{"id":15857,"date":"2015-12-01T00:00:00","date_gmt":"2015-11-30T23:00:00","guid":{"rendered":"http:\/\/ricom-web.com\/gestions-hospitalieres\/vigilance\/"},"modified":"2018-03-06T17:52:39","modified_gmt":"2018-03-06T16:52:39","slug":"vigilance","status":"publish","type":"post","link":"https:\/\/www.ricom-web8.com\/gestions\/vigilance\/","title":{"rendered":"Vigilance"},"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\"> 3<\/span> <span class=\"rt-label rt-postfix\">minutes<\/span><\/span><p>Vigilance permet de d\u00e9tecter au plus t\u00f4t les probl\u00e8mes sociaux ou sanitaires survenant aux personnes et, en mobilisant rapidement les professionnels concern\u00e9s, d\u2019anticiper et de r\u00e9duire l\u2019impact de ces probl\u00e8mes. Le r\u00e9seau est constitu\u00e9, autour de chaque b\u00e9n\u00e9ficiaire et avec son accord, des professionnels sociaux et sanitaires qui interviennent pour lui. Il s\u2019appuie sur des moyens techniques, dont une plate-forme \u00e9lectronique s\u00e9curis\u00e9e qui s\u2019adresse \u00e0 tout professionnel participant au maintien \u00e0 domicile\u2009: service d\u2019accompagnement et d\u2019aide \u00e0 domicile (Saad), service de soins infirmiers \u00e0 domicile (Ssiad), CCAS, m\u00e9decins g\u00e9n\u00e9ralistes et sp\u00e9cialistes, pharmaciens, infirmi\u00e8res, kin\u00e9sith\u00e9rapeutes, assistantes sociales, r\u00e9seau g\u00e9rontologique, centre local d\u2019information et de coordination (Clic) et bient\u00f4t les tuteurs des b\u00e9n\u00e9ficiaires.<\/p>\n<h1>Vigilance 2\u2009: la technologie en plus<\/h1>\n<p>Vigilance 2 est la suite de l\u2019exp\u00e9rimentation commenc\u00e9e il y a huit ans, mais il associe la technologie smartphone au r\u00e9seau existant. L\u2019application mise en place permet d\u2019associer le suivi sant\u00e9 des personnes aid\u00e9es et le contr\u00f4le d\u2019effectivit\u00e9 de l\u2019activit\u00e9 des agents de terrain.<\/p>\n<h2>Un suivi am\u00e9lior\u00e9<\/h2>\n<p>Le suivi des patients est assur\u00e9 gr\u00e2ce \u00e0 des capteurs plac\u00e9s sur un tensiom\u00e8tre, un p\u00e8se-personne ou un glucom\u00e8tre. L\u2019information collect\u00e9e est ensuite transmise au m\u00e9decin traitant ou \u00e0 l\u2019infirmi\u00e8re qui, en fonction des alertes, peuvent contacter le patient, adapter le traitement ou envisager une hospitalisation.<\/p>\n<button data-toggle=\"collapse\" data-target=\"#4836\">Figure 1<\/button><div id=\"4836\" class=\"encadre collapse\"><h1>Figure 1<\/h1>\n<h2>L'environnement de la plate-forme Vigilance<\/h2>\n<p> <img decoding=\"async\" alt=\"environnement de la plate-forme vigilance\" data-align=\"center\" data-entity-type=\"file\" data-entity-uuid=\"e44c83bc-efc2-4394-bda1-3d9602bdbdf3\" src=\"https:\/\/gestions-hospitalieres.fr\/wp-content\/uploads\/ill_2015_596_01.png\"  class=\"img-responsive\" \/><\/p>\n<\/div>\n<div class=\"20a2e494-43df-46a6-9f76-7f89358b73fd\" style=\"display: none;\"><\/div>\n<h2>Une meilleure organisation<\/h2>\n<p>Le contr\u00f4le d\u2019effectivit\u00e9 permet de transmettre, en plus des donn\u00e9es horaires et financi\u00e8res li\u00e9es \u00e0 la facturation, les plannings et les plans de soins ou d\u2019aide aux professionnels du domicile.<\/p>\n<p>Le syst\u00e8me s\u2019adresse \u00e0 deux populations diff\u00e9rentes\u2009:<\/p>\n<ul>\n<li>les patients capables de se g\u00e9rer, dont l\u2019autonomie face \u00e0 la maladie est cons\u00e9quente. C\u2019est le rapport avec les professionnels de sant\u00e9 qui est ici am\u00e9lior\u00e9, la plate-forme servant simplement d\u2019interface. Par exemple, le m\u00e9decin dispose, dans le dossier \u00e9lectronique de son patient reli\u00e9 \u00e0 la plate-forme, de la variation de certains indicateurs sur la dur\u00e9e\u2009: tension art\u00e9rielle, temp\u00e9rature, rythme cardiaque\u2026\u2009;<\/li>\n<li>les personnes en forte perte d\u2019autonomie\u2009: l\u2019aide \u00e0 domicile assure la relation avec la plate-forme, une dimension sociale s\u2019ajoute donc aux informations m\u00e9dicales, une organisation plus complexe se met en place, des outils de gestion sont connect\u00e9s \u00e0 la plate-forme m\u00e9dicale, laquelle devient m\u00e9dico-sociale.