Optimisation de la prise en charge de la plaie post-chirurgicale par une équipe pluridisciplinaire : étude pilote de faisabilité

Abstract

The management of post-surgical wounds is complex and suffers from a lack of coordination between the hospital and the community. The pharmacist could improve the efficiency of the care pathway by optimizing the compliance of discharge orders (DO) with current standards and reducing the associated expenditures. The objective of this study was to evaluate the impact of a multidisciplinary intervention on the quality and cost of acute post-surgical wound management. This is a pilot study, monocentric, prospective, before/after. Non-conformities (NC) of DO for post-surgical wounds were analyzed before and after a multidisciplinary intervention (development of protocols, provision of prescription aid supports, training) in 3surgical departments. The cost of each OS filled in the community was collected and the satisfaction of community pharmacists was evaluated. Out of 120OS collected, 576NC were detected. The intervention halved the number of DO with at least 1NC and divided the median number of NC per order by 7. Community pharmacists were 4times more satisfied with the quality of DO after the intervention. The cost of the multidisciplinary intervention was estimated at 787euro. This intervention did not change the average cost per prescription. The multidisciplinary intervention improved the quality of post-surgical wound management by making the hospital-city pathway more fluid. The intervention requires a low investment in human resources and could be economically interesting if the costs avoided by the prevention of complications were valued.