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SERVICES

CHARTER

ArcispedAle s. MAriA NuovA irccs Services Charter - Anno 2013 2 3

INTRODUCTION

The Services Charter aims to offer a useful tool for patients, their relatives

and anyone wishing to find out more about this hospital and the services it

provides.

Here you can find specific information on the care paths and practical in-

formation on how to access the various services, or how to obtain health

documents and certificates.

You will also find general information on the ASMN-IRCCS’s commitment

to users and the rules and regulations governing its actions.

Summary

INTRODUCTION 3

PRESENTATION 5

SECTION 1 PRESENTATION OF THE HOSPITAL Mission and strategic vision 7 Founding Values 8 Organisation 9

SECTION 2 INFORMATION ON PATHS AND SERVICES Emergency services 11 Hospital admissions 17 Outpatient services 27 Clinical and care services 29 Training 38 Research 38 Informed consent and privacy 41 Organ and tissue donations 42 Private Practice 43 Other services 45

SECTION 3 COMMITMENTS AND PROGRAMMES Transparency and guarantees 51 Health services network 52 Research and care 52

SECTION 4 PUBLIC INFORMATION, LISTENING TO CITIZENS, PROTECTION AND COOPERATION Information and communication 55 Voluntary Associations Committe (CCM) 56 Relations with voluntary associations 57 Provincial Ethics Committee 58 Assessment of the quality preceived by users 58

APPENDIX Citizens’ rights (drafted by the CCM) 62

ArcispedAle s. MAriA NuovA irccs Services Charter - Anno 20133 4 5

PRESENTATION

Founded in 1384 in Reggio Emilia as a hospice for the sick, Santa Maria Nuova Hospital has occupied its current premises in Viale Risorgimento since 1965.

With over 900 beds and 50 specialities, Reggio Emilia Hospital is a reference point for the whole province for second and third level care.

Alongside its specialist services, over time its research vocation has expanded, leading in May 2011 to the recognition as a Research Hospital (IRCCS) for Advanced Technology and Healthcare Proctols in Oncology, by the Ministry of Health.

Patient care, the humanisation of treatment and working towards excellence in care quality: these have always been our objectives and over time have distinguished the history of this Hospital in its approach to users.

The dimensions we have achieved and the complexity of the care paths make it indispensable for us to make available a wide range of information to users and citizens, who are becoming increasingly aware of their health care choices.

This is the principal aim of this Services Charter: to provide clear, useful information, offering precise, punctual references to help users overcome any difficulties they may encounter in using our services.

We hope that we have achieved this objective.

The General Director

Ivan Trenti

ArcispedAle s. MAriA NuovA irccs Services Charter - Anno 2013 6

SECTION 1- PRESENTATION OF THE HOSPITAL

7

SECTION 1

PRESENTATION OF THE HOSPITAL

MISSION AND STRATEGIC VISION

S. Maria Nuova Hospital, Reggio Emilia - IRCCS (ASMN-IRCCS) works to

maintain and promote health in the local community. ASMN-IRCCS does

not merely deliver healthcare, it also pursues the “health” objective in terms

of improving overall quality of life among the local population, with specific

focus on the person.

In 2011 S. Maria Nuova Hospital in Reggio Emilia was recognised as a

Research Hospital (IRCCS) for Advanced Technology and Healthcare

Protocols in Oncology.

This is a further recognition of the ASMN-IRCCS as a centre of excellence

in the regional, national and international health sector.

Research is therefore a qualifying element of our Hospital’s mission.

The ASMN-IRCCS pursues the integration of care, research and training

functions, also working with other boards and bodies in the National and

Regional Health Systems, the universities and other Research Hospitals.

The strategic vision of the ASMN-IRCCS focuses on the provision of high

quality services, in step with scientific and technological evolution, through

an organisational structure marked by appropriate, effective and efficient

actions.


SECTION 1- PRESENTATION OF THE HOSPITAL

9

ORGANISATIONThe ASMN-IRCCS is organised into Departments.

The Department is a coordination body comprising Divisions and Units based on uniformity and complementarity, pursuing common aims, including: promotion of the mutual exchange of competences and professional skills, integrated management of allocated resources, definition of activity levels consistently with the healthcare strategies and available resources, development of professional, training and care paths aiming to promote quality of service.

This organisation considers the recognition of the ASMN as an Research Hospital (IRCCS) for Advanced Technology and Healthcare Protocols in Oncology in 2011. The Oncology and Advanced Technologies Department is linked to the IRCCS.

FOUNDING VALUESHere below we describe the set of principles that explicitly govern our day to day actions and activities and define the ASMN-IRCCS hospital organisation.

RESPECTRecognising and listening to the needs of users-citizens and professionals in full compliance with all fundamental rights.

COOPERATIONStimulating integration and cooperation to foster cohesion among professionals, our Hospital and other health boards, particularly the Local Health Authority of Reggio Emilia (AUSL), and other institutions and associations working in the local community.

TRANSPARENCYGuaranteeing transparency in the delivery of services, in our dialogue with other boards providing health services, in the clear explanation of objectives.

RESPONSIBILITYEnsuring coherence and compliance in commitments undertaken at all levels.

CLINICAL QUALITYActing on the basis of “scientific evidence”, and on the basis of the demonstrated effectiveness of healthcare practices.

SAFETYAt all professional and operational levels, guaranteeing the highest safety standards of health care and health services, aiming to improve the organisation by achieving standards of excellence.

INNOVATIONSupporting the development of new ideas, seeking flexibility and freedom of action, relying on the intelligence and professional experience of the hospital staff.

EQUITYGuaranteeing equal access, use of services, quality of care for all users faced with the same health need.

General DirectorIvan Trenti

Administrative DirectorDavide Fornaciari

Medical DirectorGiorgio Mazzi

Emergency MedicineAnna Maria Ferrari

RadiologyPierpaolo Pattacini

Clinical and Endocrinology LaboratoryLuigi Vecchia

OBSTETRICS, GYNECOLOGY

AND PEDIATRICSMartino Abrate

Children RehabilitationAdriano Ferrari

Obstectris and GynecologyGiovanni La Sala

Oncogynecological SurgeryMartino Abrate

EndocrinologyRoberto Valcavi

OphthalmicLuigi Fontana

OtolaryngologyVerter Barbieri

Oncological and Reconstructive SurgeryClaudio Pedrazzoli

UrologyFranco Bergamaschi

Breast SurgeryGuglielmo Ferrari

Internal Medicine IIdo Iori

Internal Medicine IIAurelio Negro a.d.*

Internal Medicine IIIGiovanni Fornaciari

RheumatologyCarlo Salvarani

Nephrology and DialysisSonia Pasquali

DermatologyGiuseppe Albertini

Long-term CareWilliam Giglioli

EMERGENCYAnna Maria Ferrari

CARDIOLOGY, THORACIC AND VASCULAR SUR-GERY, CRITICAL CARE

MEDICINECardiology

Stefano Savonitto

PulmonologyLuigi Zucchi

Vascular SurgeryEnrico Vecchiati

Anesthesia and Intensive Care Antonio Pistilli

PROVINCIAL HOSPITAL

Nursing DirectorMarina Iemmi

Legal, institutional and general affairs. Communica-

tions network

Budget and planningAlessandro Morini a.d.*

PersonnelLiviana Fava

High Directorate

EDUCATION AND HEALTH INNOVATION AREA

Pier Paolo FerrettiBiomedical technologies

Pier Paolo FerrettiInformation & Communication

Technology (ICT)Sergio Bronzoni

Thoracic SurgeryGiorgio Sgarbi

Interventional CardiologyAntonio Manari

SURGERYVerter Barbieri

INTERNAL MEDICINE AND SPECIALITIES

Sonia Pasquali

AMMINISTRATIVEAREA

Elena Costa

Public tendering procedures and

contracts Nursing Directorate

Infectious DiseasesGiacomo Magnani

PharmacyFederica Gradellini a.d.*

Education and Health InnovationSalvatore De Franco

TECHNICAL ADMINISTRATIVE

AREA AND TECHNICAL ACTIVITIES

Technical ActivitiesDaniele Pattuelli

Logistics ServiceLaura Reggiani

Prevenzione e Prot.Giovanni Guatelli

General Surgery IIStefano Bonilauri

TECHNICAL AND ADMINISTRATIVEDEPARTMENT

Daniele Pattuelli

Medical Hospital’sDirectorate Operative Director

IRCCS

Medical Director IRCCS Administrative Director IRCCS

Nursing Director IRCCS

Gastroent. and Diges. EndoscopyRomano SassatelliMedical Physics

Mauro IoriNuclear Medicine

Versari AnnibaleRadiation Therapy

Cinzia Iotti

PathologyGiorgio Gardini

OncologyCorrado Boni

HaematologyFrancesco Merli

Genetics LaboratoryFabrizia Franchi a.d.*

ONCOLOGY AND ADVANCED

TECHNOLOGIESGiorgio Gardini

Trasfusion MedicineRoberto Baricchi

Laboratory of Molecular BiologyBruno Casali

Cervical Cancer ScreeningSonia Prandi

IRCCS

Board of auditors Board of Directors

Evaluation and Verification Board

Scientific DirectorGiovanni Apolone

Clinical Microbiology LaboratoryEdoardo Carretto

Clinical Chemistry Laboratory and Transfusion Medicine

Gianpaolo Russi

Chil Neuro-PsychiatryGianna Bertani a.d.*

PediatricsSergio Amarri

Neonatology Intensive CareGiancarlo Gargano

Clinical GeneticsLivia Garavelli

AngiologyAngelo Ghirarduzzi

Controlling and MarketingElena Costa

Clinical Immunology, Allergy, and Advanced

Biotechnologies

Diabetologic UnitEnrica Manicardi

QualitySystems

BODIESSTRUCTURES IN STAFF HEALTH DEPARTMENTS

DIAGNOSTIC IMAGING AND LABORATORY

MEDICINEPierpaolo Pattacini

Physical and Rehabilitation MedicineClaudio Tedeschi

NeurologyNorina Marcello

Orthopedics and TraumatologyEttore Sabetta

GeriatricsAlberto Ferrari

NEUROMOTOR PHISIO-PATHO-

LOGY

Oncological Medicine Luciano Masini

Neuro-surgery Franco Servadei

Medical Hospital’s DirectorLuigi Rizzo

Epidemiological Research - Paolo Giorgi RossiPROVINCIAL

DEPT. INFRASTRUCTURE RESEARCH AND STATISTICSAdriana Albini

Statistics and Quality of Clinical TrialsTraslational Research - Adriana Albini

HEALTH DEPARTMENTS

a.d.* acting director


SECTION 2 - INFORMATION ON PATHS AND SERVICES

11

EMERGENCY SERVICES

Throughout the province of Reggio Emilia, the emergency and urgency services guarantee immediate (emergency) and prompt (urgency) health services to the local communities where needed. Working as a network, these services include:

