title: [The implementation of the week surgery in an orthopedic and urology ward and assessment of its impact].
abstract: CONCLUSIONS
  The implementation of the week surgery in an orthopedic and urology ward and the assessment of its impact.
  
  
  BACKGROUND
  The week surgery (WS) is one of the models organized according the intensity of care that allows the improvement of the appropriateness of the hospital admissions.
  
  
  OBJECTIVE
  To describe the implementation and the impact of the WS on costs and levels of care.
  
  
  METHODS
  The WS was gradually implemented in an orthopedic and urology ward. The planning of the surgeries was modified, the wards where patients would have been transferred during the week-end where identified, the nurses were supported by expert nurses to learn new skills and clinical pathways were implemented. The periods January-June 2012 and 2013 were compared identifying a set of indicators according to the health technology assessment method.
  
  
  RESULTS
  The nurses were able to take vacations according to schedule; the cost of outsourcing services were reduced (-4.953 Euros) as well as those of consumables. The nursing care could be guaranteed employing less (-5) full-time nurses; the global clinical performance of the ward did not vary. Unfortunately several urology patients could not be discharged during the week-ends.
  
  
  CONCLUSIONS
  A good planning of the surgeries according to the patients' length of staying, together with interventions to increase the staff-skill mix, and the clinical pathways allowed an effective and efficient implementation of the WS model without jeopardizing patients' safety.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mulloni
authors.forename: Stefania
authors.initials: S
authors.lastname: Petrucco
authors.forename: Raffaella
authors.initials: R
authors.lastname: De Marc
authors.forename: Cheti
authors.initials: C
authors.lastname: Nazzi
authors.forename: Roberto
authors.initials: R
authors.lastname: Petri
authors.forename: Giovanni Maria
authors.initials: GM
authors.lastname: Guarrera
mesh_terms: D000368:Aged; D005260:Female; D006757:Hospital Units / Q000191:economics; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009730:Nursing Assessment / Q000191:economics; D009732:Nursing Care / Q000592:standards; D009741:Nursing Staff, Hospital / Q000191:economics; D016530:Orthopedic Nursing / Q000191:economics; D013222:State Medicine / Q000191:economics; D013997:Time Factors; D014572:Urology / Q000191:economics; D000078329:Workforce