{"id":15584,"date":"2010-12-01T00:00:00","date_gmt":"2010-11-30T23:00:00","guid":{"rendered":"http:\/\/ricom-web.com\/gestions-hospitalieres\/les-suites-concretes-de-la-loi-hpst\/"},"modified":"2018-03-09T14:27:10","modified_gmt":"2018-03-09T13:27:10","slug":"les-suites-concretes-de-la-loi-hpst","status":"publish","type":"post","link":"https:\/\/www.ricom-web8.com\/gestions\/les-suites-concretes-de-la-loi-hpst\/","title":{"rendered":"Les suites concr\u00e8tes de la loi HPST"},"content":{"rendered":"<span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Temps de lecture\u00a0: <\/span> <span class=\"rt-time\"> 4<\/span> <span class=\"rt-label rt-postfix\">minutes<\/span><\/span><p>Parmi les \u00e9volutions dont la loi H\u00f4pital, patients, sant\u00e9, territoire (HPST) de juillet 2009 est porteuse, celle sur le management de la s\u00e9curit\u00e9 des soins est l\u2019une des plus ambitieuses, en termes d\u2019enjeux directs pour le patient. Deux points forts se d\u00e9gagent :<\/p>\n<ul>\n<li>l\u2019obligation r\u00e9glementaire de mettre en \u0153uvre une politique de qualit\u00e9 et de gestion des risques associ\u00e9s aux soins ;<\/li>\n<li>la responsabilit\u00e9 de la commission m\u00e9dicale d\u2019\u00e9tablissement (CME) et de la conf\u00e9rence m\u00e9dicale dans l\u2019\u00e9laboration d\u2019un programme d\u2019actions en faveur de la qualit\u00e9, de la s\u00e9curit\u00e9 et de la gestion des risques associ\u00e9s aux soins.\u2008La gouvernance hospitali\u00e8re est donc, \u00e0 cet \u00e9gard \u00e9galement, profond\u00e9ment remani\u00e9e.<\/li>\n<\/ul>\n<p>En application directe de la loi, et en coh\u00e9rence avec cette orientation majeure relative \u00e0 la s\u00e9curit\u00e9 des soins, plusieurs textes r\u00e9glementaires sont en pr\u00e9paration \u00e0 la Direction g\u00e9n\u00e9rale de l\u2019offre de soins :<\/p>\n<ul>\n<li>lutte contre les \u00e9v\u00e9nements ind\u00e9sirables associ\u00e9s aux soins,<\/li>\n<li>management de la qualit\u00e9 de la prise en charge m\u00e9dicamenteuse,<\/li>\n<li>qualit\u00e9 de la prise en charge de l\u2019op\u00e9r\u00e9\u2026<\/li>\n<\/ul>\n<p>Ces projets ont en commun de promouvoir la qualit\u00e9 <em>via<\/em> la gestion de projet et la culture de r\u00e9sultat.\u00a0Diff\u00e9rentes \u00e9tudes, notamment celle r\u00e9alis\u00e9e en 2009 par la Direction g\u00e9n\u00e9rale de l\u2019offre de soins, sur l\u2019effectivit\u00e9 de la mise en place d\u2019une gestion des risques en \u00e9tablissement<sup class=\"appel\" data-toggle=\"modal\" data-target=\"#notes\">(1)<\/sup>, concordent pour montrer une implication encore tr\u00e8s in\u00e9gale, et globalement insuffisante, du management des \u00e9tablissements dans la gestion des risques. D\u00e9sormais, le r\u00f4le pr\u00e9\u00e9minent du pr\u00e9sident de la CME, et celui de la CME elle-m\u00eame, dans l\u2019\u00e9laboration de la politique d\u2019am\u00e9lioration continue de la qualit\u00e9 et de la s\u00e9curit\u00e9 des soins des \u00e9tablissements, tels qu\u2019ils sont inscrits dans la loi du 21 juillet 2009 et dans les d\u00e9crets des 30 d\u00e9cembre 2009 et 30 avril 2010, traduisent la n\u00e9cessit\u00e9 d\u2019un engagement actif et formalis\u00e9 de la communaut\u00e9 m\u00e9dicale, en coordination avec la direction.