118•

EmergencyRoom•

On-callphysicianservices•

This network of services also includes the many voluntary associations who use their own ambulances to provide public assistance.The ASMN-IRCCS also hosts the Provincial (ASMN-AUSL/Local Health Authority) Emergency and Urgent Care Department (DEU). Through the Emergency Room and in collaboration with the other hospital departments, the DEU ensures prompt and appropriate responses to healthcare emergencies and urgencies.

118 - TELEPHONE NUMBER FOR EMERGENCY HEALTH SERVICES

118 is the phone number to call in the event of a health emergency.

The number is active throughout the country, 24-7, 365 days a year.

You may call 118 from any phone, without any prefix and free of charge. You can also call 118 from a public payphone without a phone card and from mobile phones with no credit.

SECTION2

INFORMATIONONPATHS

ANDSERVICES



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EMERGENCY ROOM (ER)The Emergency Room (ER) is the hospital department dedicated to health emergencies and urgent care. The ER is not the place where non-urgent health problems or chronic diseases can be dealt with.

When to go to the Emergency RoomGo to the Emergency Room only if you have a serious and/or urgent health problem or when there is a condition which places the patient in imminent, life-threatening danger which demands immediate intervention.

Who to contact in non-urgent situationsFor non-urgent healthcare needs, citizens may contact:

their • Family Doctor or Primary Care Paediatrician, during surgery hours;the Physician-on-call.•

The correct and responsible use of the Emergency Room by local citizens will reduce waiting times and guarantee an appropriate response to the really urgent care needs which cannot be postponed.

How to access the Emergency RoomYou may contact the Emergency services by:

calling 118; •with a request for an urgent specialist consultation issued by: the Family •Doctor (general practitioner), the Primary Care Paediatrician, the Physician-on-call, a doctor on call in another primary intervention facility;direct access, going directly to the Emergency Room•

What you need in order to access the Emergency RoomYou should bring an ID document and your national health card or tax ID with you.

How it worksYour 118 call is answered by one of the specifically trained nurses manning the 118 Operations Switchboard. The nurse will ask the caller a few important questions. These questions help to understand which is the most appropriate and effective action to take.When necessary, the Operations Switchboard will send the required emergency services. According to the seriousness of the case in hand, the emergency team may also include a doctor.

When to call 118You should call 118 only in real health emergencies, such as collapsing, road accidents, serious domestic or sports incidents or accidents at work, where you are sure or you suspect that one or more people are in a life-threatening condition.

What to do

Dial 118.1.

Answer precisely to the questions the 118 nurse asks you. The information 2. requested by the nurse helps to ensure that the most appropriate health workers and a suitable number of ambulances and medical vehicles are sent to deal with the situation. In the case of a road accident, for example, the 118 nurse may ask what happened, how many people are involved in the accident and what their health conditions are. Waiting for the ambulance to arrive, the 118 nurse may need to remain in phone contact with the caller. The nurse could also ask for more information on what is happening in order to provide the most appropriate practical advice also to the persons present at the scene of the accident.

For all these reasons, do not hang up until the 118 nurse does.3.

Waiting for the emergency services to arrive, it is important to keep 4. the area where the emergency staff have to work clear of all vehicles and persons. At night, switch on as many lights as possible (such as outside house lights) to highlight the area the emergency services have to reach.



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Forfurtherinformationonexemptionfromco-payment,callthesingleRegionalHealthServicefree-phonenumber

800033033Monday to Friday from 8.30 am to 5.30 pm

and Saturday from 8.30 am to 1.30 pm.

Emergency service outcomesAfter diagnosis, the Emergency Room doctor will redirect the patient to one of the following paths:

Urgentadmission

Patients requiring urgent (non-postponable) diagnosis or treatment are admitted to the appropriate Operative Unit.

Admissionforobservation

Patients requiring medical observation are admitted for not more than 24 hours to the Short-Stay Observation unit

Programmedhospitalisation

Patients requiring non-urgent (postponable) diagnosis or treatment are sent home and given the information necessary to initiate the procedure for programmed hospitalisation

Transfer

For patients needing care at another facility, procedures are implemented for transportation. If necessary, the patient may also be transported by helicopter (Helicopter Emergency Medical Service)

Homedischarge

Patients whose condition does not require hospitalisation are sent home and referred to their family doctor (general practitioner) for home carePatients are given a discharge form which provides all information and medical prescriptions required to continue with diagnosis and/or treatment.

Who deals with your caseUsers arriving at the ER are welcomed by trained expert nurses (triage nurses) who will assess the health conditions of each case. Depending on the seriousness of each case, the nurses assign a colour code which establishes the order of access to the care facilities. Colour codes therefore aim to avoid waiting in the most urgent cases.

THE COLOUR CODESThe colour code defines the access priorities according to seriousness: red code (very critical, immediate access to care), yellow cod (critical, rapid access to care), green code (uncritical, low priority access), white code (non critical, non urgent).Foreign citizens who are present in the territory only temporarilymay access the healthcare services without presenting any residency papers. Foreign citizens without a residency permit may access the health services in Emilia-Romagna without the risk of being reported to the judicial authorities.

Exemption from co-paymentWithout prejudice to the exemptions laid down in regional and national legislation, co-payment is not required in the following cases:

patients subject to Short-Stay Observation • (OBI), for diagnostic examination or treatments requiring an observation period usually between 6 and 24 hours;

patients admitted to any hospital ward;•

anyone accessing the ER at the request of the family doctor, paediatrician, •physician on-call or a doctor from another emergency room;

anyone aged under 14;•

exemption from co-payment also applies in the event of illnesses, •income or other exemptive conditions laid down in national and regional legislation;

foreign people staying for temporary periods • (STP) holding poverty declarations.



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HOSPITAL ADMISSIONSPatients may be admitted to hospital for diagnosis, interventions or complex treatments which are not possible either at home or in the local outpatient facilities.Admission to hospital may be:

Ordinary admission: urgent and programmed •Hospitalisation in the day hospital and day surgery •Hospitalisation in long-stay and rehabilitation wards •

URGENT ORDINARY ADMISSION It is ordered by the Emergency Room doctor or the Ward Doctor in charge of hospitalisation. The nursing coordinator in the ward or the nurse in charge will provide the patient and/or his relatives with all useful or necessary information.

PROGRAMMED ORDINARY ADMISSIONOrdinary hospitalisation may be proposed by:

• TheFamilyDoctororPrimaryCarePaediatrician;

• thePhysicianon-call (local medical on-call services);

• SpecialistdoctorThe ward doctor orders the admission and enters the name of the patient in a special booking register according to the clinical conditions of the patient and on the basis of a chronological order. As soon as a bed is available, the patient is contacted by phone and given all the information needed for hospitalisation.

PHYSICIAN-ON-CALL The Physician-on-call (previously the Guardia Medica) provides free medi-cal care at the surgery or via home visits, at night, at the weekend, on days before holidays and on public holidays, when the family doctor or primary care paediatrician is not available.You may contact the physician on-call:

TIMEPHYSICIAN-ON-CALL

intheevening,from8.00pmuntil8.00amofthefollowingmorning

from 10.00 am every Saturday or on days before holidays, until 8.00 am on Monday or the first

following working day

PAEDIATRIC SERVICESTo protect the needs of child users, a special area at the General Emergency Room has been dedicated to urgent paediatric cases.All children requiring urgent medical care must be taken to the Triage counter of the paediatric emergencies area. Here, a specifically trained nurse will assess the child’s conditions and assign a colour code according to the seriousness of the case.The urgent visits clinic is open 24-7 in the facilities available at the General Emergency Room.

URGENTVISITSCLINIC open24-7

DENTAL SERVICEThere is no Dental Service at the Emergency Room.For dental conditions, contact the dental service at the Reggio Emilia Local Health Authority-AUSL Outpatient Centre (Poliambulatorio) in Via Monte San Michele 8, tel. 0522-335651.



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What to bring to hospitaLRequired documentsFor Italian citizens and foreign nationals duly REGISTERED with the National Health Service:

an ID document;•national health card or Tax ID.•

EU citizens not registered with the National Health Service:an ID document;•European health card (EHIC) or E112 form.•

For non-EU citizens the following are required:an ID document;•valid residence permit or renewal application form;•health card or insurance policy or regional STP code • (for foreign people staying for temporary periods).

You should also bring all your health documentation and give the doctors the names of any drugs you are taking for any treatments in progress.

Personal belongingsPyjamas/nightdress, slippers, robe or bed jacket, underwear, personal toile-tries (soap, toothbrush, toothpaste, towels, comb, razor), preferably paper tissues, where required, container for dentures.Place any cash or valuables in the locked cupboard or the safe inside (ask staff for instructions if required).

