Admission

Information and services

Access to urgent care

The Hospitals of the Fondazione Toscana Gabriele Monasterio do not have an Emergency Department.
Urgent admissions are accepted, for the relevant disciplines (cardiology, cardiac surgery, respiratory medicine), as follows:

• admission request on 118: the Foundation is a point of reference (hub) for primary angioplasty in the acute coronary syndromes network in the local area;
• request for admission from Emergency Departments of other hospitals;
• requests for transfer from wards of other hospitals, from which patients come for urgent and unavoidable care;
• ordered by the on-call doctor on the recommendation of the family doctor or specialist for urgent and unavoidable care.

Access to elective inpatient admission

It is proposed by the general practitioner or the referring specialist. It can only be arranged by one of the in-house specialists, after sharing the case with the head of the department and the other specialists involved in order to identify the most appropriate diagnostic and therapeutic strategy, level of care and clinical priority. Following this multidisciplinary assessment, the following steps are taken:

• inclusion in the list of elective admissions
• admission, in line with the number of beds available.

In order to ensure timely access to care appropriate to each patient’s clinical situation, inclusion on the waiting list and the order of admission are made on the basis of clinical priority criteria. In accordance with the principles of transparency and fairness guaranteed by the National Health Service, the patient has the right to know his or her clinical priority level and position on the waiting list by making a request to Healthcare Management.

The patient is called in for admission via telephone contact, at which time they are informed of the day and time of admission to the ward.

Access to elective day hospital admission
(day hospital – day surgery)

Admission can only be booked at the request of an in-house doctor after a specialist assessment, which can be requested directly by your general practitioner or external specialist. The pathway includes the same steps as for ordinary admissions:

• multidisciplinary clinical evaluation
• inclusion in the day-hospital / day-surgery list on the basis of priority
• call for admission

 For more information see Day Hospital.

Administrative reception of the admission

The Administrative Reception of admissions is carried out at the Admissions reception Point present in each Centre, in the following service hours:

• Pisa: Admissions desk on the first floor of building C (ask for directions to the concierge) from 8.00 am to 9.00 am and from 2.00 pm to 3.00 pm from Monday to Friday, unless otherwise indicated at the time of the call for admission. 
• Massa: Admissions desk in the ground floor atrium (admission to the hospital wards – mountain side) from Monday to Saturday from 7.00 am to 8.00 am, unless otherwise indicated at the time of the call for admission.

Patients enrolled in the National Healthcare Service who are admitted on an elective basis (arriving at the hospital following an admission reservation), must present him/herself at the Administrative Reception Point prior to accessing the ward, equipped with:

• Valid ID document
• Health card (Electronic Health Card)

If the patient is experiencing difficulties, the administrative admission can be carried out by a relative.

For urgent admissions a family member of the inpatient must submit the following documentation to the Admissions Reception point as soon as possible:

• Valid ID document
• Health card (Electronic Health Card)

In the event of closure of the Admissions Reception Point, the administrative reception procedure must be carried out as soon as possible on the following working day.

For patients without the support of family members or companions, an administrative reception service is activated at the patient’s bedside.

Admission to the ward

San Cataldo Hospital (Pisa): Monday to Friday from 8:30 a.m. to 12:00 p.m. and from 1:00 p.m. to 4:00 p.m. and on Saturdays from 9:00 a.m. to 1:00 p.m..

Ospedale del Cuore (Massa): from Monday to Saturday from 7:30 a.m. to 8:00 a.m. Unless specifically indicated by the Head of Department.

At the time of admission to the ward, the patient is invited to:

• submit personal clinical documentation: discharge letters and any medical records of previous admissions, reports of instrumental and laboratory specialist visits already carried out
• provide information on current medications, possibly with an up-to-date list compiled by your general practitioner/paediatrician of choice
• indicate the name of the attending physician for any exchange of information with the doctors of the hospital ward.

Child admissions

One of the parents or another family member or other reference figure, at the parents’ request, may stay with the child day and night, unless otherwise specified by the Department Manager.

Health services under the freelance professional and paid room scheme

Health services are provided on a freelance basis for inpatient care. You can choose the medical team to perform surgery or a haemodynamics or electrophysiology procedure under the freelance professional scheme (intramoenia). 

The user can also opt for hotel amenities for a fee: the relevant tariffs are brought to the user’s attention before admission, in order to allow the possibility of an informed and transparent choice.
The management of these paid spaces does not, of course, entail any reduction in the standards of care guaranteed in ordinary hospital rooms.

