Department of anaesthesiology, institut mutualiste Montsouris, Paris, France.
Department of anaesthesiology and intensive care medicine, Grenoble university hospital, Grenoble, France.
Anaesth Crit Care Pain Med. 2017 Dec;36(6):353-357. doi: 10.1016/j.accpm.2017.07.003. Epub 2017 Aug 5.
Operation and organisation of ambulatory surgical activity in France remains largely undocumented. This nationwide observational prospective survey, carried out between December 2013 and December 2014, was undertaken to characterise the organisational processes of ambulatory surgery in France. Three hundred centres were randomly chosen from a list of 891 hospitals practicing ambulatory surgery, with stratification according to the type of facility (public general hospital, university hospital, private hospital) and region. An email was sent to the board of the randomly chosen facilities with an attached information letter explaining how the survey worked. Hospitals who did not reply to this email were contacted by phone. Among the 206 hospitals that answered the survey, 92 were private, 78 were public and 36 were university hospitals. Median accommodation capacities of ambulatory units were 8 beds, mostly distinct from conventional surgical ward. Patient pathways dedicated to ambulatory surgery appear as the current predominant practice. 77% of the French ambulatory units have a head nurse in charge of logistics and coordination. Several items still have to be improved, such as the adherence to modern fasting rules and the unnecessary use of stretcher to move the patient. Objective discharge score is used in 77% of ambulatory units. This survey highlights the implementation of some positive organisational parameters corresponding to common good practices recommendations. In contrast, several other recommendations are still insufficiently applied and may hamper the development of safe ambulatory surgery. This brings up new challenges for health regulatory boards, hospitals and ambulatory units managers.
法国门诊手术活动的运作和组织在很大程度上仍未记录在案。这项全国范围的观察性前瞻性调查于 2013 年 12 月至 2014 年 12 月进行，旨在描述法国门诊手术的组织流程。从 891 家开展门诊手术的医院名单中随机选择了 300 家中心，根据医院类型（公立医院、大学医院、私立医院）和地区进行分层。向随机选择的医疗机构的董事会发送了一封带有附加说明的电子邮件，解释调查的工作方式。未回复此电子邮件的医院将通过电话联系。在回答调查的 206 家医院中，92 家是私立医院，78 家是公立医院，36 家是大学医院。门诊单位的住宿能力中位数为 8 张床，大多与传统的外科病房分开。专门用于门诊手术的患者路径似乎是当前的主要做法。77%的法国门诊单位都有一名护士长负责后勤和协调。还有一些项目需要改进，例如遵守现代禁食规则和不必要地使用担架来搬运患者。77%的门诊单位使用客观出院评分。这项调查强调了一些符合共同良好实践建议的积极组织参数的实施。相比之下，其他一些建议仍未得到充分应用，可能会阻碍安全门诊手术的发展。这给卫生监管委员会、医院和门诊单位管理人员带来了新的挑战。