<\/p>\n<p>\u00c0 cette mise en avant de la qualit\u00e9 des soins et de la s\u00e9curit\u00e9 du patient, d\u00e9sormais plac\u00e9es au c\u0153ur du projet strat\u00e9gique des \u00e9tablissements, correspond la refonte du paysage institutionnel que repr\u00e9sente la cr\u00e9ation des agences r\u00e9gionales de sant\u00e9 (ARS) et aussi la mise en place, \u00e0 la Direction g\u00e9n\u00e9rale de l\u2019offre de soins, d\u2019une sous-direction Pilotage de la performance des acteurs de l\u2019offre de soins (PF) au sein de laquelle efficience, qualit\u00e9 et s\u00e9curit\u00e9 des soins ont une dimension notablement renforc\u00e9e, avec des missions reconfigur\u00e9es\u00a0sur une logique de pilotage strat\u00e9gique (\u00e9laboration de politiques nationales) et d\u2019appui \u00e0 la mise en place et \u00e0 l\u2019\u00e9valuation de ces politiques.<\/p>\n<p>L\u2019\u00e9quipe en charge de la qualit\u00e9 et de la s\u00e9curit\u00e9 des soins (PF2), compos\u00e9e de professionnels de sant\u00e9 et de gestionnaires d\u2019\u00e9tablissements, a pour mission d\u2019\u00e9laborer et de mettre en \u0153uvre les politiques du m\u00e9dicament, de la s\u00e9curit\u00e9 des soins dispens\u00e9s en \u00e9tablissements ou en ville, de la qualit\u00e9 des fili\u00e8res et des structures de soins (labellisation de centres de r\u00e9f\u00e9rence \u2013 centres sp\u00e9cialis\u00e9s sur les infections ost\u00e9o-articulaires ou la douleur chronique \u2013, plan Maladies rares\u2026). Le bureau Qualit\u00e9 et s\u00e9curit\u00e9 des soins exerce un r\u00f4le pivot dans la d\u00e9finition et le d\u00e9ploiement des indicateurs de qualit\u00e9, en continuit\u00e9 avec les indicateurs du tableau de bord des infections nosocomiales et en lien \u00e9troit avec la Haute Autorit\u00e9 de sant\u00e9 (HAS).\u00a0Pour la gestion des risques associ\u00e9s aux soins, les objectifs strat\u00e9giques de la Direction g\u00e9n\u00e9rale de l\u2019offre de soins sont de d\u00e9finir les axes prioritaires d\u2019une politique de qualit\u00e9 et de s\u00e9curit\u00e9, avec les accompagnements n\u00e9cessaires, et de contribuer \u00e0 l\u2019essor des structures d\u2019appui et r\u00e9seaux indispensables \u00e0 l\u2019appropriation des objectifs nationaux par l\u2019ensemble des professionnels de sant\u00e9.<\/p>\n<p>Ces orientations sont d\u00e9ploy\u00e9es en coh\u00e9rence avec les initiatives internationales, au premier rang desquelles figure la recommandation du Conseil de l\u2019Union europ\u00e9enne relative \u00e0 la s\u00e9curit\u00e9 du patient, y compris la pr\u00e9vention des infections associ\u00e9es aux soins et la lutte contre celles-ci<sup class=\"appel\" data-toggle=\"modal\" data-target=\"#notes\">(2)<\/sup> adopt\u00e9e en juin 2009.<\/p>\n<p>&nbsp;<\/p>\n<h2>www.securitesoins.fr<br \/>\nLe p\u00f4le Sant\u00e9 et s\u00e9curit\u00e9 des soins\u00a0du m\u00e9diateur de la R\u00e9publique<\/h2>\n<p>Dans le domaine de la sant\u00e9 et de la s\u00e9curit\u00e9 des soins, le m\u00e9diateur de la R\u00e9publique dispose d\u2019un p\u00f4le d\u2019information et de m\u00e9diation charg\u00e9 de renforcer le dialogue entre les usagers du syst\u00e8me de soins et les professionnels de sant\u00e9.<img decoding=\"async\" class=\"alignright size-medium wp-image-33477\" src=\"https:\/\/gestions-hospitalieres.fr\/wp-content\/uploads\/2010\/12\/ecran_mediateur-300x180.jpg\" alt=\"ecran_mediateur\" width=\"300\" height=\"180\" srcset=\"https:\/\/www.ricom-web8.com\/gestions\/wp-content\/uploads\/2010\/12\/ecran_mediateur-300x180.jpg 300w, https:\/\/www.ricom-web8.com\/gestions\/wp-content\/uploads\/2010\/12\/ecran_mediateur.jpg 600w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p>Lors de la survenue d\u2019une infection nosocomiale, d\u2019un accident m\u00e9dical, c\u2019est-\u00e0-dire d\u2019un \u00e9v\u00e9nement ind\u00e9sirable li\u00e9 aux soins, les explications donn\u00e9es par le personnel m\u00e9dical et le temps consacr\u00e9 au patient sont primordiaux. L\u2019information est alors un \u00e9l\u00e9ment essentiel car de sa qualit\u00e9 na\u00eet un climat de confiance r\u00e9ciproque entre le m\u00e9decin et le patient.