{"id":33132,"date":"2017-03-01T11:25:16","date_gmt":"2017-03-01T10:25:16","guid":{"rendered":"https:\/\/gestions-hospitalieres.fr\/?p=33132"},"modified":"2018-04-06T14:58:23","modified_gmt":"2018-04-06T12:58:23","slug":"%e2%80%89guide-michelin%e2%80%89-ars","status":"publish","type":"post","link":"https:\/\/www.ricom-web8.com\/gestions\/%e2%80%89guide-michelin%e2%80%89-ars\/","title":{"rendered":"Le \u00ab\u2009guide Michelin\u2009\u00bb des ARS"},"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\"> 2<\/span> <span class=\"rt-label rt-postfix\">minutes<\/span><\/span><p>En septembre 2015, la FHP a lanc\u00e9 son premier projet d\u2019\u00e9valuation des ARS, selon deux axes\u2009: d\u2019une part les \u00e9l\u00e9ments \u00ab\u2009mesurables\u2009\u00bb qui concernent les autorisations sanitaires, la r\u00e9partition des ressources sur lesquelles les ARS ont la main**, d\u2019autre part une vision qualitative des relations avec l\u2019agence. Ces relations entre ARS et \u00e9tablissements ont lieu lors des contr\u00f4les et visites de conformit\u00e9 des activit\u00e9s de soins autoris\u00e9es, lors des discussions sur la contractualisation ou de d\u00e9veloppement de projets.<\/p>\n<p>La consultation des \u00e9tablissements a eu lieu en mars 2016 sur le p\u00e9rim\u00e8tre de l\u2019ann\u00e9e 2015, men\u00e9e par un institut de sondage missionn\u00e9, aupr\u00e8s des cliniques et h\u00f4pitaux priv\u00e9s. Les \u00e9tablissements ont pu donner leur avis sur des \u00e9l\u00e9ments tels que la qualit\u00e9 et la fr\u00e9quence des \u00e9changes, la transparence des d\u00e9cisions, les crit\u00e8res d\u2019\u00e9valuation, les d\u00e9lais de r\u00e9ponse, etc.\u00a0Les r\u00e9sultats ont \u00e9t\u00e9 pr\u00e9sent\u00e9s lors de la convention de la FHP-MCO, en mai 2016. Ces premiers r\u00e9sultats sont s\u00e9v\u00e8res, t\u00e9moignant de situations in\u00e9quitables entre les r\u00e9gions, voire entre les secteurs public\/priv\u00e9. \u00c0 noter toutefois le faible nombre de r\u00e9pondants, sur un public tr\u00e8s homog\u00e8ne, ce qui tend \u00e0 concentrer des r\u00e9ponses assez similaires. Les 201 r\u00e9pondants ont d\u00e9crit des agences per\u00e7ues comme \u00ab\u2009bureaucratiques\u2009\u00bb (66\u2009%), \u00ab\u2009in\u00e9quitables\u2009\u00bb (51\u2009%), \u00ab\u2009chronophages\u2009\u00bb (50\u2009%) et \u00ab\u2009opaques\u2009\u00bb (40\u2009%). Peu ouvertes au dialogue et manquant d\u2019objectivit\u00e9 dans leurs d\u00e9cisions, les ARS sont aussi accus\u00e9es de favoriser les \u00e9tablissements de sant\u00e9 publics. Au total, le niveau de satisfaction des \u00e9valu\u00e9s atteint \u00e0 peine la moyenne (5,8\/10), avec une forte dispersion des r\u00e9sultats entre les r\u00e9pondants mais aussi une meilleure perception des relations avec les d\u00e9l\u00e9gations territoriales des ARS (63\u2009%) qu\u2019avec le si\u00e8ge de l\u2019ARS (49\u2009%).<\/p>\n<p>Sur l\u2019aspect de la performance organisationnelle, les r\u00e9sultats sont aussi s\u00e9v\u00e8res puisqu\u2019ils indiquent l\u2019absence d\u2019impact sur\u2009:<\/p>\n<ul>\n<li>la qualit\u00e9 et la s\u00e9curit\u00e9 des soins apport\u00e9s aux patients (57\u2009%),<\/li>\n<li>l\u2019efficience des soins apport\u00e9s aux patients (78\u2009%),<\/li>\n<li>l\u2019innovation m\u00e9dicale et organis\u00adationnelle (83\u2009%)<\/li>\n<li>les coop\u00e9rations \u00e9tablissement\/m\u00e9decine de ville (84\u2009%).<\/li>\n<\/ul>\n<p>Plus inqui\u00e9tant, un tiers des r\u00e9pondants (28\u2009%) fait \u00e9tat d\u2019une r\u00e9gression des coop\u00e9rations publiques\/priv\u00e9es suite \u00e0 une intervention de l\u2019ARS. Autre critique, celle de l\u2019absence de publications de d\u00e9cisions de financement, qui concerne six ARS.<\/p>\n<p>Le <em>best of<\/em> 2015 des agences les plus transparentes dans ses d\u00e9cisions place en t\u00eate les ARS Alsace-Champagne-Ardenne-Lorraine (Acal) et Bourgogne-Franche-Comt\u00e9, en fin de classement les ARS Nord-Pas-de-Calais-Picardie et Pays de la Loire. En mati\u00e8re d\u2019\u00e9quit\u00e9 des d\u00e9cisions, les mieux jug\u00e9es sont les deux m\u00eames, les moins bonnes les ARS Bretagne et Pays de la Loire.