conference 2012

STRESS :Link between HPH and Health Regionale and National programs

1. Stress related work risk evaluation2. Risk management 3. Gender discrimination and mobbing committees4. Accreditation systems

LIFESTYLES : healthy workplace for physical activity, healthy food, smoke free setting, alcol free strategies, balance spaces

DECISION MAKING : Deming cycle for procedures, self evaluation tools for management (HSE)

COMMUNICATION: Accountability tools, Forum, Training Plans…

RESILIENCE OF EMPLOYEES

PERSONALITY :Human development, Life purposeand purpose on job development

STRESS : Awareness of stress distress signals, Enjoy Relaxation techniques- Occupationalphysicians programs

LIFESTYLES : Enjoy Lifestyles projects

DECISION MAKING: Take part of Training forHuman profile (life skills, coping), training on prioritizing system

COMMUNICATION : Sharing Training Communication

THANKS FOR YOUR ATTENTION!

www.retehphfvg.it

HEALTH PROMOTING HOSPITALS & HEALTH SERVICES Ospedali e Servizi Sanitari per la Promozione della Salute

HPH Una Rete dell’OMS

Regione Autonoma Friuli Venezia Giulia

8 november 2012 TRIESTE - ITALY

XV National HPH Conference

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