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Service Area Competitor Analysis

Area performances, as well as the medical team performances, should be computed on the basis of the ability of both areas and teams to reach the established targets. This approach has made possible a greater integration of production and performance data, finally available within a single matrix and, hence, more sensitive and able to describe the Group’s positioning and capability, both horizontally (in a given time, between different hospitals), and vertically (in a given hospital, across different moments). Monitoring has been applied, both at single-hospital level, at hub-and-spoke area level, and at medical team level (entire network within a given medical area).

For some of the variables comprised in the above-mentioned indexes, a given numeric threshold was identified and set (in coherence with recent regulations, i.e. the ‘Balduzzi’ law), while in other cases the threshold was set at a value equal or better than GVM’s average performance. Financial incentives were used in GVM in the past but they were not sufficient to optimize doctors’ performance. Since comparing outcomes is complicated, we have implemented coordination, information sharing and team work as performance measures.33–43

These systematic measurements of results and the periodic activity of reporting outcomes using peer pressure have produced significant improvement in quality of care, outcomes and costs in GVM and have positively influenced several important indicators in the cardiovascular area: As far as the area indexes are concerned, there was a clear improvement in all areas considered. Results from the Cardiac Surgery and Cardiology Hospital Score indices are also very interesting: measuring the Cardiac Surgery index, six hospitals of nine improved their performance, one showed no difference, while only two showed a lower score, due to external reimbursement regulations.

  1. the volume of cardiovascular surgical procedures performed by GVM in 2013 rose by ∼10%, inverting the negative trend of the previous 3 years;
  2. the average length of hospital stay in cardiac surgery decreased in 2013 by about half a day compared with the same period in the previous year;
  3. cardiac surgery mortality decreased significantly, by 1%, in the same period;
  4. endovascular cardiology increased by ∼1% in 2013 with respect to 2012.

Clinical research