<br \/>\nPremi\u00e8re \u00e9tude de ce type visant \u00e0 retourner la charge de l\u2019\u00e9valuation, \u00e0 la mani\u00e8re de ce qui se pratique d\u00e9j\u00e0 en ressources humaines avec les \u00ab\u2009entretiens d\u2019\u00e9valuation \u00e0 360\u00b0\u2009\u00bb o\u00f9 l\u2019\u00e9valu\u00e9 non seulement \u00e9value son \u00e9valuateur mais est \u00e9valu\u00e9 par d\u2019autres collaborateurs, cette initiative sera renouvel\u00e9e par la FHP-MCO en 2\u2009016. La question d\u2019une extension du p\u00e9rim\u00e8tre de la consultation aux autres \u00e9tablissements (priv\u00e9s non lucratifs, publics, sociaux et m\u00e9dico-sociaux) n\u2019a pas \u00e0 ce stade \u00e9t\u00e9 soulev\u00e9e, moyen peut-\u00eatre d\u2019augmenter l\u2019impact de cette initiative et d\u2019atteindre une meilleure qualit\u00e9 des relations administratives entre r\u00e9gulateurs et \u00e9tablissements r\u00e9gul\u00e9s.<\/p>\n<p>* Sources\u2009: communiqu\u00e9 de presse de la FHP-MCO du 12 mai 2016 (<a href=\"http:\/\/wellcom.fr\/presse\/fhp-mco\/\" target=\"_blank\" rel=\"noopener noreferrer\">http:\/\/wellcom.fr<\/a>) et trois articles Hospim\u00e9dia\u2009:<br \/>\n\u00ab\u2009La FHP-MCO projette d\u2019\u00e9valuer les ARS selon la qualit\u00e9 de leurs relations avec les acteurs de sant\u00e9\u2009\u00bb (22\/09\/15).<br \/>\n\u00ab\u2009Les cliniques sont appel\u00e9es \u00e0 \u00e9valuer leur ARS pour un classement d\u00e9voil\u00e9 en mai par la FHP-MCO\u2009\u00bb (24\/03\/16).<br \/>\n\u00ab\u2009Des enqu\u00eates men\u00e9es pour la FHP-MCO pointent le manque de transparence et d&#8217;\u00e9quit\u00e9 de certaines ARS\u2009\u00bb (12\/05\/16).<br \/>\n** Cr\u00e9dits du fonds d\u2019intervention r\u00e9gional (Fir) pour financer les missions d\u2019int\u00e9r\u00eat g\u00e9n\u00e9ral et aides \u00e0 la contractualisation (Migac).<\/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\"> 2<\/span> <span class=\"rt-label rt-postfix\">minutes<\/span><\/span>En septembre 2015, la FHP a lanc\u00e9 son premier projet d\u2019\u00e9valuation des ARS, selon deux axes\u2009: d\u2019une part les \u00e9l\u00e9ments \u00ab\u2009mesurables\u2009\u00bb qui concernent les autorisations sanitaires, la r\u00e9partition des ressources sur lesquelles les ARS ont la main**, d\u2019autre part une vision qualitative des relations avec l\u2019agence. Ces relations entre ARS et \u00e9tablissements ont lieu lors des contr\u00f4les et visites de conformit\u00e9 des activit\u00e9s de soins autoris\u00e9es, lors des discussions sur&hellip; <\/p>\n","protected":false},"author":23133,"featured_media":0,"comment_status":"open","ping_status":"closed","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":[],"class_list":["post-33132","post","type-post","status-publish","format-standard","hentry","category-dossier","category-gestions-hospitalieres"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.8.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Le \u00ab\u2009guide Michelin\u2009\u00bb des ARS - Gestions hospitali\u00e8res<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ricom-web8.com\/gestions\/\u2009guide-michelin\u2009-ars\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Le \u00ab\u2009guide Michelin\u2009\u00bb des ARS - Gestions hospitali\u00e8res\" \/>\n<meta property=\"og:description\" content=\"Temps de lecture\u00a0:  2 minutesEn septembre 2015, la FHP a lanc\u00e9 son premier projet d\u2019\u00e9valuation des ARS, selon deux axes\u2009: d\u2019une part les \u00e9l\u00e9ments \u00ab\u2009mesurables\u2009\u00bb qui concernent les autorisations sanitaires, la r\u00e9partition des ressources sur lesquelles les ARS ont la main**, d\u2019autre part une vision qualitative des relations avec l\u2019agence. 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