Charter of Services English

le Terrazze Casa di Cura Privata per la Riabilitazione e Poliambulatori Charter of Services 2011 Dear Customer, We are pleased to present our Charter of Services, with which we wish to describe the services we offer, how you can access them and how they are fulfilled. Any suggestions on how to improve the services we offer is greatly appreciated. History Mission and facilities

The Le Terrazze care home is a nursing home The Le Terrazze care home is committed to 05 History and facilities and specialized rehabilitation centre. It is ensuring scientifically and technically well situated in , in the province of advanced services, rehabilitation programs and 05 Mission about 13 Km from the capital city. Located on the performance to maintain high quality standards road that connects Varese to , it is 65 Km in specialized rehabilitation. To this aim from , 38 Km from Malpensa airport and 7 considerable investments are made in structural, 06 Our activities Km from the Swiss border. Built between 1990 technological, organizational and management and 1996, the facility has 152 beds and is built on innovations, focusing on patient centrality and three floors which are accessible via routes that safety, on the continuous improvement of the 07 Neuromotor Rehabilitation have no architectural barriers; separate groups quality of the assistance we offer, and developing of elevators lead from the basement to the our human resources. large sunny terraces covering the buildings and 10 Cardiac Rehabilitation offering an incomparable view. The large garden, The primary commitment of the care home is accordingly-equipped, offers patients, relatives to provide: 12 Respiratory Rehabilitation and staff further space to enjoy. – care and assistance to patients in full respect of human dignity and the principles of quality, equity, humanization, effectiveness and efficiency; 14 Staff – clear and exhaustive information to patients on their diagnostic, therapeutic and rehabilitative 15 Admittance, stay and discharge journey, to enable them to consent and be involved in their treatments; – complete information on our services and 18 Patient rights and duties performance; – opportunities to receive feedback from patients and their families, also through satisfaction 19 Out-patient services questionnaires; – prompt evaluation and management of any complaints, which are considered a useful tool in 22 A facility in constant evolution continuously improving the service we offer. 23 Contacts Moreover the Care Home places primary importance on staff training: all staff takes part in on–going refresher programs accredited by the Ministry of Health. In 2009 the Le Terrazze care home was accredited by the Regional Government of as a regional provider for training courses in Continuing Medical Education (CME/ CPD).

5 Our activities: Rehabilitation Neuromotor Rehabilitation

Rehabilitation involves using all means available The multidisciplinary team is formed by doctors, Who the Neuromotor Rehabilitation to distinguish pathologies as ganglia-type to reduce the impact of disability to allow specialists in Physiatrics, Internal Medicine, program is designed for (such as Parkinson’s disease) and SNC-type disabled people to achieve social integration. Cardiology, Pneumology and Neurology (such as multiple sclerosis). These pathologies Rehabilitation at the Le Terrazze care home is who take part in the specific Rehabilitation The Neuromotor Rehabilitation programs are begin insidiously and progress chronically, not limited to simple functional re-education Projects, together with other professionals designed for: therefore often requiring repeated hospitalized (which is only one of our technical tools), but it (Otolaryngologists, Orthopaedists, General rehabilitation. intervenes on the individual in his/her entirety. Surgeons, Vascular Surgeons, Cardio Surgeons, – Patients suffering from post cerebro accident For this reason, to provide an effective individual Radiologists, Nutritionists…) and medical (of ischemic and hemorrhagic causes): patients Who the Motor Rehabilitation rehabilitation project, specific for each patient, operators who form the rehabilitation team, such are preferably in the post acute stage and they program is designed for it will focus on multiple well-planned objectives as physiotherapists, occupational therapists, are admitted directly from the wards of nearby so that the level of autonomy which can be speech therapists, psychologists, social workers, hospitals. Patients in more or less stabilized The Motor Rehabilitation programs are reached in different areas translates into a better orthopaedic technicians, who intervene in their conditions are also admitted. For the latter, due designed for patients with the following quality of life. Consequentially, the Project, not fields of competence. to clinical aggravation or the insurgence of other pathologies: only deals with strictly clinical aspects aimed at In following with the project, the care home pathologies, during the re-evaluation carried stabilizing the basic condition and reducing the establishes individual rehabilitative programs out at the out-patient clinic the physiatrist – Patients who have undergone orthopaedic risk of subsequent pathological events, it also that foresee a period of hospitalization which may require them to be hospitalized for a new surgery: we treat patients through the focuses on psychological and social aspects. varies in duration according to the basic rehabilitation program. post-acute stage when they are transferred The fundamental conditions required to reach pathology and to the patient’s recovery potential, – Patients suffering from the after effects of directly from hospital wards following prosthetic these objectives are: the presence of an within a more global endeavour which may some serious brain damage (coma due to extended surgery (the most frequent are hip and knee interdisciplinary team that assesses existing cases require the treatment to be continued at haemorrhaging, post-traumatic or infectious replacements), osteosynthetic surgery or comorbidities and intervenes in several the outpatient clinic and /or through a home cerebral hypoxia,): patients are admitted directly politraumatized patients requiring intensive aspects of the disability, cooperating and care plan. from the nearby hospital wards for acute cases. rehabilitation. continuously comparing results obtained from Recovery potential allowing, the patient’s – Amputated patients (due to traumatic or the various practitioners; the use of validated stay may extend to a few months. The level of ischemic causes): we treat patients in the and standardized protocols that have been recovery defines the future of these patients post-acute stage when they are transferred developed with the support of the National in view of social reintegration is having them directly from hospital wards, and embark on Guidelines for Rehabilitation and in accordance transferred to suitably equipped long-stay their prosthetic rehabilitation journey. with the recommendations of both national and facilities. – Patients suffering from immobilization international Scientific Societies of the single – Patients suffering from the after effects of syndrome due to surgery or severe clinical sectors; the continuity of the therapeutic medullary injuries: these patients have a history pathologies: we treat patients in the post-acute program; the active involvement of the patients of more or less recent traumas and/or infective/ stage, who are transferred directly from hospital and their families regarding the reduced vascular pathologies. They have extremely wards and have disabilities requiring complex functional reserves, the psychological attitude of variable clinical pictures, and are more or less rehabilitation. both patients and families. stabilized. – Patients suffering from severe osteoarticular – Patients suffering from neuromuscular pathologies (such as polyarthrosis, rheumatoid pathologies: these are mainly patients arthritis): patients who come to our Institute with peripheral neuropathies, myopathies, due to an aggravation of their clinical picture motoneuron diseases, etc. causing a loss of their functional autonomy These patients sometimes require repeated and, according to the physiatrist, requires stays due to the progression of their pathologies. hospitalized rehabilitation. – Patients suffering from neurodegenerative pathologies: according to the positioning of the injuries to the nervous system it is possible

