Faujour Véronique, Couray Targe Sandrine, Berthier Sophie, Azaïs Henri, Fauvet Raffaèle, Foulon Arthur
Direction des coopérations et de la stratégie, Hospices Civils de Lyon, 3 Quai des Célestins, F-69002 Lyon, France.
Département d'information médicale, Hospices Civils de Lyon, 3 Quai des Célestins, F-69002 Lyon, France.
J Gynecol Obstet Hum Reprod. 2022 May;51(5):102375. doi: 10.1016/j.jogoh.2022.102375. Epub 2022 Apr 6.
For many specialties and operating techniques, enhanced recovery after surgery provides greater economic benefit if it is deployed across a whole healthcare institution rather than in just one or two departments. As with all innovations in the world of hospital care, the adoption of new procedures is a slow process because it is based on a consensual approach. To promote the dissemination and uptake of new practices at the local, national or institutional level, incentives must be developed and examples must be given. Successful deployment within a healthcare institution requires strategic adaptations in three areas: (i) the management of human resources dedicated to the patient pathway, (ii) a care unit architecture that facilitates working practices and patient management, and (iii) the use of digital tools and smart objects. Hospital decision-makers need to have a clear understanding of what is at stake, so that they can implement coordinated actions and encourage adoption. The investment required is hard to define because it results from a combination of skills and knowledge. At the institutional level, the return on investment is greater when the strategy is applied to all surgical specialties at once, since the structure can provide more care with fewer beds and fewer care units while maintaining the quality of patient management.
对于许多专科和手术技术而言，如果在整个医疗机构而非仅一两个科室推行术后加速康复，会带来更大的经济效益。与医院护理领域的所有创新一样，新程序的采用是一个缓慢的过程，因为这基于一种共识性方法。为了在地方、国家或机构层面促进新实践的传播和采用，必须制定激励措施并给出范例。在医疗机构内成功推行需要在三个方面进行战略调整：（i）致力于患者就医流程的人力资源管理；（ii）便于工作实践和患者管理的护理单元架构；（iii）数字工具和智能设备的使用。医院决策者需要清楚了解其中的利害关系，以便他们能够实施协调行动并鼓励采用。所需投资难以界定，因为它是技能和知识相结合的结果。在机构层面，如果该战略一次性应用于所有外科专科，投资回报率会更高，因为这样的架构可以用更少的床位和更少的护理单元提供更多护理，同时保持患者管理的质量。