Contact staffThe Nursing Coordinator or the nurse in charge will deal with your admission. A team of professionals and qualified staff will take care of all patients in line with their respective competences. By learning to recognise the different types of professional figures, you will be able to request their assistance precisely and effectively.The medical staff are your contact point for your clinical treatment and can provide information on the state and evolution of your condition.The nursing and obstetric staff are responsible for providing all-round and specific personal care and assistance, from administration of treatment to management of primary needs including hygiene, nutrition, rest, etc.The support staff collaborate with the nursing staff to ensure the patient’s comfort, and keep the hospital facilities clean and hygienic.All staff can be identified by a badge and the different colour of their uniforms.

Here’s how we present ourselves

Physicians

Nursing

Coordinator

Nurses MidwivesCoordinator Midwives

Technicians

Coordinato

r

Technicians Support

StaffSupportStaff CleaningOperators

Student

Nurses

Student

Techinicians

OperatingRoomOperators

AdministrativeOperators VoluntaryOperators



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For reasons of hygiene and as a form of protection for them, avoid bringing children aged under 12 to the wards.Respecting these simple rules will help maintain a serene atmosphere on the ward, respecting the needs of all patients and staff and avoiding unpleasant situations.In special cases the doctor or ward coordinator may authorise the presence of a family member or trusted person appointed by the relatives (carer or private care worker) outside of ward visiting times, to provide continuous care to a patient.The nursing coordinator should be contacted for all needs and information, and for the issue of such authorisation. This type of care involves supporting the patient for company, conversation, psychological tranquillity and generally the everyday tasks (psychological, emotional and relational support). This form of care does not in any case replace the specific health care provided by the medical, nursing and technical staff, who shall remain directly responsible for these activities.

Rules for patients It is strictly forbidden to smoke anywhere in the Hospital. Cigarette •smoke is forbidden not only by law, but also and above all in order to respect your own health and that of the other patients.It is forbidden to use mobile phones in areas where electro-medical •equipment is in operation, and elsewhere where signs forbid their use. Stay in your bed while the medical staff are performing the daily •rounds.

Permission to leave the hospitalIf the clinical conditions allow, self-sufficient patients may leave the hospital temporarily. Please contact the ward doctor for information.

Talking to doctorsThe medical staff are available to provide information on the patients’ clinical conditions at the times specified in each ward. The times are indicated on the notice boards near each ward entrance and are specified in the leaflets or brochures provided on admission. Staff will not provide information on the patient’s state of health by telephone.

MealsNutrition is an integral part of care. In order to ensure that meals are as close as possible to the patients’ own habits, they are offered a selection of daily menus. The menus are drafted considering different nutritional requirements and cover all food groups.The menus offer a variety of foods to cover various religious and cultural beliefs, and are available in the following languages: English, Chinese, Arabic, Punjabi, Russian, Albanian.Staff serve meals at the following times:

TimingofmealsLunch:from12.00pm

Dinner:from6.45pm

If the doctor has prescribed a special diet, a dietician will monitor the patient and consider his/her own personal tastes while complying with the doctor’s instructions. Moreover:

if the patient has dietary limits, he/she will be offered a choice from •among the foods he/she can eat;if the patient has difficulty chewing the food may be ordered chopped •or blended;parents of children aged up to 10 have the right to receive a free meal •during the child’s hospitalisation;anyone assisting a seriously ill patient who are away from home may •have lunch in the canteen. In this case, the patient’s carer should apply to the Nursing Coordinator on the ward. The Coordinator will assess the effective need and issue a special certification to purchase the vouchers at the Cashier’s Office (Ground Floor).

Patient visits and assistanceOnly a few visitors at a time are allowed, at the times indicated at the entrance to each ward.Not more than two visitors should be with a patient at any one time, in order to avoid disturbing the other patients.



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Transfer to another hospital wardThe times and methods for transfer to another ward are agreed between the medical teams and notified to the patients and their relatives. Patients are transferred with all their clinical documentation and a short accompanying letter.

Protected discharge to a residential facility in the services networkPatients may be discharged to one of the following facilities in the local area:

Rehabilitation Health Residence• (RSR): if the specialist doctor confirms the need for rehabilitation;

Nursing Home: if the patient’s clinical conditions do not permit the •immediate return home. The procedure is implemented by the Hospital Social Services following discussions with the patient and his/her relatives;

Villa Verde private healthcare clinic: for long-stay cases or waiting for a •place in Nursing Home;

Health-service-approved neuropsychiatric nursing home: for patients •with serious behavioural disorders or dementia;

Hospice: a board assesses the patients during hospitalisation and places •them on the waiting list where the need for palliative care is confirmed.

Voluntary dischargeIn the case of voluntary discharge, the staff provide the patient with detailed information on the health risks involved in leaving the hospital and the patient is required to give his/her consent by signing a specific part of the clinical records; in this case there is no discharge letter.

DischargeThe ward doctor assesses how and when to discharge a patient. After their stay in hospital, patients receive a discharge letter which must be given to the family doctor (general practitioner). To guarantee care continuity, the hospital works in a network with the local health services, starting from the family doctors.In some specific situations, “protected discharge” may be authorised, involving a care programme coordinated with the family doctor and the social services.

Discharge LoungeDuring discharge, while waiting for their relatives or an ambulance to collect them, a special Discharge Lounge has been established on the ground floor, near the Emergency Room. The Discharge Lounge provides patients with comfortable facilities and the required care. There are different areas for autonomous users and users in wheelchairs or stretchers. The Discharge Lounge also offers a catering area and a TV corner, as well as specific toilet facilities.The Discharge Lounge operating staff (OSS - Social-Health Workers) guarantee particular attention to health education and information concerning the treatments and therapies the patients have to follow at home and/or the facilities they are returning to. The Discharge Lounge is open

OPENINGHOURSfrom Monday to Friday from 8.00 am to 7.30

pm

on Saturday from 8.00 am to 3.00 pm.

Discharge methodsHospitalised patients may be discharged in the following way:

Ordinary home discharge

After hospital care and treatment, the staff will notify the patient and their relatives in advance of the date of discharge. The staff also prescribe any support for managing the patient at home, where necessary.On discharge the staff provide the discharge letter, to be given to the family doctor (general practitioner) and to be kept for later check-ups.



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DAY HOSPITAL CAREThe Day Hospital (DH) is a programmed service for one-day hospitalisation, with entry in the morning and discharge within 12 hours, usually from 7.00 am to 5.00 pm.

OPENINGHOURSDAYHOSPITAL

from 7.00 am to 5.00 pm.

The Day Hospital may be diagnostic, therapeutic, surgical (day surgery) or for rehabilitation. The full service may cover one or more consecutive or non-consecutive visits to the Day Hospital.

Activation and AdmissionPatients can access the DH only with an order by the specialist hospital doctor. On the first visit to the Day Hospital, the admission procedures are the same as those for Ordinary Admission to hospital.If the patient has to attend the day hospital for several treatments, on subsequent visits said procedure shall not be repeated.

MealsPatients remaining at the day hospital also in the afternoon and whose health conditions permit to do so may request lunch, served on the ward.

What to bringGenerally speaking only essential items are necessary. The Nursing Coordinator will provide more specific information, also depending on the reasons for the visit.

DischargeWhen the medical treatment received at the Day Hospital has been completed, patients are provided with a clinical report to be given to the family doctor (discharge letter).

Drugs In order to guarantee care continuity following discharge, it is possible to obtain the prescribed drugs for free to continue the treatment, only for the first complete cycle.These drugs can be collected from the Drug Distribution Service on the 1st floor of Block (Corpo) A, Access route (Gruppo di salita) 1 - green path, from Monday to Friday from 8.30 am to 3.30 pm, and on Saturday from 8.30 am to 1.30 pm.

OPENINGHOURSdal lunedì al venerdì dalle ore 8.30 alle ore 15.30

Sabato dalle ore 8.30 alle ore 13.30

For patients discharged from the Infectious Diseases and Oncology wards, drugs are distributed in Building I – Infectious Diseases Building from Mon-day to Friday from 8.30 am to 2.30 pm and on Saturday from 8.30 am to 1.30 pm.

OPENINGHOURSMonday to Friday from 8.30 am to 2.30 pm

on Saturday from 8.30 am to 1.30 pm.

Transportation by AmbulanceWhen ordered by the Hospital, transportation of patients by ambulance is free of charge and is provided to:

hospitalised patients •non-self sufficient elderly patients in health-service-approved nursing •homes, going to or leaving hospitalall users on dialysis. •

In all other cases, transportation by ambulance must be paid for. To request transportation by ambulance, where not ordered directly by the facility, and for information, call the free-phone number 800 118 000, available 24-7, which connects all the 118 Operations Switchboards in Emilia-Romagna.

FREE-PHONENUMBER

available 24-7

free



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OUTPATIENT SERVICES Specialist outpatient services cover visits, minor surgical operations, treatment, laboratory examinations and instrumental diagnostics. Outpatient services are provided both on the National Health (institutional) and on a private practice basis (see page 43).

INSTITUTIONAL SERVICES (via the National Health Service) Outpatient services must generally be booked. To book an appointment, you must have a prescription from your family doctor (general practitioner) or your primary care paediatrician, a physician on-call or a specialist doc-tor.Exceptions:

Obstetric and Gynaecological visits: available also without a prescrip-•tion from the general practitioner, in case of need;Paediatric visits: available outside of the opening hours of the primary •care paediatrician.