6 7 The programs Specific techniques on locomotor function in patients suffering patient can take part in everyday occupations from Parkinson’s disease. In many patients a whether the lost function causes temporary or The Neuromotor Rehabilitation program is Neurocognitive Rehabilitation specialist evaluation provides clear instructions permanent inability. organised as follows: The rehabilitation treatments offered at our for the use of this device in conjunction with In many cases Occupational Therapy represents facility are in line with the principles of Cognitive exercises traditionally carried out in the gym. a bridge between hospitalization and 1. An evaluation of the patient’s clinical situation Therapeutic Exercise and are performed by Simple and safe, the exercises include having reintegration into society, since it minimizes the and existing problems requiring a diagnostic physiotherapists with specific professional the patient walk adopting a pace marked by impact of disability in everyday activities and investigation and rehabilitation treatment. training.This method is advisable for a series of stimuli which can be both acoustic or visual. The provides the patient with the tools for greater 2. An evaluation of dysphasia and radiologic pathologies affecting the Central and Peripheral frequency of such stimuli is regulated by the autonomy. investigation of deglutition in patients suffering Nervous System, in the fields of Orthopaedics physiotherapist by setting the device according The starting point is, therefore, the overall from certain neurologic pathologies (Parkinson’s and Traumatology. According to the principles to specific physiological data based on the evaluation of the person as an individual and disease, Multiple Sclerosis, Stroke…). of Neurocognitive Rehabilitation, the quality of patient’s age, gender, pathology or functional his/her residual potential, to enhance his/ 3. Planning and pre-arranging an individual recovery significantly depends on the ability of picture. The aim of the Treadmill exercises is her motivation and ability to adjust, to try and rehabilitation project aimed at identifying the patient to activate cognitive processes such to improve certain parameters of deambulation meet his/her needs, desires, requirements and the main rehabilitation steps required for the as Attention, Memory, Perception, etc., which the such as number of steps per minute, walking expectations. individual patient. re–learning processes of the damaged function speed, length of stride or total distance covered The tool provided by Occupational Therapy is 4. Having the personal rehabilitation program depend on. thanks to the reduction of “freezing” episodes. therefore focused on “doing”, and is intended be drawn up by the rehabilitation therapists in To this aim, accordingly designed devices as a journey towards awareness of limitations order to reach the set goals. are used by the physiotherapist to formulate Prosthetics following amputation imposed by the pathology and at the same time 5. Optimizing the patient’s general clinical appropriate motor and perception tasks, which The Institute offers patients who have undergone determining suitable strategies to overcome conditions and their medical treatment are performed in different ways and which the amputation of a lower limb the possibility to these limitations, in a perspective of reaching necessary to limit symptoms and promoting become more and more complex according to the be taken care of by a team of qualified staff, from social reintegration. the patient’s recovery of a satisfactory level of evolution of the patient’s clinical and functional the post-operative stage to the use of a definitive functional ability. picture. prosthetic limb. 6. A nutritional evaluation and individual Therapeutic exercises are carried out in an The rehabilitation program is divided into education for a correct diet, as well as nutritional environment which is particularly suited to favour subsequent periods, each finalized to reach therapy (nutritional education is part of the the patient’s concentration and are planned different functional objectives through program for patients suffering from Parkinson’s according to individual treatment programs. specifically planned actions. disease). In the first stage intervention is necessary to 7. An evaluation of the patient’s psychological Neuropsychology and Speech Therapy service avoid muscular atrophy, trophic alterations wellness and quality of life, together with the The Neuropsychology and Speech Therapy and hypoventilation; the stump is modelled required psychological measures to manage the service deals with the evaluation and treatment by means of compressive bandages. The aim patient’s psychic problems. of cognitive illnesses connected to diffuse, is to allow the patient to reach the highest 8. An evaluation of the patient’s residual acquired and focal brain injuries consequent to level of autonomy possible. The possibility of disability and the need to provide and prescribe cerebral ictus, cerebral haemorrhage, cerebral prosthetics is evaluated at this early stage. One orthoses, aids and prostheses to improve neoplasia, post–anoxic and traumatic coma. or more subsequent stays can help the patient recovery of the patient’s functional autonomy. Brain injury causes a modification of cognitive to correctly manage his/her prosthesis, with the 9. An evaluation of the patient’s social needs to functions, competences and performance in aim of recovering deambulation. promote and support his/her reintegration at correlation with difficulties in amnestic function, The Clinic guarantees amputees a long term home and at work and /or his integration in host attention span, planning abilities, critical follow-up program, also through the out-patient facilities. abilities, speech. clinic. The rehabilitation program is of primary The Neurologic Rehabilitation area is equipped importance for the patient’s reintegration in the Occupational Therapy service with logistic–structural distance monitoring family and society. The Service is composed of The Occupational Therapy service aims at equipment to control the main vital parameters of Doctors, Psychologists and Speech Therapists promoting health and wellness of those patients in critical conditions. specializing in the field of Rehabilitation individuals who have physical or psychic Regarding patients suffering from Parkinson’s Medicine. disabilities. The underlying principle of this disease in particular, but also in the case of other form of rehabilitation to recover autonomy neurological diseases, the Institute is equipped Treadmill rehabilitation for patients with through a wide range of everyday life and with a Gait Trainer to treat freezing and walking Parkinson’s disease creative activities, making the person capable disorders, as well as a Prokin Stabilometric Recent studies have demonstrated the of participating in life activities. One of its Platform to improve balance control. effectiveness of a specific treadmill training primary aims is to recover autonomy so that the

