FOC&CARE – the care that connects: Implementing the Fundamentals of Care framework in the clinical practice of the Pisa University Hospital based on the I-PARIHS model. Study Protocol

Introduction: Promoting patient-centered care as a fundamental principle of healthcare quality represents a strategic challenge in modern hospital settings. The FOC&CARE project, based on the Fundamentals of Care framework, aims to improve the perceived quality of care, strengthen continuity of care, and support the professional well-being of nursing staff. Objectives: The main objective of the study is to evaluate the effectiveness of implementing the FOC&CARE project in improving satisfaction perceived by patients and nurses, with particular attention to care quality, the therapeutic relationship, and organizational well-being. Secondary objectives will include analyzing the impact on clinical and nurse sensitive outcomes, as well as organizational and managerial indicators. Materials and methods: The study will adopt a mixed-methods design structured in three phases: the first will involve context analysis, training of key personnel, and co-design of tools; the second will consist of implementing the model in two wards, with continuous monitoring of quality, satisfaction, well-being, and collection of clinical and managerial data; the third phase will focus on evaluating effectiveness, consolidating the model into organizational processes, and disseminating results through validated recommendations and training tools. The theoretical framework guiding the implementation will be I-PARIHS. Expected results and conclusions: Improvements are expected in the quality and continuity of care, increased satisfaction among patients and staff, reduced work-related stress, and enhanced clinical and care outcomes. The adoption of the model may promote organizational efficiency and sustainability of the healthcare system, contributing to the consolidation of a care culture based on relationships, safety, and quality of care.