Phd in ADVANCES IN INFECTIOUS DISEASES, MICROBIOLOGY, LEGAL
MEDICINE AND PUBLIC HEALTH SCIENCES

Thesis title: Development and application of a data-driven model for the optimization of waiting lists and the evaluation of its impact on service quality: a pilot project in a teaching hospital

Introduction According to current Italian healthcare regulations, the term waiting list refers to the set of scheduled but not yet provided healthcare services, managed based on clinical priority—assessed by the prescribing physician—and related time priority. In this context, the increasing pressure on healthcare professionals to shorten waiting times raises the risk of burnout and work-related stress, which can negatively affect the quality of care provided. Objectives: The main goal of this project is to develop and validate a data-driven model aimed at optimizing waiting lists in a University Hospital by combining objective data with the subjective perceptions of both patients and healthcare professionals, in line with national and regional standards. Materials and Methods: The project lasted three years and was carried out at a large teaching hospital in central Italy. Two ad hoc questionnaires, validated by the researcher, were employed: healthcare personnel work well-being questionnaire, patient perception of service quality questionnaire. In addition to subjective data, a monitoring system of Key Performance Indicators (KPIs) was developed to measure organizational and systemic dimensions. Results: By September 23, 2025, the survey had been completed by 312 healthcare professionals and 198 patients. The analysis of mean scores across the dimensions assessed in the Work Well-Being Questionnaire revealed a moderate level of organizational well-being and perceived work management, while interpersonal relationships were rated relatively higher. Specifically, the following values were obtained: Psychological well-being: F(2,309) = 0.92, p = 0.399; Management perception: F(2,309) = 0.77, p = 0.464; Interpersonal relationships: F(2,253) = 2.92, p = 0.056. A generally positive perception of the National Health Service (SSN) emerged across all age groups, with the highest satisfaction levels recorded among individuals aged 31 to 60, followed by a slight decline among those over 75 years of age. The multilevel comparison with regional data and two benchmark hospitals further supports the model’s validity. In most services, the company’s first available appointment (PUI) was shorter than both the regional average and those of the comparison hospitals—for example, optical coherence tomography (OCT) at 1 day versus 13 and 95 days; bone densitometry at 21 days versus 69; and ophthalmology visits at 1 day versus 4 and 77. The model also highlights that each service requires specific, targeted management efforts. These results indicate an enhanced ability to manage demand and reduce organizational bottlenecks. Discussion: The experience described in this thesis demonstrates that a participatory, and sustainable approach to waiting-list management is not only possible but essential for the future of the SSN. The model does not originate as a purely technical project, but as a cultural paradigm shift—from a reactive healthcare system that responds to delays to one that anticipates, prevents, and manages them with fairness and accountability.