8 9 Cardiac Rehabilitation

Who Cardiac Rehabilitation for an effective change of life style and 6. Evaluation of possible logistic / environmental / patients affected by chronic or post-acute is designed for psychological support. social-assistential problems related to heart condition can maintain or regain their – Patients affected by peripheral arteriopathy reintegration at home or to continuity of role in society”. The aim of Cardiac Rehabilitation, according with walking disability (claudicatio intermittens), territorial assistance requiring adequate From this definition makes us understand that to the definition provided by the World Health pain at rest or trophic injuries, at a chronic stage preparation. Cardiovascular Rehabilitation, by combining Organization, is to favour clinical stability in or subject to recent peripheral revascularization 7. The elaboration of an adequate physical physical exercise with the modification of risk patients affected by cardiovascular pathology, surgery (through traditional surgery or exercise program and customized behavioural factors (secondary prevention), aims to reduce to reduce disabilities due to the disease and to angioplasty). An Angiologic Rehabilitation rules for the long term. the symptoms connected to the disease, improve support maintenance and resumption of an active program is implemented for these patients the ability for physical activity, reduce disability, role in society, with the aim of reducing the risk with the aim of increasing autonomy, managing Among the logistic-structural equipment at its favour reintegration in the work place and lower of subsequent cardiovascular events, to improve antalgic therapy and possible ulcerative injuries, disposal, the Cardiology area has the possibility the risk of cardiovascular events. quality of life and to positively affect survival. together with post-surgery assistance and to monitor patients by means of telemetry. After physiotherapic evaluation (Six-Minute the implementation of secondary preventative Moreover, it has dedicated ultrasonographic Walk Test, EuroQol, Cardiopulmonary Test and The Cardiac Rehabilitation programs are actions common in heart patients. equipment and the medical staff from the functional evaluations), a customized program designed for: cardiology area autonomously see to the of physical re-conditioning with treadmill, The programs cardiovascular diagnostic needs of the patients stationary bike, group and individual exercises – Patients with recent cardiac, coronary, (echocardiography, vascular ecocolor-Doppler is implemented in conjunction with respiratory valvular surgery, or to the great vessels, with According to the clinical typology and the erogometric test, Holter ECG, MAPA). The exercises for patients who require it. particular priority to those patients at a high risk previously-identified needs, a Cardiology recently adopted cardiopulmonary test allows The rehabilitation process is completed with of new cardiovascular events, clinical instability, Rehabilitation program could involve the a more accurate evaluation of the patient’s educational activities, both individual and associated morbidities or other significant following actions: functional ability and identifying the appropriate collective, receiving informative material complications. physical training program. Furthermore, devices regarding pathology, life style, pharmacological – Patients with advanced cardiac 1. Monitoring clinical conditions and managing for the detection of the main biochemical therapy and the continuity of the physical de-compensation, particularly those problems possibly persisting after the acute markers for point of care evaluations (TnI, exercise program at home. requiring therapies such as dose titration of phase, with particular attention to the outcome of NT-proBNP) and a system for distance cardioprotective drugs and/ or continuous recent surgery or stay in an Intensive Care Unit. transmission of electrocardiographic tracing, intravenous infusions of inotropic agents and 2. Adequate physical exercise to reach and useful in defining the most adequate assistance vasodilators, nutritional support and intensive maintain a satisfying level of functional ability, for patients in emergency/ urgency situations, rehabilitation treatment (due to marked with a combined focused educational program. are available to all Hospital Units. physical de-conditioning, for example). 