BookingsDepending on the service required, appointments may be booked:

at the counters of the Booking Centre - Centro Unico Prenotazione •(CUP) in any of the local health districts;at some Pharmacies in Reggio Emilia • (contact your pharmacy for more information);by phone using the AUSL CUPTEL service - tel. 800 425036 from •Monday to Friday, 8.00 am to 6.00 pm;at the ward secretary’s office • (Surgery, Medicine, Gynaecology, Rheu-matology/ Endocrinology, …), for the services managed directly by the operating units;at the ASMN-IRCCS Department • (Poliambulatorio), directly at the ad-mission counter or by phone on 0522296227 from Monday to Friday

DAY SURGERY CARE Patients are admitted to day surgery for programmed minor surgical operations, with admission in the morning and discharge within 12 hours.Patients may also be admitted for check-ups and pre- or post-operative visits.The day surgery aims to reduce the impact of surgery on the patient’s life habits to a minimum.Patients are managed by a special team, right from their admission to hospital, on the day of the surgery, until full recovery.

Activation and AdmissionThe proposal for day surgery is made by the surgeon who visits the patient at the outpatient clinic, based on clinical and socio-family criteria.On the day of operation, admission is done using the same procedures as those for Ordinary Admission to hospital.

DischargeBefore home discharge, the surgeon gives the patient an appointment for a post-operative check-up and the discharge letter.

It is advisable to be accompanied by a friend or relative who can wait as long as is needed to help the person to return home.

After day surgery The ward doctor will advise patients of the care and precautions to be taken and any therapy required. The doctor will also notify of the dates and times for subsequent check-ups. The staff will provide in writing to the patient and/or relatives with a telephone number to contact in case of need in the 24 hour period following discharge. When needed, the patient and/or relatives can call the number and ask to speak to a ward doctor.

HOSPITALISATION IN LONG-STAY AND REHABILITATION WARDSAfter the acute phase of an illness, patients requiring further observation or rehabilitation may be admitted to a long-stay ward. Generally this type of hospitalisation does not last more than two months. Clinical and nursing care are guaranteed 24-7.



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treatment. The services provided are classifiable as specialist outpatient services provided on the National Health Service, so unless patients are exempt the services are subject to co-payment.

CLINICAL AND CARE SERVICES

PRE-OPERATIVE PROCEDURESPre-operative procedures are usually implemented for programmed surgical interventions. The pre-operative phase is important in order to correctly plan and assess the intervention. This phase involves all the assessments required to define the level of complexity of the surgical procedure, the clinical and physical conditions of the patient and the choice of the most appropriate anaesthetic technique.In the pre-operative phase, the patient will undergo:

blood tests•any other prescribed specialist exams • (e.g: ECG, chest x-ray)perioperative nursing assessment • (Perimed) or check up by the anaesthetist depending on the surgical programme and the care needs.

All the phases of this procedure are designed to ensure the safety and tranquillity of the user. All preoperative check-ups are free and are done on an outpatient basis prior to admission.

AutotransfusionIn some cases prior to surgery patients may undergo “autotransfusion”. This means that the patient deposits some of their own blood which may be used during surgery. Autotransfusion is a safe procedure that reduces the risk of immunological reactions or infections. For more information, patients may contact their surgeon or the anaesthetist.

from 7.20 am to 7.20 pm and on Saturday from 7.20 am to 1.20 pm.MyCUP is a mobile phone software used to book exams and check-ups •directly from your phone, by connecting to the CUP counters. For more information, refer to the specific website (www.auslre.mycup.miliaris.it).

Once you have booked your appointment by phone, an on-line service is available to print out your booking, so that you do not have to collect it from a CUP counter (stampa prenotazione – print your booking).If you cannot attend your appointment, please cancel it, to allow others to fill the empty slots (disdetta prenotazione – cancel your booking).

Payment methods

Specialist outpatient services are subject to co-payment (ticket). Patients usually have to pay the ticket prior to accessing the service, or in any case before collecting the results. When paying the ticket, patients must have their EHIC card (European Health Insurance Card) or STP (foreign people staying for temporary periods) or ENI (Non-registered European) code, for foreign nationals temporarily in Italy.You may pay the ticket at:

the cashier’s desks at the hospital 1. (ASMN-IRCCS main hall);automatic tellers in the main hall and the outpatient clinics of the ASMN-2. IRCCS (these machines operate 24 hours a day, with coins, banknotes, debit card, give change and automatically issue a receipt);the bank counter of the Banca Popolare di Verona - Banco S. Geminiano 3. e S. Prospero, only for services booked via the CUP (1st floor, main hall);on line by connecting to the website www.pagonlinesanita.it, entering 4. the payment code 9301 0122 0976 0994 in the website.

All payments are documented by a receipt indicating the amount paid.

DAY SERVICEThe Day Service is a care facility that provides various specialist outpatient services and minor or complex clinical and instrumental investigations as part of a specific diagnostic and therapeutic path focusing on the clinical problems of the patient rather than on the single service. It is provided to patients who do not have urgent or serious conditions that warrant admission to hospital or to the Day Hospital, but who require several diagnostic investigations. The Day Service is based on specific criteria and can be ordered only by the hospital doctors responsible for the patient’s



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BREAST CANCER SCREENING The AUSL and the S.M. Nuova Hospital in Reggio Emilia run a programme for the prevention and early diagnosis of breast cancer, for women aged between 45 and 74 resident in the province of Reggio Emilia. The screening centre sends a letter directly to users inviting them to come for a mammogram (a special type of x-ray). The letter indicates the day, time and place for the exam. The invitation letter also provides a telephone number if you need to change the appointment. Screening frequency depends on age. For women aged between 45 and 50, the invitation is sent once a year. For women aged between 50 and 74, the invitation is sent once every two years.The mammogram and any further diagnostic investigations are free of charge, and do not require the request of the family doctor (general practitioner). The programme guarantees the continuity of the diagnosis and any required care.

Where to do the mammographyThe Mammogram Diagnostics centre is in the Radiology Department at the Hospital (first floor, access route no. 5 - yellow path).

Who to contact for informationAny clarifications or information required may be provided by your family doctor or by calling 0522-335327. Website: http://www.regione.emilia-romagna.it/screening/

How the results are notifiedIf no further investigations are required, the results are sent by post to your home address within 1 month. If further investigations are required, the user is contacted by phone to make a new appointment. CERVICAL CANCER SCREENING

The AUSL and the S.M. Nuova Hospital in Reggio Emilia run a programme for the prevention of cervical cancer, for women aged between 25 and 64

PREVENTION AND SCREENINGTogether with the Reggio Emilia Health Board (AUSL), the Hospital participates in regional screening programmes for the prevention of colorectal, breast and cervical cancer.As part of the cancer prevention programme, the ASMN-IRCCS works with Anti-Smoking Centres to combat smoking addictions among both patients and staff.

COLORECTAL CANCER SCREENINGThe Health Board and the ASMN Hospital run a colorectal cancer prevention programme targeting men and women aged between 50 and 69, resident in the province of Reggio Emilia. The AUSL screening centre sends a letter inviting people to undergo a faecal occult blood test. This test checks for the presence of blood in the faeces which cannot be seen with the naked eye. The test is repeated every two years. The test and any subsequent investigations are free of charge. The programme guarantees the continuity of diagnosis and any care required, also through services provided by the Digestive Endoscopy centre at the ASMN-IRCCS.

Where to do the testThe kits used to perform the test are available from various centres in the provincial health districts. The invitation letter specifies the place where users should go to collect the kit.

How the results are notifiedThe results are sent directly to the user. If the result is negative (no blood in the faeces), the letter is sent to the user’s home. If the result is positive (occult blood in the faeces) the user is contacted directly by the Screening Centre staff in order to carry out further diagnostic procedures (colonoscopy).If for technical reasons the test is not legible, it may be necessary to repeat the test. In this case the screening centre will send a second letter specifying the methods for collecting a new kit.

Who to contact for informationYou may contact the AUSL Screening Centre by phone on 0522 335327 from Monday to Friday from 8.00 am to 1.00 pm. You may also visit the AUSL website, www.ausl.re.it

OPENINGHOURSfrom Monday to Friday from 8.00 am

o 1.00 pm



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To do the test, you do not need an appointment or a request from a general practitioner. The HIV indicates the presence of specific antibodies in the blood, which are produced by the body when the infection is caught. The positive test is always associated to the presence of the virus in the blood, and indicates that the person is infected and could infect others. It does not necessarily mean that the person has AIDS, namely that has contracted full-blown AIDS. For this reason, a person infected with the HIV virus should contact an Infectious Diseases Centre as soon as possible.To do the test, you must sign an informed consent form; minors must have the authorisation of a parent or their legal guardian. All data relating to those who do the test is processed in compliance with the privacy laws. The test results are generally available in 3 days and are notified exclusively to the person tested.

Where and how to do the HIV test at the HospitalInfectious Diseases Clinic (Tel. 0522.296456) Blood tests: Mon-Sat 8.30 -10.30 amAccess to the clinic:

Direct access, without an appointment and without a request (referral) •from a doctorBooking on the AIDS freephone number 800 856 080•

A doctor will talk to you before and after the test. The test results are usually available in 3 days.

Blood Test Centre of Outpatient Clinic (Centro Prelievi) (Tel. 0522.296677)Access: Direct access or booking via the CUP, with a referral form from the general practitioner.If the test is positive, and the person is infected by the HIV virus, the results are sent to the general practitioner or the Infectious Diseases Clinic, which

resident in the province of Reggio Emilia. The screening centre sends a letter inviting women to undergo a Pap Test (“smear” test) at a Family Clinic or specialist health centre. The smear test is a painless, non-hazardous test which is used for the early diagnosis of cervical cancer or other lesions which could in time turn into cervical cancer. Women are invited for a smear test every three years.

The smear test and any subsequent investigations are free of charge. The programme guarantees the continuity of the diagnosis and any required care.

Where to do the testThe pap test and the HPV test (as a primary test) are done free of charge, for women in the screening programme, at the AUSL Family Clinics throughout the province, without the need for a request from your family doctor (general practitioner).

How the results are notified

The results are sent directly to your home, generally within 21 days of the test, whether the results are positive or negative.

