Emergency department, sustainability, and ehealth: A proposal to merge these elements improving the sanitary system

This work is intended to propose series of interventions to have a sustainable first aid in the hospitals of the Italian area. The interventions proposed are devoted to rationalize and contain the annual number of access inside the first aid taking into account all the potential urban area connected that use the first aid with a special attention to the so-called fragility band composed by senior citizens and frequent users. The proposed system has the mission to improve the work performances ensuring a reduction of the inappropriate access inside the first aid through the introduction of Hi-Triage, intended as the introduction of technologies (hardware and software) to support the medical triage and give a fast response times improving the performances of the operators; H24 assistance departing from the hospital (that has a direct impact on access to the first aid); e-Health to improve the electronic flow of medical information. The social impact is linked on one side to a first-aid optimization (reduced waiting times, improved operator performances, more comfortable situation in the waiting room) and on the other to the improvement of an integrated education through the creation of educational and sustainable scientific paths properly customized. The environmental impact is also a key factor of this proposal, with a reduction of movements from and to the first aid that has as final result reductions of pollution emissions and energy consumptions. Last but not least, the economic impact of this proposal lies in the reduction of access cost of the patients in the first aid access and of the direct and indirect costs needed to support patients. The authors will use the “Policlinico of Tor Vergata” Medical Structure as case study to estimate (quantitative and qualitative) the values of the above-mentioned proposals. © 2018 by Taylor and Francis Group, LLC.