3. Optimizing the medical therapy aimed at Moreover, the Institute joined the Closed-Circuit – Patients with recent myocardial infarction reducing the symptoms, maintaining an adequate Television Project for patients with cardiac and /or coronary angioplasty, particularly those clinical stability and reducing the progress of the insufficiency, for the implementation with residual left ventricular dysfunction and existing cardiovascular disease. of the new health care networks of the rhythm disorders, or with complications and 4. Nutritional evaluation and individual or Regional Government of Lombardy. clinical instability correlated to the acute event, group educational action for a correct diet and or, finally, with high risk of impairing the quality nutritional therapy, aimed at keeping risk factors Specific techniques of everyday and professional life. such as diabetes and dyslipidaemia under – Patients suffering from chronic ischemic control. The World Health Organization (WHO) and heart disease, stable cardiac insufficiency 5. Evaluation of the psychological wellness and the European Society of Cardiology have or at high cardiovascular risk, for which it is quality of life, together with individual or group defined rehabilitation in patients affected by necessary to maintain an adequate clinical psychological actions aimed particularly at cardiovascular disease as the “sum of activities stability, good functional ability and an active managing anxiety/ stress/ depression/ smoke required to guarantee the best physical, lifestyle, together with proper education abolition problems. psychological and social conditions so that

10 11 Respiratory Rehabilitation

Who Respiratory Rehabilitation is People affected by chronic obstructive Specific programs Admission to rehabilitation programs implies designed for pulmonary disease (COPD) suffer from a vicious specific entrance and outcome measures which circle. It is initially perceived only slightly by the Granted that physical re-conditioning, are carried out at the beginning and at the end Respiratory Rehabilitation, integrated with patient, but breathlessness causes a progressive compatibly with clinical conditions, is the priority of the rehabilitation process: pharmacological support, represents the most limitation of physical activity and consequent in every Respiratory Rehabilitation program, – Questionnaires: MRC dyspnoea scale; CAT effective treatment for people suffering from muscular hypotrophy (physical de-conditioning), rehabilitation activity comprises individual (COPD Assessment Test); BDI/TDI (Baseline/ chronic respiratory diseases with reduced aggravation of dyspnoea, limitation of everyday actions carried out according to the most recent Transitional Dyspnoea Index); Epworth respiratory capacity, at all stages of the disease. activities, social isolation, depression. and validated methods within the following sleepiness scale. The aim of the Respiratory Rehabilitation general programs: – Functional evaluations: spirometry, walk test, It is a fundamental strategy in the treatment of program is to break this vicious circle as energy consumption evaluation. the following chronic respiratory diseases: soon as possible. – Muscular re-conditioning through re-training – Predictive evaluations of survival: BODE index. protocols of both global musculature and − Chronic obstructive pulmonary disease respiratory muscles. Continuity of the rehabilitation program at − Bronchial asthma – Disobstruction of respiratory tracts from home is stimulated through the distribution of − Pulmonary emphysema secretions. informative material and of a work chart to be − Pulmonary fibrosis – Pulmonary re-expansion for obstructed or filled in at each training session and verified − Cystic fibrosis hypo ventilating pulmonary areas. during the planned controls. Particular attention − Neuromuscular diseases – Management of tracheotomised patients and is dedicated to patients with severe respiratory − Sleep respiratory conditions tracheotomy cannula weaning protocols. insufficiency in non-invasive or invasive − Thoracic cage diseases – Management of patients with severe mechanical ventilation, where reintegration − Severe respiratory insufficiency in non- respiratory insufficiency in non-invasive and in the home after discharge presents complex invasive and invasive mechanical ventilation invasive mechanical ventilation and of ventilator problems concerning logistic aspects, training − The treatment of thoracic and abdominal weaning protocols. of the care giver and counselling for relatives. surgery in pre and post-operative stages.