The day in hospital

The inpatient day, respecting the basic needs of the individual, is characterised by:

• Visits and medical checks
  
• Diagnostic tests
  
• Drug therapy

Cohabitation within the hospital is guaranteed by the behaviour of each inpatient who observes respect for others and avoids causing disturbance or discomfort.

Reception to the ward: the admitted patient is received by the nursing co-ordinator or by nurses who assign: the bed, the bedside table, the wardrobe, as fundamental elements of reception. In the departments organised with the “primary nursing” model, the reference nurse is introduced. Upon entering the ward, the patient receives a satisfaction questionnaire, aimed at detecting the perceived quality of the services, care and accommodation, to enable us to constantly improve. The questionnaire is anonymous and includes the possibility of leaving personal comments.

During admission, hospitalised patients must follow these rules of conduct:

• Smoking is prohibited in all areas of the hospital
• Food not provided by the hospital should not be consumed, unless authorised by a doctor
• The use of mobile devices is allowed, except in risk areas where electronic medical devices are active and in particular situations, which will be pointed out from time to time by the Operators. In the interests of mutual respect, the use of a mobile phone should be avoided during rest hours and during medical visits and therapies
• The volume of radio equipment, cell phones, etc., should be kept low to respect the rest of other patients. The use of headphones is recommended.
• Before leaving the ward, the patient must always inform the staff on duty. To temporarily leave the Hospital, for exceptional reasons, authorisation must be requested from the Medical Manager, who may deny authorisation if it is not compatible with the patient’s clinical conditions. The patient has the right to request discharge against medical advice, which entails the conclusion of the admission: to be subsequently re-admitted, the patient will have to make a new reservation, with reinsertion on the waiting list
• To facilitate the cleaning of the bedside table, do not cover it with sheets or paper; keep only water and a glass on the bedside table
• Throw cotton, gauze, plasters and other waste exclusively in the basket provided with the room; never put them in the cups or on the food trays.

Interviews with the Department’s Physicians: it is advisable to contact the Ward Sister or the Department Staff

The Department Staff are recognisable by their ID card and by the uniform which varies in line with their role and level of seniority:

• Ward doctor: uniform and white coat
• Head nurse: white uniform and gown with dark blue trim
• Nurse: white uniform with light blue trim
• Healthcare assistant: white uniform with burgundy trim
• Radiology Technician, Laboratory Technician: white uniform with green trim
• Physiotherapist: white uniform with orange trim

Before discharge, there is always an interview with the medical and nursing staff to clarify the post-admission course and/or the check-ups to be carried out.

At the time of discharge the patient receives a “discharge letter” from the doctor, addressed to the general practitioner / freely chosen paediatrician, with the diagnosis, the type of surgery performed (if any), the medical treatment performed and that recommended after admission, indications on the convalescence period and the date of the next medical check-up, if any. The necessary referrals for short-term monitoring services are issued.

Discharge prescription (Law 405/01 and subsequent regional provisions): continuity of care in the discharge phase is guaranteed for patients resident or domiciled in the Region of Tuscany with the delivery of the first cycle of therapy. For patients who do not reside in the Region of Tuscany, continuity of care is guaranteed with the issue of a prescription on the regional health service prescription form; for paediatric patients being treated with customised therapies prepared with a magistral formula because they are not available on the market, a special procedure is envisaged, which involves contacting the Pharmaceutical Service of the institution to which they belong and delivering what has been agreed upon between the facilities.
For paediatric patients being treated with customised therapies prepared with magistral formulas because they are not commercially available, a special route is provided for the delivery of what is needed through contact with the pharmaceutical service of the institution to which they belong.

Rehabilitation: where necessary, after admission for cardiological problems, the ward doctor activates in continuity of care the transfer of the patient to accredited external facilities for cardiological rehabilitation.

Protected discharge: in order to avoid a prolongation of the hospital stay, the patient is sometimes discharged from the ward with a fixed appointment for the outpatient service needed to complete the diagnostic and therapeutic process of the admission. To this end, please remember to bring the prescription note provided at discharge bearing the words “protected discharge-post-hospitalisation service”, which entitles you to not pay the ticket.

Certification for work or insurance reasons: at the request of the interested party, the certificate of hospitalisation is issued, relating to the period of hospitalisation, in the form provided for by current legislation. Certifications relating to the presence of family members/companions in the hospital are not issued. The certificate of prognosis is issued by the discharging physician.