\u00a0<em>Via<\/em> ce p\u00f4le Sant\u00e9 et s\u00e9curit\u00e9 des soins, le m\u00e9diateur de la R\u00e9publique analyse et traite toutes demandes d\u2019information ou de r\u00e9clamation en provenance des usagers du syst\u00e8me de sant\u00e9 ou des professionnels de sant\u00e9 qui mettent en cause le non-respect des droits des malades, la qualit\u00e9 du syst\u00e8me de sant\u00e9, la s\u00e9curit\u00e9 des soins et l\u2019acc\u00e8s aux soins.<\/p>\n<p>Les objectifs poursuivis :<\/p>\n<ul>\n<li>l\u2019information sur les droits des patients ;<\/li>\n<li>l\u2019information sur les risques li\u00e9s aux soins et les mesures de pr\u00e9vention mises en \u0153uvre ;<\/li>\n<li>l\u2019\u00e9clairage individuel de l\u2019usager sur son v\u00e9cu et son histoire m\u00e9dicale ;<\/li>\n<li>l\u2019information des professionnels de sant\u00e9 concern\u00e9s suite \u00e0 la survenue d\u2019un effet ind\u00e9sirable ;<\/li>\n<li>l\u2019orientation et la contribution au d\u00e9veloppement de la m\u00e9diation au plan local ;<\/li>\n<li>la m\u00e9diation, lorsque le dialogue est rompu entre usagers et professionnels de sant\u00e9 ;<\/li>\n<li>l\u2019alerte, si n\u00e9cessaire, des autorit\u00e9s sanitaires comp\u00e9tentes ;<\/li>\n<li>le retour d\u2019exp\u00e9rience aupr\u00e8s des acteurs concern\u00e9s afin d\u2019identifier des actions de pr\u00e9vention appropri\u00e9es.<\/li>\n<\/ul>\n<p>Le p\u00e9rim\u00e8tre d\u2019action du m\u00e9diateur de la R\u00e9publique s\u2019\u00e9tend \u00e0 tous les \u00e9tablissements publics et priv\u00e9s de sant\u00e9 ainsi qu\u2019\u00e0 la m\u00e9decine de ville et le m\u00e9diateur de la R\u00e9publique peut utiliser son pouvoir de contr\u00f4le et d\u2019injonction. Il peut aussi formuler des recommandations et les rendre publiques et, au-del\u00e0 de l\u2019\u00e9coute et du dialogue, s\u2019assurer que des mesures correctives sont mises en \u0153uvre \u00e0 la suite d\u2019un accident d\u00e8s lors qu\u2019il s\u2019est av\u00e9r\u00e9 \u00e9vitable.<\/p>\n<p><a href=\"http:\/\/www.securitesoins.fr\" target=\"_blank\" rel=\"noopener noreferrer\">www.securitesoins.fr<\/a> &#8211; Num\u00e9ro Azur : 0810 455 455<\/p>\n<script>function PlayerjsAsync(){} if(window[\"Playerjs\"]){PlayerjsAsync();}<\/script>","protected":false},"excerpt":{"rendered":"<p><span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Temps de lecture\u00a0: <\/span> <span class=\"rt-time\"> 4<\/span> <span class=\"rt-label rt-postfix\">minutes<\/span><\/span>\ufeffParmi les \u00e9volutions dont la loi H\u00f4pital, patients, sant\u00e9, territoire (HPST) de juillet 2009 est porteuse, celle sur le management de la s\u00e9curit\u00e9 des soins est l\u2019une des plus ambitieuses, en termes d\u2019enjeux directs pour le patient.<\/p>\n","protected":false},"author":1202,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[26,2],"tags":[525,50,10,529],"class_list":["post-15584","post","type-post","status-publish","format-standard","hentry","category-dossier","category-gestions-hospitalieres","tag-gestion-des-risques","tag-gouvernance","tag-loi-hpst","tag-qualite-des-soins"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.8.1 - 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