12 13 Staff Admittance, stay and discharge

Nursing assistance Who to refer to Admittance to the clinic Documents required for admittance:

Nursing assistance is guaranteed 24 hours Medical staff Access to treatment is possible through the 1. Admission authorization (only for admissions a day. The nurse, in strict collaboration and The medical staff is available to provide the National Health System or through a solvency through the NHS) interaction with the other medical operators patient with indications on their diagnosis, regime. 2. Identity card of the rehabilitation team and with the therapy, rehabilitation treatment and, upon the 3. Regional service card patient and his/her relatives, participates in patient’s authorization, provide his/her relatives Booking and access 4. Tax code identifying the patient’s health needs, with the all the information requested. aim of determining his/her potential residual Doctors are available to provide information Access through the NHS Non-Italian citizens will also have to present: collaboration. during their office hours indicated in notices Patients can access the Care Home by being Nursing staff, in cooperation with supporting in every wing of the building. out on a Waiting List upon the request of 5. Valid identity card or passport specialized staff (social-medical operators), hospital doctors operating in qualified structures 6. E112 form for EU citizens provides customized assistance aimed at the Nursing staff for seriously affected patients or on proposal of 7. FTP form for non-EU citizens recovery of the highest level of autonomy The nursing staff deals with technical- their GPs, with an evaluation of their real need possible by the patient in everyday life activities. assistential aspects and is available to provide for hospitalization by specialists in the field It is opportune to also bring reports of previous Based on an accurate analysis of gathered the patient with further information and employed at the Care Home. diagnostic controls and to inform us of any information (medical history), the nurse explanations he/she might need during Admittance strictly adheres to the priority medicines being taken. formulates a nursing diagnosis and the related his/her stay. established by the waiting list and can be objectives for each life activity and for each The nursing team is composed of a Chief of delayed only due to reasons of force majeure. Administrative admittance category of needs; he/she plans, manages, Nursing Services, by a Charge Nurse and by Management of the waiting list is assigned to On the day of admittance the patient must arrive evaluates the assistance to be provided and the nurses. the Chief of Functional Units Grouping under at the Admissions Office to complete all of the guarantees the correct application of the the supervision of the Medical Director. administrative procedures. diagnostic–therapeutic prescriptions. Rehabilitation Staff (Physiotherapist-Speech Therapist-Occupational Therapist) Access through a solvency regime Items to bring for your stay How to recognise the staff The team for the Rehabilitation Medical Patients can access the Care Home through We suggest bringing only strictly necessary Professions carries out the Individual a solvency regime, with an evaluation of the personal belongings: products for personal All the people working in the Care Home Le Rehabilitation Program, documenting the opportunity to be admitted performed by the hygiene, tooth brush, toothpaste, underwear, Terrazze have an identification badge with their adopted techniques, the operative conditions Chief of the Operational Units. Private care pyjamas, dressing gown, tracksuit, slippers, name, role and photograph. Every category of and the evolution of functional progresses in includes a single room, with the comforts of towels. staff members can be distingushed by their the Rehabilitation Form. a high-quality hotel. We do not recommend keeping relevant sums uniform. To submit a request form or for any information of money, valuables, important documents and Doctor (white coat) / Chief of Nursing services Social services regarding admittance please contact personnel to take care of all personal belonings. (white jacket with green hem, green trousers) / The social service available in the Care Home at the Admissions Office. The care home takes no responsibility for any Charge Nurse (white jacket with blue hem, blue meets the patient’s need for information and In both cases bookings can be made from eventual theft and/or loss. trousers) / Nurse (white jacket and trousers) / social standing. To benefit from this service Monday to Friday, from 8.30 am to 4.30 pm Social-medical operator (sky-blue jacket and the patient and/or his relatives must submit directly at the Admissions desk on the ground trousers) / Chief of Rehabilitation Medical a request by filling in the form provided at floor or by phoning +39 0332 992501. Professions (bordeaux button-neck sweater and the time of admission. white trousers) / Physiotherapist, Occupational Therapist, Speech Therapist (green button- neck sweater and white trousers).