For more information, contact the Provincial Screening Centre for Cervical Cancer Prevention (Centro Screening Provinciale Prevenzione dei Tumori del Collo dell’Utero), S. Maria Nuova Hospital, Viale Risorgimento, 80 - 42123 Reggio Emilia - Tel. 0522-296965 - Fax 0522-295080.

You may also visit the websites: http://www.asmn.re.it/ScreeningCCV/ScreeningPap_Mamm.htm http://www.regione.emilia-romagna.it/screening/

HIV and AIDSHIV or “Human immunodeficiency virus” is a virus that over a period of 5 to 10 years progressively destroys the immune system. HIV can make the immune system incapable to reacting against viruses, bacteria and generally other agents that cause diseases. The term AIDS refers to the terminal phase of the HIV infection, and is marked by serious tumour-type diseases and infections.The Infectious Diseases Ward runs a “HIV/AIDS outpatient clinic” to monitor patients with HIV infections, and where it is possible to be tested for HIV.

What is the HIV test?The HIV test is done by a simple blood test. The test is free of charge (even for foreign nationals without a residence permit) and is totally anonymous.



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Visits to the Delivery RoomOn the first and third Saturday of the month, meetings are held by midwives for couples wishing to visit the delivery room. To book, phone 0522.296711

Services providedDuring pregnancy, the ASMN-IRCCS provides gynaecological examinations, 1st and 2nd level ultrasound and prenatal screening for foetal chromosomal abnormalities, both invasive (amniocentesis and chorionic villus sampling) and non-invasive (combined test). Appointments can be booked with the Ward Secretary Office, Monday to Saturday from 8.00 am to 1.30 pm (also by phone on 0522.296464) or at the High Risk Pregnancy Clinic, on Monday, Wednesday and Friday from 10 am to 1 pm, phone number 0522.295094.For the combined test, you require a referral from your doctor (GP or gynaecologist) or the physiological pregnancy form completed by a midwife at the Family Clinic.

Full Term Pregnancy Clinic Pregnant women have a check-up at the Obstetrics and Gynaecology ward indicatively on the presumed birth date. They should bring all the documentation concerning the entire pregnancy to the appointment. During the check-up the mother’s state of health is checked and a cardiotocography is done. To book an appointment, call the ward around 1 week prior to the presumed birth date, on 0522.296015 on Monday, Wednesday and Friday between 9.00 am and 1.00 pm. You do not need a doctor’s referral.

will handle the case. Access is direct or can be booked by phone (tel. 0522.296456 10.30 am - 12.30 pm).

Who to contact for informationFor more information you may contact:

AIDS freephonenumber80085608• 0: from Monday to Friday, from 2.00 to 6.00 pm; Mondays also from 9.00 am to 12.00 pm.HIV/AIDSclinicattheInfectiousDiseaseUnit0522.2964• 56 - Monday to Saturday 8.30 am - 12.30 pmHelpaidswebsite:• www.helpaids.it

ANTI-SMOKING CAMPAIGNThe ASMN-IRCCS is committed to fighting smoking among both patients and staff, and to the protection of non-smokers from passive smoke It is forbidden to smoke anywhere in the hospital or in any of its vehicles. This is a national and regional law, and is also laid down specifically in the hospital regulations concerning smoking. The regulation can be found on the hospital website, www.asmn.re.it.Every year the ASMN-IRCCS takes part in various awareness raising and prevention activities on the subject of active and passive smoking.The health staff are involved in information campaigns to help hospitalised patients and hospital staff to give up smoking. Patients and operators who are smokers and motivated to stop and/or reduce their smoking habits are referred to the local Anti-Smoking centres for help in stopping smoking.

MATERNITY SERVICESThe ASMN provides assistance to mothers during pregnancy, labour and puerperium, and for neonatal care. The Obstetrics, Gynaecology wards, the Neonatal unit and the Nursery work closely together and with the community services in order to ensure continuity of care for mothers and their babies.

Assistance during PregnancyThe departments provide a range of services to help mothers-to-be to face pregnancy, labour and birth in a more aware and relaxed manner. This includes peer group meetings and an overview of birthing facilities and techniques.To take part, you will be required a referral from your own General Practitioner. Participation in the course is free and should be booked within the 12th week of pregnancy by phoning the Obstetrics Ward Secretary Office (tel. 0522.296464).



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Outside visiting hours during daytime, the woman’s partner or a trusted person may remain with her during the day, except when medical visits are performed and when meals are being distributed. Special permits may be issued by the Coordinating Obstetrician.

While in hospital it is possible to register the birth directly in the hospital, at the Births Office (First floor, block A). On discharge, the mother and baby have a check-up, respectively by the gynaecologist and the neonatologist. Generally the baby undergoes a further check-up a few days after discharge, at the Nursery on the Obstetrics ward. The appointment is agreed and indicated in the discharge letter.

PROTECTED DISCHARGESProtected discharge aims to ensure continuity of care and assistance, helping patients to return to their usual home or to adjust to more protected solutions found after hospitalisation. The protected discharge programme is run in cooperation with the social services.

Applications for protected discharge are made mainly by the hospitalisation ward, notifying the AUSL-Local Health Authority Reception Point (Punto Unico di Accoglienza - PUA) (tel 0522. 33 9074–76). Alternatively, relatives, the hospital social services, the community social services or other local organisations may request the protected discharge of a patient. The PUA starts operating immediately during the first 48 hours after admission to hospital for all discharges that require the intervention and coordination of several professional figures and/or services, and the preparation of specific supports for the patient’s physical and clinical condition.

The need for protected discharge is also notified to the Hospital Social Services, which assess the psycho-social and care needs of the patient and

Giving birthThe labour and birth methods can be chosen even at the time of labour, together with the doctor and the midwife. You may choose between traditional labour, in the positions you choose, or one of the non-drug pain relief techniques (water, massage, one-to-one, etc.); C-sections and labour analgesia are performed only on specific medical order and for clinical reasons.During labour and birth you may have a person to assist you (your partner, mother or other person). Immediately after the birth, the parents and the baby remain together in the delivery room to get to know each other, make contact and begin breast-feeding. At birth, the baby is assessed to check his/her adaptation to life outside the womb, and an ID bracelet is fitted, exactly the same as the mother’s.

Donating umbilical cord bloodThe blood that remains in the umbilical cord after it has been cut when the baby is born contains “haemopoietic (blood-forming) stem cells”. Every woman giving birth can decide to donate the cord blood, performing an altruistic act for others suffering from diseases which can be cured by transplants of haeomopoietic stem cells. Women wishing to donate their cord blood should contact the midwives at the Obstetrics ward, Delivery Room, every Thursday from 10.00 am to 1.00 pm for an interview in order to check the health conditions and the wishes of the mother-to-be (for information on the methods and forms to bring, phone 0522/296711 or 0522/296015). Donations are anonymous, free of charge and can be done with both natural births and C-sections, and imply no risks for either the mother or the baby. After birth the midwives will collect the cord, which will be sent to the regional cord blood bank at the S. Orsola-Malpighi Hospital in Bologna, where it will be stored.

Staying in hospital after the birthAfter the birth, the mother is assisted by a midwife from the Obstetrics and Gynaecology ward, who will provide all information for her stay in hospital. The ward operates on a “rooming-in” basis, allowing mothers to keep their babies with them in the room for the whole of their stay.During the stay, mothers are helped and encouraged by the midwives and nursery nurses to breast feed their babies.Relatives and friends may visit the mother and baby during visiting hours, displayed on the panels near the ward entrances:



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Theresearchers perform basic, clinical and translational research.

Basic research covers activities performed mainly in the laboratory on mechanisms of the organism.

Clinicalresearch includes clinical trials which also involve the patients. To take part in the clinical trials, patients must:

fall into the so-called “inclusion criteria” for a given trial and must •therefore have certain characteristics which change from trial to trial;

be clearly informed by the health staff on all aspects of the trial;•

give express written consent in order to take part in the trial.•

Translationalresearch transforms the scientific discoveries made in the laboratory into applications and tools for everyday practice for care and the treatment of diseases.

his/her family and identify the most appropriate social and health local services.

Over the past years in Reggio Emilia a network of integrated social and health services has been working for the elderly population, managed through agreements made between the Health Boards, the Municipalities and the Management Bodies.

TRAININGTo manage patients properly and correctly, all professional figures and staff are required to undergo continuous in-service training. For this purpose, the ASMN-IRCCS plans and programmes training activities for all staff, both medical and non medical, every year.Particular attention is paid to sharing good clinical and care practices and to training related to safety at work. Supporting the Staff Training, the Medical Library works in close cooperation with the University of Modena and Reggio Emilia, with the Health sector degree programmes, and with the University’s e-learning

RESEARCHResearch is conducted at the ASMN-IRCCS in the cancer field (this specialisation has obtained ministerial recognition in the form of a Research Hospital - IRCCS) as well as in other specialist areas. Supporting these activities, there is a Research and Statistics Infrastructure-Department and various Research Laboratories.Research mainly focuses on the following four lines of investigation:

Complex Oncological Pathologies involving cancer research from 1. different points of view (biological, clinical, social and health);Advanced Diagnostic and Therapeutic Technologies which involve 2. innovative research projects focusing on technologies, drugs and medical devices, both to verify diagnoses and to provide therapeutic treatments;Healthcare protocols and oncological pathways involving organizational 3. and health-based projects designed to offer the best forms of care for cancer patients;Innovative therapeutic strategies and targets in Oncology and 4. Haematology/Oncology including mainly laboratory based projects.