<\/li>\n<\/ul>\n<button data-toggle=\"collapse\" data-target=\"#4837\">Figure 2<\/button><div id=\"4837\" class=\"encadre collapse\"><h1>Figure 2<\/h1>\n<h2>Exemple de suivi quotidien r\u00e9alis\u00e9 via le syst\u00e8me<\/h2>\n<h3>Courbe de la s\u00e9quence cardiaque, poids, glyc\u00e9mie<\/h3>\n<p> <img decoding=\"async\" alt=\"suivi quotidien\" data-align=\"center\" data-entity-type=\"file\" data-entity-uuid=\"4c5f78a6-1303-403f-8ec6-cb08b7b72e96\" src=\"https:\/\/gestions-hospitalieres.fr\/wp-content\/uploads\/ill_2015_596_02.png\"  class=\"img-responsive\" \/><\/p>\n<\/div>\n<div class=\"947614dc-fa7d-462c-ad60-fa6af7c65b6a\" style=\"display: none;\"><\/div>\n<p>Pour les personnes b\u00e9n\u00e9ficiant d\u2019aides financi\u00e8res, cet outil permet un contr\u00f4le de l\u2019effectivit\u00e9 des prestations. Pour la municipalit\u00e9, elle permet le contr\u00f4le de l\u2019effectivit\u00e9 des prestations.\u00a0Vigilance 2 est ainsi la combinaison des deux approches, m\u00e9dicale et sociale, avec des outils connect\u00e9s plus performants.<\/p>\n<button data-toggle=\"collapse\" data-target=\"#4838\">Figure 3<\/button><div id=\"4838\" class=\"encadre collapse\"><h1>Figure 3<\/h1>\n<h2>Exemple de plan de soins prise en charge transmis \u00e0 l'aidant via smartphone<\/h2>\n<p> <img decoding=\"async\" alt=\"plan de soins\" class=\"img-responsive\" data-align=\"center\" data-entity-type=\"file\" data-entity-uuid=\"8ea41cb4-2c42-404d-9f87-bafb4765243d\" src=\"https:\/\/gestions-hospitalieres.fr\/wp-content\/uploads\/ill_2015_596_03.png\" \/><\/p>\n<\/div>\n<div class=\"d6cee979-be9e-406f-836d-883695f55cb9\" style=\"display: none;\"><\/div>\n<h1>Le mod\u00e8le \u00e9conomique<\/h1>\n<p>Jusqu\u2019alors, le financement \u00e9tait issu d\u2019un appel \u00e0 projets du minist\u00e8re de la Sant\u00e9 pour les professionnels m\u00e9dicaux et param\u00e9dicaux\u2009; en \u00e9taient exclues les personnes publiques. La ville de Parthenay a d\u00fb mettre en place un financement pour les personnes \u00e2g\u00e9es suivies par les services du CCAS en compl\u00e9ment des financements Ssiad et Saad.<\/p>\n<p>Les perspectives financi\u00e8res sont \u00e0 l\u2019\u00e9tude. Le volet m\u00e9dical est en n\u00e9gociation avec l\u2019Assurance Maladie, le volet social sera d\u00e9velopp\u00e9 dans un partenariat entre communes par une mutualisation des ressources via la cr\u00e9ation d\u2019un centre intercommunal d\u2019action sociale (Cias).<\/p>\n<h1>Des difficult\u00e9s de mise en \u0153uvre qui s\u2019effacent peu \u00e0 peu<\/h1>\n<ul>\n<li>Des divergences philosophiques entre les acteurs du projet sur la technologie \u00e0 d\u00e9velopper, jusqu\u2019\u00e0 aboutir au d\u00e9veloppement de deux syst\u00e8mes compl\u00e9mentaires.<\/li>\n<li>Une application, bas\u00e9e au d\u00e9part uniquement sur la e-sant\u00e9, qui s\u2019am\u00e9liore et s\u2019adapte avec les demandes des services utilisateurs et des financeurs. On d\u00e9passe le champ strictement \u00ab\u2009m\u00e9dical\u2009\u00bb ou \u00ab\u2009soin\u2009\u00bb pour accompagner la gestion humaine, administrative et financi\u00e8re d\u2019une situation complexe.<\/li>\n<li>Une crainte de l\u2019informatisation des transmissions, qui entra\u00eene une impression de d\u00e9shumanisation du soin \u00e0 domicile s\u2019estompera avec l\u2019am\u00e9lioration de qualit\u00e9 du service rendu.<\/li>\n<li>Un manque de notori\u00e9t\u00e9 de ce type de syst\u00e8me, qui tend \u00e0 s\u2019amenuiser gr\u00e2ce \u00e0 une reconnaissance du minist\u00e8re de la Sant\u00e9 des professionnels engag\u00e9s.<\/li>\n<\/ul>\n<script>function PlayerjsAsync(){} if(window[\"Playerjs\"]){PlayerjsAsync();}<\/script>","protected":false},"excerpt":{"rendered":"<p>Le re\u0301seau Vigilance, e\u0301labore\u0301 en 2007 par la ville de Parthenay \u2013 dans les Deux-Se\u0300vres \u2013 et son centre communal d\u2019action sociale (CCAS), en colla- boration avec la socie\u0301te\u0301 d\u2019inge\u0301nierie Isas et l\u2019association des professionnels de sante\u0301, Informed79, a pour objectif d\u2019ame\u0301liorer significativement les conditions de maintien a\u0300 domicile des personnes a\u0302ge\u0301es, des personnes sortant d\u2019hospitalisation et des personnes en situation de handicap.<\/p>\n","protected":false},"author":1202,"featured_media":0,"comment_status":"closed","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":[2131,2130,2128,409,89,2129,1312,1093],"class_list":["post-15857","post","type-post","status-publish","format-standard","hentry","category-dossier","category-gestions-hospitalieres","tag-aide-a-domicile","tag-ccas","tag-deux-sevres","tag-e-sante","tag-maintien-a-domicile","tag-parthenay","tag-reseau-de-sante","tag-vigilance-sanitaire"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.8.1 - 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