14 15 Welcoming and assistance Your stay machines for drinks, mineral water, ice creams Discharge and clinical documentation and snacks are available for the guests inside Admission to the ward The rooms the Care Home. Upon discharge the doctors provide the patient Admission to the ward is carried out by a nurse The rooms have one or two beds. Only a few with the necessary documentation to submit who accompanies the patient to his/her room. have three or four beds. Each room is spacious Integrative assistance to their GP and social services. If necessary, The nurse provides the patient and his/her and has a terrace, en suite bathrooms, and is The Care Home guarantees direct assistance to they schedule opportune meetings with the relatives with all the necessary information for equipped with services for the disabled, air its patients through qualified staff. family. Moreover, in case of necessity, according admission. conditioning, medical gases, alarms, day and Inside the Institute, however, there is also to what has been agreed upon with the local The patient will be given a welcome letter where night lights. voluntary staff, authorized to provide particular health authority - A.S.L., they activate A.D.I. all the ward information essential for admission, Each room has colour TV and cable radio set and types of assistance to patients. (Integrated Home Assistance) for the continuity including the Doctor and Staff of reference, are telephone. of therapy at home. provided. Upon request of the patient to Reception, the Religious assistance Requests for a copy of one’s medical records, line is immediately enabled for urban and long For catholic patients the Holy Mass is celebrated which according to the law can be given Medical visits distance calls. once a week. exclusively to the patient or to a person who The medical visit is a fundamental diagnostic– Phone calls will be debited at the time of Every patient can have personal religious has power of attorney, must be addressed to therapeutic event and it is therefore necessary discharge. assistance by submitting a request. the Medical Director by filling in the according for patients to remain in their rooms during the Pre-paid phone cards cannot be used from the For non catholic patients religious assistance form available at Reception. The copy of the medical inspection tour. rooms’ internal phones. can be requested by informing the charge nurse, medical records can be sent by registered mail Outside of these hours and the hours when he/ At the ground floor there is a public telephone who will see to it, within the limits of availability to the patient’s address, upon payment of the she is busy with rehabilitation activities or in that can be used with a phone-card for all of ministers of the requested religion. mailing costs. other types of assistance, the patient can leave clients of the facility. the ward, although he/she must stay inside the Smoking hospital area, after having informed medical Silence and composure Smoking is absolutely prohibited within the operators about their wherabouts. To prevent disturbing other patients, we kindly Institute. ask you to avoid making noise as much as Nursing assistance possible, to speak in low voices during visits The service guarantees all aspects concerning and to moderate the volume of radios and TVs. nursing assistance and hospitality of patients. To favour night sleep, silence is compulsory It is important to point out that any handling between 10.00 pm and 7.00 am. or procedure addressed to the patient must be carried out by authorized staff. Visits For any problem or request concerning nursing Every patient can receive visits from 11.00 am to assistance patients may speak to the charge 8.00 pm. nurse. However visits should not impair medical activities nor cause annoyance.

Meals Meals are served at the following hours:

– Breakfast: 7.30 am – Lunch: 12.30 am – Dinner: 7.00 pm

At mid-afternoon tea is served. All patients, except for those who have been prescribed a specific diet by the doctor and by the nutritional service, can choose from different menus proposed by the catering service. During distribution of meals relatives are kindly requested not to move along the corridors. In the multifunctional room located on the ground floor and on the 3rd floor some vending

