Vol. 75 - No. ?? MiNerVa ChirurgiCa 1 8472-MC_N SPECIAL ARTICLE Patient fow for the management of ostomy patients Danila MaCuLOTTi 1 , Viviana MeLiS 2 , Gabriele ROVERON 3 , Pier R. SPENA 4 , giulia ViLLa 5 * on behalf of the Patient Flow Stoma Group ‡ 1 Fondazione Poliambulanza Istituto Europeo Multispecialistico, Brescia, Italy; 2 ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy; 3 Associazione Tecnico-Scientifca di Stomaterapia e Riabilitazione del Pavimento Pelvico (AIOSS), Padua, Italy; 4 Federazione Associazioni Incontinenti e Stomizzati (FAIS), Milan, Italy; 5 irCCS San Raffaele Institute, Milan, Italy ‡ Members are listed at the end of the paper. *Corresponding author: Giulia Villa, IRCCS San Raffaele Institute, via Olgettina 60, 20132 Milan, Italy. E-mail: villa.giulia@hsr.it ABSTRACT Subjects undergoing ostomy are increasing and share a reduced quality of life. The patient fow (PF) is the pathway of a patient from hospital admission to discharge and should provide care appropriateness to the patient himself. In the recent literature no paper exists regarding the PF of the patient undergoing (intestinal or urinary) ostomy, which is the objective of the present article. This paper stems from the work done during the Educational Camp entitled “The Patient Flow in Stoma Care,” which took place on three separate days (27 th May, 18 th September, and 21 st November 2019) at B. Braun Milano S.p.A. and regarded 33 stomatherapy nurses from all over Italy supervised by the authors. The participants, divid- ed into heterogeneous groups, developed the PF by means of three specifc work methodologies: mental maps, timeline and appreciative inquiry. The elaborated PF was inspired to the International Charter of the Ostomates’ Rights. The effca- cious and empathic communication and the role of the patient and/or the caregiver as the main characters are transversal to every step and must be always pursued. The PF is developed in eight macro-areas: diagnosis; pre-admission; admission and preoperative phase; surgical operation; awakening; postoperative phase; discharge; follow-up. In agreement with the recent literature, this systematic approach will give benefts to the patients in terms of outcome and perception of taking charge before, during and after the ostomy. At the same time the performances, the therapeutic appropriateness, the opti- mization of technology and healthcare resources and the staff satisfaction will equally be guaranteed. (Cite this article as: Maculotti D, Melis V, Roveron G, Spena PR, Villa G; Patient Flow Stoma Group. Patient fow for the management of ostomy patients. Minerva Chir 2020;75:000–000. DOI: 10.23736/S0026-4733.20.08472-2) Key words: Ostomy; Surgical stomas; Patient care management. Minerva Chirurgica 2020 mese;75(0):000–000 DOI: 10.23736/S0026-4733.20.08472-2 © 2020 EDIZIONI MINERVA MEDICA Online version at http://www.minervamedica.it i n Italy, about 70,000 people have had an intes- tinal and/or urinary ostomy. 1, 2 In Europe about 700,000 people live with ostomies 3 and in the USA about 1 million. 4 The most common diseas- es requiring an ostomy are cancer, infammatory bowel disease, intestinal volvulus, trauma, bowel obstruction or familial adenomatous polyposis. 5 In 2018, the estimate was of over 1.8 million new cases of colorectal cancer and 549,000 new cases of bladder cancer. 6 People facing this type of operation expe- rience a major change in their daily life with physical (intestinal, urinary and sexual func- tion, stomal complications), psychological (body image, depression), social (isolation, loneliness, anxiety, decreased relationships) re- percussions and a consequent decline in quality of life. 2, 7-10 Patient fow (PF) is the patient’s path from hospital admission to discharge and should en- sure the appropriateness of his/her care. It repre- sents the ability of healthcare systems to register and accompany the patient through the various stages of the treatment process until discharge. 11 PROOF MINERVA MEDICA