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INFORMED CONSENT AND PRIVACYInformed consent for health care is the patient’s confirmation of his/her awareness and acceptance of the medical treatment proposed by the doctor.Patients have the right to receive full and clear information from the doctor concerning:

diagnosis• (the elements composing the illness)prognosis • (forecast of the progress or outcome of the illness)prospects and any diagnostic and therapeutic alternatives•foreseeable consequences of the choices made. •

All this allows the patient to provide his/her full and aware consent to the treatment, in his/her interests and for his/her own good. In particular, the doctor is bound to inform the patient and acquire valid, aware consent in the case of:

surgical interventions;•clinical examinations and invasive diagnostics;•transfusions of blood and blood derivatives;•clinical trials;•reasonably complex medical procedures.•

During the discussions with the patient prior to procedure/treatment, the doctor provides all the information necessary in a clear, understandable manner. After the information has been provided, the patient confirms his/her consent to procedure/treatment by signing the forms in use in each ward or department.

“Consent to the processing of personal data” is required for users of the ASMN-IRCCS services, who must consent to the Operative Units and Professionals working at the hospital to gather information concerning

LIBRARYThe ASMN-IRCCS hosts the Medical Library - Centro di documentazione per il Governo Clinico delle Aziende Sanitarie della Provincia di Reggio Emilia (Documentation Centre for the Clinical Management of the Health Boards of the Province of Reggio Emilia). The Medical Library specialises in biomedicine and services both health workers in the province and external users (researchers, university students studying health degrees, medicine scholars, health professionals etc.).

The Medical Library also includes the Patients’ Library, a project which •has been running since 2005 and which has: An Infopoint for Patients and their relatives, a dedicated service to •promote health and improve the quality of care through the provision of high quality health care information;Cure leggère... Lèggere cura • (Light treatments - Reading is medicine!), “leisure” library service aiming to “humanise” the hospital, through a wide range of activities (reading aloud and book loans) for patients, their relatives and companions.

The Library staff respond to requests for information received by letter, fax, phone, e-mail and through the website http://biblioteca.asmn.re.it.Opening hours:Monday – Tuesday – Wednesday – Friday from 9.00 am to 3.00 pm | Thursday from 9.00 am to 6.00 pm | Saturday from 9.00 am to 1.00 pm[Summer opening hours: Monday to Friday from 9.00 am to 3.00 pm | Saturday from 9.00 am to 1.00 pm]

Location:Viale Murri 9, 42123 Reggio Emilia

Contacts:Medical Library: Tel. 0522 296216 | Fax 0522 296125 | e-mail: •[email protected] | http://biblioteca.asmn.re.itPatients’ Library: Tel. 0522 295992 | Fax 0522 296125 | •e-mail: [email protected] | http://biblioteca.asmn.re.it/bibliotecapazienti).



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PRIVATE PRACTICE Users are also able to request specialist services, both as outpatients and inpatients, performed on a private practice basis by individual professionals (individual private practice) or teams of professionals (group private practice). Private Practice services are in addition to the institutional activities and are performed by the staff outside of their contractual working hours.Private Practice services are delivered:

on an outpatient basis: users choose the professional or team of •professionals and receive the services in the hospital facilities.on an inpatient basis: the patient is admitted to the hospital facilities and •the service is provided not only by the chosen doctor but also by the team chosen by him/her and in some cases staff from other wards.Hospitalisation required through private practice may also include •superior facilities, including accommodation in 2-bed rooms and a private bathroom.

BookingsYou may book outpatient and inpatient services either by phone or by direct access, at the Admission counter of the Outpatient Clinic (Poliambulatorio) or with the secretary office of the department providing the service. For specific information concerning Private Practice services, contact the doctor or team directly. For more information on the services, activities and fees, contact the Patient Advisory and Liaison Services – URP (see paragraph on page 55)

AccessAll services follow the procedure set for institutional activities: access to the outpatient facilities for visits/check-ups or wards for instrumental services.

the patients, their health conditions, and where required also their private life. The Operative Units and professionals may have to gather, organise, transform data into scientific documents (diagnoses, reports and treatments) as well as store this information. This is also an informed consent, as the patients grant their consent after having been provided with all the useful data in the “information note” drafted specifically for this purpose.

ORGAN AND TISSUE DONATIONS AND TRANSPLANTS

In the case of brain death, i.e. death due to the irreversible cessation of all brain functions, it is possible to donate organs for transplant to other patients suffering from serious illnesses and who are on the waiting list for such organs. A single donor can help many patients. Donating organs after death is an act of great generosity, offering other patients in serious conditions the possibility to recover and return to a normal life.For patients who when alive confirmed their wish to donate their organs, at the time of death the medical staff start the assessment of the suitability of the organs. At the ASMN-IRCCS organs are taken from patients dying from brain death in all cases in which both the will of the deceased and the criteria of suitability of the donor are confirmed. It is possible to be an organ donor also when alive. In specific cases it is possible to donate:

organs• (a kidney, part of the liver or lung),tissues • (skin, bone segments, blood vessels),cells • (bone marrow and cord blood).

The wish to donate organs, tissues and cells can be confirmed by living persons in the methods laid down by law. This will can be expressed at the URP (Patient Advisory and Liaison Services) by signing a “declaration of will” to donate organs and tissues.To find out more, read the publication of the Emilia-Romagna Region “Donazione e trapianto” on the website www.saluter.it or phone the free-phone number 800 033 033.



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OTHER SERVICESHOSPITAL PHARMACYThe Hospital Pharmacy provides drugs and medical supplies to the hospital wards for patient care, and also ensures the continuity of care between the hospital and the local community by distributing drugs on discharge or to patients requiring continuous check-ups at the hospital

MUNICIPAL PHARMACIES NEARBY AND 24 HOUR SERVICE

Farmacie Comunali Riunite, Viale Umberto I, N.17Farmacie Comunali Riunite, Via Luciano Manara, N.18/BFarmacie Comunali Riunite, Via Maiella, N.33Apertura 24 Ore: farmacie Comunali Riunite, Via Pansa N.59/G

HOSPITAL SOCIAL SERVICESThe Hospital Social Services, which report to the social area of the AUSL (Local Health Authority) Reggio Emilia district, operate closely with the wards to support hospitalised patients of all ages and their relatives.This service provides guidance and counselling, designing social and health services to tackle problems of social fragility, care and relational difficulties connected with admission to and discharge from hospital. The service is provided in collaboration with the ward staff and, where required, with the local social and health services in order to guarantee the continuity of care after discharge.

Service organisationThe service is open to users and for reports from Monday to Friday from 8.30 am to 1.30 pm and on Saturday from 8.30 am to 1.00 pm. For appointments, the secretary office is open to the public from Monday to

CostsThe Private Practice Services are subject to the payment of a fee which includes an amount due to the Hospital to cover the costs incurred. The cost of outpatient services and instrumental diagnostics are borne fully by the user. For inpatient services, users pay 50% of the so-called “DRG” (the total costs the regional health services allocates to the service), and the remaining 50% is borne by the health board in the user’s place of residence. In addition to this amount, users must pay the costs of the Operating Theatre staff.

Payment methodsPayment of these services may be made:at the cashier’s desks (cassa ticket) in the main hall;

at the automatic tellers in the main hall, the Poliambulatori •(outpatient clinics) and on the first floor, north wing, only for specialist appointments;

by postal order or bank transfer;•

directly on-line, using the PagOnline system.•

As for institutional services, private practice services must also be paid prior to the appointment. Payments are documented by the receipt which indicates the amount paid.



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illegal immigrants and the poor for urgent and essential services 3. (e.g. pregnancy, infectious diseases, all medical services for minors) may receive health treatment presenting the STP form (foreign people staying for temporary periods) issued by the relative body. The STP code, which can be applied for to the Hospitalisation Office (Ufficio Spedalità), does not lead to the right to registration with the National Health Service

Foreign nationals legally in Italy without a health card (EHIC or E111) must pay the full cost of the service.

For more information you may contact:

Ufficio Spedalità, S. Maria Nuova Hospital, Reggio Emilia - IRCCS open 1. from Monday to Saturday from 8.00 am to 1.00 pm

The AUSL Foreign Family Health Centre 2. (Centro per la salute della famiglia straniera) in via Monte S. Michele, 8/a - Reggio Emilia (tel. 0522 335580, e-mail: [email protected])

MORTUARY SERVICESThe mortuary is located at the hospital access in Via Benedetto Croce. The mortuary is open at the following times:Winter (1 October - 31 March)Week days/Saturday: from 8.00 am to 5.00 pmSundays/Holidays: from 8.00 am to 12.00 pm and 2.00 pm to 5.00 pm Summer (1 April - 30 September)Week days/Saturday: from 8.00 am to 6.00 pmSundays/Holidays: from 8.00 am to 12.00 pm and 3.00 pm to 6.00 pmFor information, relatives are requested to contact the staff at the Autopsy Department during opening hours (tel. 0522 29 6222).

Friday from 8.30 am to 12.30 pm (Tel. 0522/ 335018). Meetings are usually held in the offices of the Social Workers, made available by the Hospital.

SECURITY SERVICESIn order to guarantee security in the Hospital, a 24-hour security service is in operation in the buildings manned by qualified, armed staff; video surveillance cameras, anti-intrusion devices and access control systems are also in operation. Moreover, specific procedures have been established to manage alarms and risk situations, coordinated by the Emergency Management Switchboard which is in operation 24-7.At night (10.00 pm to 6.00 am) access to the hospital is permitted only in the following cases:

to assist hospitalised patients, where an entrance permit has been issued •by the nursing coordinator;in the event of worsening of the clinical conditions or the death of a •patient, notified by the ward;for urgent requirements to be checked with the ward. •

CULTURAL LINGUISTIC MEDIATION SERVICES - INFORMATION ON ACCESS TO SERVICES BY FOREIGN USERS In order to respect cultural diversity and respond in the best way to the needs of foreign users, the ASMN-IRCCS runs a Cultural Linguistic Mediation Service.

Cultural linguistic mediators may be called in by health workers in order to facilitate communication and relations with foreign users. This is done both through translation services and through the promotion of the knowledge of different cultures. The service is free of charge and may involve the presence of the mediator during the medical services, or may be done by phone.