16 17 Patient rights and duties Out-patient services

Equality ad impartiality Effectiveness and efficiency Booking Admission and payment In the Care Home all the patients have the right Admission to the Care Home Le Terrazze is to receive the most appropriate care, without justified only if the patient’s conditions require Out-patient activity is carried out by On the day of their appointment the patient any discrimination or privilege according to their the continuous availability of diagnostic – professionals with vast experience, with the must arrive at the admission office to complete gender, age, social condition, origin or religion. therapeutic – rehabilitation services and if support of the most advanced technology. the administrative procedures and pay for the Staff behaviour towards patients is based on admission is considered appropriate, necessary At the Admissions Office it is possible to consult service. objectivity, impartiality and fairness. and efficient. the complete list of the services available in our All citizens must contribute to medical expenses It is prohibited for operators to establish Admission procedures include the evaluation of Institute, the relevant waiting time, the time (with ‘tickets’), except for those who are economic relations with the patients. the possibility to reach significant improvements for the handover of reports, and the price list, exempted, as per applicable legislation. within a reasonable time limit, by providing both private and through the NHS. There are Continuity an adequate therapy with an interdisciplinary also exposed the names of the doctors and their For services supplied through the NHS, the The Care Home ensures continuity and regularity approach (motor, occupational, of speech and relative visting days and hours. The choice of the following documentation must be provided by the of care, also by establishing the necessary cognitive). specialist is only possible for private services patient: relation with the patient’s GP or Institute (through solvency regime). of origin. Respect for the person’s dignity 1. valid authorization by the requesting doctor The patient has the right to have his/her dignity Booking (valid for one year from the date of compilation) The Right to choose respected and the behaviour of all staff members Before booking it is necessary to have valid indicating the patient’s references and tax code; The patient, in compliance with applicable at Le Terrazze is distinguished by maximum medical authorization (within one year from the any recognised exemption; the kind of service legislation, has the right to freely choose his/her consideration for all patients. date of compilation). being applied for, the diagnostic request, the service providers. prescribing doctor’s signature and stamp. Respect for privacy Bookings can be made: 2. the regional services card. Participation Personal data are treated as per Legislative 3. the exemption card. The patient has the right to receive exhaustive Decree 196/2003. Correctness and discretion directly at the front office information on his/her illness, the prognosis when treating the patient are a moral and from Monday to Friday from 8.00 am to 6.00 pm, and on the therapy and he/she must be put in professional duty for all staff members. on Saturday from 8.00 am to 1.00 pm. a condition to give his/her “informed consent” All necessary measures to guarantee before undergoing treatment. confidentiality while patient’s are at the clinic by telephone The patient must have the opportunity to access are adopted. Consent regarding the treatment at +39 0332 992500 from Monday to Friday from all information concerning the services offered of personal data is acquired from the patient by 8.00 am to 8.00 pm and Saturday from 8.00 am by the Institute and the admission modalities and filling out the relative form, describing in details to 1.00 pm. to express, also through simple questionnaires, the regulations and the aims of this consent his/her satisfaction or suggestions on how to upon admittance. The leaflet is available at the via internet improve the service. Admissions Office. by accessing the link on the website www.clinicaleterrazze.com

No booking is required for medical laboratory services. Direct access is possible from Monday to Friday from 7.30 am to 10.00 am and Saturday from 7.30 am to 9.30 am.

18 19 Out-patient services offered by Le Terrazze care home

Medical laboratory Otolaryngology Rehabilitation physical medicine Vasular diagnostics – Clinical chemistry – Specialist visit – Specialist visit – Supra–aortic trunks Echo(color)Doppler – Haematology – Fibre optic laryngoscopy – Ionophoresis* – Arterial and venous Echo(color)dopplergraphy – Coagulation – Tonal audiometric test – Analgesic Electrotherapy (tens–diadynamic)* of upper/lower limbs – Serology and viral serology – Impedentiometric Test – Distrectual Massotherapy* – Microbiology – Oto-vestibular check-up – Ultrasound therapy Cardiology – Immunology – Acoustic evoked potentials – Radar* – Specialist visit – Tumour markers – Laser – Electrocardiogram – Hormone dosage Neurology – Electrotherapy for normo or denervated – Cardiac Holter – Medicine haematic dosage – Specialist visit muscles – Cardiac Eco(color)dopplergraphy – Allergens – Ambulatory for patients affected by – Electro stimulation (KOTZ) – Continuous monitoring of arterial pressure – Urine Parkinson’s disease – Mechanical Pressotherapy – Under stress cycle ergometry test – Faeces – Electromyography – Kinesitherapy – Ambulatory dynamic polygraph – Group treatment of pathologies of the Ophthalmology Visual diagnostics spine for adults – Specialist visit Radiology Orthopaedics – Treatments with specific methodologies – Corneal Topography (corneal map) – Osteoarticular – Specialist visit (upon request)* – Corneal Pachymetry – Direct abdomen – Injection of therapeutic substances into the – Evaluation and rehabilitation of – Corneal Bio microscopy – Thorax articulation or ligament pelvic pavement – Schirmer Test – Computerized Tomography (CT) – Focal or radial shock wave therapy for – Retinal Fluor angiography graphics contrast musculoskeletal pathologies Moc–Dexa – Argon laser – CT with contrast means (mdc) – Bone densitometry – Fundus oculi – Radiologic study of deglutition Acupuncture* (Total-body and spinal-femoral) – Iridectomy – Acupuncture – Injection of theraputic substances behind Echography Oxygen-ozone therapy* the eyebulb – Abdominal – Intra articular, paraspinal infiltration – Coherent radiation optic tomography – Glandular (salivary, testicle, thyroid, of an oxygen-ozone mixture no breast) Urology – muscle tendon (not performed on Pneumology – Specialist visit neonatal hips) – Specialist visit – Transrectal echography – Simple / global spirometry – Uroflowmetry Magnetic resonance – Systematic arterial Emogasanalysis – Articular using dedicated equipment with low – Bloodless arterial saturation monitoring magnet field, both with and without mdc – Walking test intra articular injection – Pharmacological bronchodilation test – Total body with high field equipment, both with and without mdc intravenous injection

