Bontemps Gilles
Agence Nationale d'Appui à la Performance des établissements de santé et médico-sociaux, 75013 Paris, France.
Presse Med. 2014 Mar;43(3):309-18. doi: 10.1016/j.lpm.2013.09.006. Epub 2014 Jan 18.
In France, the delayed development of day surgery compared to other countries led the ANAP and the HAS in 2011 to enter into a joint work program to provide some reference guide for hospitals to change their practices to outpatient. In this context, organizational guidelines and operational tools were published in May 2013. The method of construction of the recommendations resulting from an original work that combined a three-fold approach: field vision by identifying the highlights of 15 hospitals selected for their representative performance and analyzing the risks of five voluntary hospitals, mobilization organizational theories from the social sciences, using 53 professional experts. The work concluded on 16 organizational recommendations under four forms (basic principles, strategic elements, operational elements and perspectives). These recommendations are accompanied by tools and guides diagnosis and implementation, as well as productions for further reflection. These organizational recommendations confirmed the specificity of day surgery, which is not related to the act, but to the organization, management and optimization of different flows of a hospital (patient flow, professional flows, logistical, informational…). The performance of a day surgery organization is linked to its ability to control its flow and anticipation.
在法国，与其他国家相比，日间手术发展滞后，这促使法国国家卫生管理局（ANAP）和高级卫生管理局（HAS）于2011年启动了一项联合工作计划，为医院向门诊手术转变提供一些参考指南。在此背景下，组织指南和操作工具于2013年5月发布。这些建议的制定方法源于一项开创性工作，该工作采用了三重方法：通过确定15家因其代表性表现而被选中的医院的突出特点并分析5家志愿医院的风险来进行实地考察；从社会科学中引入组织理论，召集53位专业专家参与。这项工作最终形成了16条组织建议，分为四种形式（基本原则、战略要素、操作要素和展望）。这些建议还配有诊断和实施工具及指南，以及供进一步思考的成果。这些组织建议证实了日间手术的特殊性，它并非与手术行为本身相关，而是与医院不同流程（患者流程、专业流程、后勤、信息等）的组织、管理和优化相关。日间手术组织的绩效与其控制流程和提前规划的能力相关。