Free access to medical services is assured to foreign nationals as follows:

EU patients holding an EHIC card1. (European Health Insurance Card) who have the right to urgent and necessary health care during their temporary stay in another EU country;

Non-EU patients from countries holding social security conventions 2. (bilateral agreements) with Italy, in the possession of an appropriate certified statement.


Families are free to choose the funeral services they wish, and contacts must be made outside of the hospital area (including the mortuary and relative forecourt). A list of funeral services operating in the city and in the province is available at the Mortuary.

RELIGIOUS ASSISTANCECatholic patients may use the Chapel on the Ground Floor of the central hospital building. Here the Perpetual Adoration is held and Holy Mass is celebrated daily at 7.30 pm. On Sundays mass is also held at 8:00 and 9:30 am and 12:00 pm. Furthermore, the Chaplain visits the patients on the wards and on request personal religious assistance is given. Patients belonging to other religions should ask the Patient Advisory and Liaison Services or the Ward Coordinator for information.

ACCESSORY SERVICES In the main hall (ground and first floor) of the main hospital building the following accessory services are available:

newsagent - haberdashers - perfumery - toy shop•bank and automatic teller•bar•public card- and coin-operated telephones • (also available on other floors) wi-fi connection • (request the password from the Patient Advisory and Liaison Services, URP - first floor, main hall)post box in the main hall.•

24-7 automatic food and drinks vending machines are also available on the floors and in the Emergency Room. The wards and departments are also equipped with seating facilities and tables for users and visitors.

NewsAgeNt

bANk bAr

urp post-box

ACCESSORY SERVICES


SECTION E - COMMITMENTS AND PROGRAMMES

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TRANSPARENCY AND GUARANTEESThe ASMN-IRCCS hospital and its staff are committed to providing users with all the information necessary to:

understand the health services proposed to them•choose their treatment in an aware manner • (informed consent).

In the case of treatments which may involve risks, the health staff also provide users with written information.Having provided all useful and necessary information, the health workers ask the users to sign the consent forms. By signing these forms, users demonstrate their aware agreement to the treatments proposed by the doctors. This information process is therefore very important and helps to ensure that users are really aware of the treatments and health procedures proposed.

All hospital departments make available to users information materials concerning:

the activities carried out•the opening hours•other useful information to ensure the best use of the care and assistance •services provided.

The ASMN-IRCCS undertakes to provide information on the patients’ state of health in the times and manners laid down in the privacy laws. To foster communication with users, the hospital staff shall always be identifiable and wear their badge.The ASMN-IRCCS undertakes to listen to the point of view of users through:

the organisation of specific surveys•the promotion of forms of active participation•the collection of complaints and praise•

The ASMN-IRCCS undertakes to respond to any complaints received within

SECTION 3

COMMITMENTS AND

PROGRAMMES


SECTION E - COMMITMENTS AND PROGRAMMES

53

producing organisational models which ensure the best possible care of cancer patients.

The ASMN-IRCCS is also committed to research for integration and sharing of competences. Fundamental elements are the integration, sharing and cooperation among regional, national and international cancer centres.

The ASMN/IRCCS is therefore specifically committed to developing scientific research through rigorous clinical studies and research projects aiming to improve patient care and assistance.

COMFORT, ARCHITECTURAL BARRIERS AND PRIVACY

In order to maintain the hospital structure suited to the needs of users, the ASMN-IRCCS undertakes to:

make the hospital stay and the facilities comfortable;•guarantee access to disabled users by removing the existing architectural •barriers; guarantee privacy;•promote communication with the outside world through Internet and •wi-fi connections;guarantee patients the possibility to choose meals from menus that •consider cultural and religious diversity; guarantee patients food quality suited to their health needs;•promote healthy lifestyles through awareness raising actions targeting •patients and workers on the risks of smoking and a poor dietary habits;protect personal dignity and guarantee privacy for relatives in particular •situations (seriously ill or deceased patients).

30 days, as required by law. Following the principle of mutuality, the ASMN-IRCCS and the users undertake to guarantee relations based on respect and correctness.Secondo il principio della reciprocità, l’ASMN-IRCCS ed i cittadini si impegnano a garantire un rapporto improntato alla correttezza e al rispetto.

HEALTH SERVICES NETWORK AND OFFERING The ASMN-IRCCS undertakes to:

guarantee quality services based on the so-called “scientific evidence”, •i.e. demonstrations of the effectiveness of health servicesguarantee “urgent” services within 24 hours and “postponable urgent” •services within 7 days. comply with the waiting times laid down by the Region for instrumental •services and specialist appointments. Users may request information concerning the waiting times from:

the CUP• (Booking Centre), on bookingthe URP • (Patient Advisory and Liaison Service)

do everything possible to contain pain and suffering, respecting personal •dignity and in compliance with the relative lawsguarantee the continuity of care through protected discharge, with the •direct cooperation of the local services;respond fairly to the health needs of users based on specific needs and •personal features.

RESEARCH AND ASSISTANCE

The ASMN-IRCCS is committed not only to care and assistance services but also to research and training in cancer and other fields.

The mission of the ASMN-IRCCS hospital is the continuous effort to achieve excellence through the development of clinical and scientific research, in order to improve patient care and assistance.

S. Maria Nuova Hospital in Reggio Emilia is recognised as an Research Hospital (IRCCS) for Advanced Technology and Healthcare Protocols in Oncology. In this field, attention focuses on the best possible satisfaction of the needs of cancer patients. The ASMN-IRCCS is therefore committed to the development of new technologies, conducting clinical trials and


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55

INFORMATION AND COMMUNICATION

PATIENT ADVISORY AND LIAISON SERVICES (U.R.P.) AND INFORMATION POINTSThe Patient Advisory and Liaison Services (U.R.P.) are the tool used by the ASMN-IRCCS to communicate with users in order to improve accessibility and promote the protection and participation of the local citizens. In every Ward there is a notice board providing general information and specific information on the organisation of the ward. On admission, users are given a brochure explaining the activities, organisation and access to the ward.The URP is located on the 1st floor of the Santa Maria Nuova Hospital.The URP is open to the public From Monday to Friday from 7.30 am to 1.30 pm, and from Monday to Thursday from 3.00 to 5.30 pm, Saturday from 8.30 am to 12:30 pmThe URP telephone information service is open from Monday to Friday from 7.30 am to 1.30 pm Saturday from 8.30 am to 12:30 pm (during the summer, the URP is closed to the public in the afternoons)Tel. 0522/296677 - Fax 0522/296080 - E-mail: [email protected]

INTERNETOn the hospital website (http://www.asmn.re.it), users, professional staff and partners of the ASMN-IRCCS can choose their own customised path to access information on its organisation and the services offered.

INTRANET - “NOTIZIE” (NEWS)The ASMN-IRCCS also uses other communication channels, including the intranet and the e-newsletter “Notizie”.

SECTION 4

PUBLIC INFORMATION, LISTENING TO CITIZENS,

PROTECTION AND COOPERATION


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57

RELATIONS WITH VOLUNTARY ASSOCIATIONS

The ASMN-IRCCS is committed to offer full collaboration with all the health and social associations working in the local community with a view to the mutual exchange of good practices and joint learning activities, in line with an appropriate organisational development of the hospital.Since 2009, the ASMN-IRCCS Training Service has been running a specific relations area to liaise with the Voluntary Associations, NGOs and non-profit organisations working in the Province of Reggio Emilia. In 2011 the Training Service also opened a “Volunteers Desk” (“Sportello del Volontariato”) to support the activities promoted by the various Association managers, in order to facilitate interaction with the ASMN-IRCCS. The “Volunteers Desk” is located in the Spallanzani Building.Around seventy voluntary associations are listed in the dedicated hospital publication/calendar, working in three main areas:

support to non-autonomous patients who require assistance during •normal everyday relational activities,support to patients, who may also themselves be volunteers, participating •in self/mutual-help groups and supporting the health promotion activities running in the hospital,support to fund-raising activities for the recruitment of professional •persons to be involved in specific projects on research or for improving care,support to fund raising initiatives for the purchase of particular, innovative •healthcare technologies.

The intranet service is available to all ASMN-IRCCS staff.The e-newsletter “Notizie” is sent monthly by e-mail and can also be consulted on the hospital website (http://www.asmn.re.it).

MISSION RESULTS STATEMENTThe Mission Results Statement is a document describing the activities of the hospital in the past year and contains a report on the resources invested and the staff employed. The Mission Results Statement is published once a year.

VOLUNTARY ASSOCIATIONS COMMITTEE (Comitato Consultivo Misto- CCM)

The Voluntary Associations Committe (CCM) is an independent body comprising mostly representatives from the local community (voluntary and protection associations) with a minority of representatives from the ASMN-IRCCS. The CCM fosters the participation of citizens in the decision making processes aiming to improve the quality of services and communication between the hospital and its users.The CCM is chaired by a member of the citizens’ representatives, and remains in office for a period of three years.The establishment and operation of the CCM are governed by the hospital regulations. The CCM has full autonomy and, by virtue of this autonomy, drafts proposals for the General Management.

Tasks

The CCM is responsible for monitoring, supporting and making proposals concerning the health services, and in particular concerning their quality as perceived by the local community. The ASMN-IRCCS:

dialogues with the CCM about hospital programming issues,•appoints authoritative hospital representatives to sit on the CCM,•promotes training of CCM members and the knowledge of the body •inside and outside the hospital,supports the operational activities of the CCM.•

How to contact the CCMTo contact your local CCM, ask the Patient Advisory and Liaison Services (URP).


APPENDIX

59

HEALTH DOCUMENTATION

EXAMINATIONS PERFORMED AT THE EMERGENCY ROOM Patients treated at the Emergency Room who are not admitted to hospital receive examination results when discharged. If they are admitted to hospital, the results are included in the clinical records.

Subsequently, the patient may request a copy of the medical results, the results of any instrumental examinations and x-rays (on CD) free of charge.