*Services available only through solvency regime

20 21 A facility in constant evolution Contacts

How to improve Expanding The continuous improvement of the Quality of the services we offer represents one of the The wooden looking planking of the cement primary elements of the Care Home’s mission. façade of the new wing at the Le Terrazze Care Casa di Cura Privata Le Terrazze S.r.l. To this aim a quality system aiming to maintain Home is taking the twenty-year history of our I-21035 Cunardo, Varese • Via Ugo Foscolo 6/b reference standards of excellence (Iso and Joint facilities into the future, in the beautiful setting Commission regulation, as per the Regional of the . Teletext Rete 55 p. 755 Government’s program regarding Medical By expanding the main facility and building [email protected] Facilities which began in 2004) has been the administrative headquarters lower down, www.clinicaleterrazze.com implemented through the collaboration and we are integrating and making the Care Home strong commitment of the entire staff at the more complete, providing an increasingly more Switchboard: Care Home, at different levels (medical staff, functional and efficient health care system. Tel. +39 0332 992111 auxiliary staff, administrative staff). The project by Archea Associati and the architect Fax +39 0332 990074 The constant re-examination of the system Cortellari includes a main unit that creates a new by the Chief of Quality and by Management and evocative promontory in the direction of the Booking Office: Tel. +39 0332 992500 and its evaluation by third certifying bodies valley, and the new administrative building that from Monday to Friday: from 8.00 am to 8.00 pm allow a continuous evolution of the system, represents, with his shaped profile, an example Saturday: from 8.00 am to 1.00 pm which makes it possible to better meet the of contemporary architecture able to dialogue needs of the Institute. Important resources with the typical covering style of the buildings Admissions Office: Tel. +39 0332 992501 are constantly invested in structural and in these mountains. The design takes into from Monday to Friday: from 8.30 am to 16.30 pm technological innovation to improve and expand consideration sustainability and energy savings the services offered to the citizens trough the through the use of cutting edge technologies offer of new specialities and the development as well as the use of materials that provide a of a solvency area dedicated as to the high performance façade in terms of thermal hospitalization regime (ordinary, day-hospital insulation. for specialist checkups) as to the outpatient The recent expanding of the complex is the services. The patient can also actively demonstration of the Care Home’s will to contribute to the improvement process by continue investing their resources in an submitting suggestions or pointing out possible improvement of infrastructural equipment by inefficiencies to the Public Relations Office and methods and strategies harmonizing with the by taking part in the surveys regarding patient natural setting; a green and uncontaminated satisfaction. landscape, framed by the mountains, the quiet and the silence: a place where to invigorate body Public relations office and soul. The Public Relations Office is available to collect patient suggestions and complaints; Recommendations and/or complaints can be made in writing by filling in the appropriate form available on each floor and at Reception, Codice Fiscale e Iscrizione al Registro delle or over the phone by calling the Pubic Relations Imprese di Varese n. 00950160713 Office at +39 0332 992508, from Monday to Rea n. 225942 • Capitale Sociale Euro 51.480,00 i.v. Friday, from 10.00 am to 4.00 pm. Partita Iva 01994660122

22 23 This Charter of Services was printed in March 2011 Graphic Design: Archea Associati Charter of Services English

Casa di Cura Privata Le Terrazze S.r.l. I-21035 Cunardo, Varese • Via Ugo Foscolo 6/b Tel. +39 0332 992111 r. a. • Fax +39 0332 990074 [email protected] www.clinicaleterrazze.com Booking Office: Tel. +39 0332 992500

The Le Terrazze care home le Terrazze is certified according to UNI EN ISO 9001-2008