The request may be made by the interested party or someone authorised by them. The documentation is provided in strict compliance with the methods of issuing true copies of the clinical records (see below).

DURING AND AFTER HOSPITALISATION In this case, to request your health documentation you must contact the Ufficio Unificato Consegna Referti/Cartelle Cliniche (Single Results/Clinical Records Office), which may provide you with:

a true copy of your clinical records concerning your ordinary •hospitalisation or day hospital treatment, containing all the health information relating to your stay in hospital; hospital certificate concerning your hospitalization or day hospital •attendance;

The copy of the clinical records may exceptionally be requested during your stay in hospital. In this case the copy of the records includes the documents relating to the period from the start of your hospital stay until the date the copy was made.

PROVINCIAL ETHICS COMMITTEEThe Provincial Ethics Committee is an inter-board body responsible for promoting “clinically useful and relevant research”. For this purpose, the Provincial Ethics Committee has the task of:

guaranteeing the protection of rights, safety and well-being of the •persons taking part in clinical trials;providing a public guarantee of such protection.•

The Provincial Ethics Committee is the reference point for health boards and facilities working in the Province of Reggio Emilia.The Provincial Ethics Committee works with absolute independence of judgement compared to the boards and its members are health and non-health staffMoreover, the Ethics Committee has an advisory role for ethical issues linked to scientific and care activities, to promote and protect personal values and may propose training on bioethical issues.

ASSESSMENT OF THE QUALITY

PERCEIVED BY USERSPeriodically the ASMN-IRCCS surveys the level of satisfaction of its users. The surveys target both inpatients and outpatients using the wards, Day Hospital, outpatient services and the Emergency Room. The main tool used is the questionnaire, filled in directly by users or administered via a phone interview. The results are useful for each department/ward to understand which features can be improved and to ensure that the services provided are increasingly in line with the expectations of users. The survey results are disseminated to all staff and to the Voluntary Associations Committee. Moreover, the results are presented to the local community using the local communication channels and the publication of the Mission Results Statement.

The ASMN-IRCCS also conducts specific and more detailed surveys through interviews and using methods other than questionnaires. These surveys aim to highlight the point of view of the citizens and promote their active participation.


APPENDIX

61

INSTRUMENTAL EXAMINATIONS AND CHECK-UPS PERFORMED ON THE NATIONAL HEALTH SERVICE OR PRIVATELYThe hospital doctor generally provides the results at the end of the medical service.Results delivered later (e.g. laboratory examinations, x-rays etc.), are provided in a sealed envelope to the interested party or their authorised representative/guardian and addressed to the general practitioner in compliance with the above-described methods (clinical records laws). At the request of the interested party, the results may be sent home directly by post. In this case the postal charges are for the recipient’s account. In some areas of the province, an experimental system of on-line consultation of laboratory examinations results is in progress. Patients can access this service using a password given to them at the time of the tests. For all urgent diagnostic services, results are given immediately or in any case on the day of the exam or test. Users may apply for refunds or copies of the payment receipts by filling in the relative forms and presenting them to the Cashiers’ Desk.

Ufficio Unificato Consegna Referti/Cartelle Cliniche (Single Results/Clinical Records Office)Viale Risorgimento, 80 - 42123 Reggio Emilia (main hall, ground floor) Tel. 0522 296218

WINTEROPENINGHOURS(14

September-15June)

Morning: Monday to Saturday, 7.30 am to 1.00 pm.

Afternoon: Monday to Friday from 2.30 to 5.00 pm.

SUMMEROPENINGHOURS(16June-13

September)

Morning: Monday to Saturday, 7.30 am to 1.00 pm.

Afternoon: Monday, Wednesday, Friday from 2.30 to 5.00

pm.

The request may be made:at the counter by the patient or by someone authorised by him/her or •their guardian - by fax 0522 295881by written request sent to the “Ufficio Unificato Consegna Referti”•by e-mail to the following address: [email protected]•

The copy of the clinical records may be collected:by the interested party (in this case, you must bring an identity •document), by an authorised person (in this case, bring a signed authorisation, your •own identity document and the copy of the identity document of the person authorising you); by the guardian, person holding parental responsibility, legitimate heir •and/or person indicated in the will (in these cases, the documents are delivered following signature of the provisions laid down in Presidential Decree no. 445/2000).

Users shall pay for the copy of the clinical records at the time of request. Payment must be made at the Cashiers’ Desk or the Automatic Tellers.When requesting the records in writing, by fax or e-mail, the applicant requiring the documents to be sent by post shall undertake to make the payment on receipt of the clinical records, which will include a special postal payment form.


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63

Right to avoid unnecessary pain and suffering and the right to palliative careAll patients have the right to avoid suffering as far as possible, in all stages of their illness and whatever the cause of their illness.The patient and the healthcare workers shall not consider pain as an inevitable condition of the illness or the diagnostic and therapeutic procedures related to it. The patient and the healthcare workers shall consider pain as an alarm signal and shall measure and treat the pain. It is the duty of all healthcare workers, as laid down in Italian Law no. 38/2010, to monitor the patients’ pain during hospitalisation and treat it using the most appropriate pharmacological and non-pharmacological tools. Patients suffering from any incurable disease have the right to receive palliative care right from the moment of diagnosis of the incurable disease. Palliative care, and all other specific treatments, aim to ensure the best possible quality of life for the patient and his/her family and friends.

Right to a serene and dignified deathPatients have the right to:

choose the place • (home, hospital, hospice) where they spend the final stages of their lives;to avoid under all circumstances all forms of futile diagnostic or •therapeutical care, and therapeutic obstinacy;a serene and dignified death, appropriately supported by the staff and •by their families.

Right to informed consentAll sick citizens have the right to:

express their informed consent to any operation or treatment;•refuse or interrupt any health treatment;•receive appropriate information on the implications and consequences •

APPENDIX

CITIZENS’ RIGHTS (DRAFTED BY THE CCM)

Right to prompt, qualified carePatients have the right to prompt, attentive and quality care, respecting their dignity and religious beliefs.

Right to the respect of dignity and privacyPatients have the right:

to the confidentiality of data concerning their own personal illness and/•or state of health;respect for dignity, privacy and intimacy during medical, nursing, •diagnostic and therapeutic practices;to be informed on the processing of their personal and sensitive data. •All hospital staff, whether healthcare staff or otherwise, shall avoid the disclosure and/or transmission of the data to persons who are not authorised to process them; to maintain their own name in the hospital, to be referred to courteously, •formally and correctly and not by the name of the illness or the bed number;to respect for their own faith and the possibility of requesting and •obtaining religious assistance.

Right to prompt, adequate informationCitizens have the right to receive correct, clear, complete and confidential information concerning:

the diagnostic and therapeutic path they undergo,•the length of treatment,•the proposed medical procedures,•the possible risks,alternative treatments.•

Moreover, patients have the right to:be listened to by the healthcare staff whenever they require clarifications •on their own state of health;be appropriately informed, on discharge, of the best convalescence •methods;be attended to by qualified staff wearing identification badge indicating •their name and professional qualification.


APPENDIX

65

of the refusal or interruption of the treatment.Moreover, at any time patients have the right to change their mind over the consent or dissent expressed previously on an operation or procedure.

Right to respect the rhythms of daily lifePatients have the right to visiting hours that are as long as possible in order to allow the presence of relatives who may lighten the burden of hospitalization, compatibly with the needs of the healthcare activities and the other patients.

Right to accesAll citizens have the right to access the health services needed for their state of health, with no discrimination of:

age•gender•economic resources•culture•religion•ethnicity•physical or mental disability.•

Right to dignified and comfortable accommodationPatients have the right to spend their time in hospital environments that are:

safe•hygienically appropriate•where it is possible to respect personal dignity and privacy;•

Moreover, patients have the right to receive a diet that is:varied•of good quality•suited to their state of health•respectful of their own culture and religion.•

Right to make complaints and proposalsCitizens have the right to make complaints, suggestions and useful proposals aiming for the continual improvement of the quality of the services offered.

Rights of womenWomen have the right to:

give birth in a serene environment, respecting their own intimacy•be attended to by competent staff•give birth in the methods they choose among those available in the •Obstetrics wardbe accompanied by a person of their choice throughout the labour and •birth and during their stay in hospital after the birth. be assisted during puerperium (after birth) in the care and feeding of the baby.

Rights of children Children have the right to have a parent or other person of their choice with them at all times during their hospital stay. Moreover, children have the right to:

play and have fun • (in the wards, at the Toy Room in the Paediatric ward and at the Paediatric ER);socialise and have their own life rhythms respected;•avoid suffering as much as possible, through pain monitoring and •control.


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67

DUTIES OF CITIZENS(DRAFTED BY THE CCM)

Citizens accessing the ASMN-IRCCS have the duty to behave responsibly and respect and understand the rights of other sick people, and to cooperate with the staff.All patients have the duty to inform the healthcare staff of their intention to cancel any programmed health service appointments and treatments in order to avoid wasting time and resources.Citizens are bound to respect the facilities, equipment and furnishings in the hospital/health care facility, which are considered the assets of all citizens and therefore their own.All citizens have the duty to respect the visiting hours established by each Operating Unit, in order to allow normal care and therapeutic activities to be performed and to allow the patients to rest. Moreover, they should avoid all conduct which may constitute a disturbance or discomfort for other patients (noise, lights, loud radio or TV, mobile phones on during rest times or in places where their use is forbidden, etc.).It is strictly forbidden to smoke. Compliance with this provision:

is required by law,•is an act of respect towards other• helps to maintain a healthy environment for everyone.•

Citizens shall respect the organisation and the times laid down by the hospital. Healthcare services requested outside of the set hours or improperly lead to disservice for all users.Citizens have the right to be correctly informed on the organisation of the hospital, but also have the duty to request information at the appropriate times and places.

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