{"id":756,"date":"2008-04-25T10:07:41","date_gmt":"2008-04-25T14:07:41","guid":{"rendered":"http:\/\/gillesenvrac.ca\/carnet\/2008\/04\/hors-les-murs-de-lhopital\/"},"modified":"2022-01-17T16:08:32","modified_gmt":"2022-01-17T21:08:32","slug":"hors-les-murs-de-lhopital","status":"publish","type":"post","link":"https:\/\/gillesenvrac.ca\/carnet\/2008\/04\/hors-les-murs-de-lhopital\/","title":{"rendered":"hors les murs de l&#039;h\u00f4pital"},"content":{"rendered":"<p>Un rapport (<a href=\"http:\/\/www.rcplondon.ac.uk\/professional-Issues\/service\/Pages\/Reconfiguration.aspx\">Teams without walls<\/a>) du Royal College of Physicians  souligne l&rsquo;importance du travail interdisciplinaire et les effets pervers de certains modes de financement des h\u00f4pitaux en \u00ab\u00a0fonction des r\u00e9sultats\u00a0\u00bb. Une meilleure articulation des premi\u00e8re et deuxi\u00e8me lignes avec les ressources dans la communaut\u00e9 de m\u00eame que le leadership que devraient assumer les m\u00e9decins sont parmi le spistes d&rsquo;am\u00e9lioration sug\u00e9r\u00e9es dans ce court rapport. Source [<a href=\"http:\/\/www.bmj.com\/cgi\/content\/full\/336\/7650\/907\">BMJ<\/a>]<\/p>\n<p>Dans un ordre d&rsquo;id\u00e9es similaire <a href=\"http:\/\/www.bmj.com\/cgi\/content\/extract\/336\/7650\/912-b\">un projet pilote<\/a> \u00e9value que les soins palliatifs offerts \u00e0 domicile \u00e0 des patients en phase terminale de cancer ne sont pas plus co\u00fbteux qu&rsquo;en milieu hospitalier, ouvrant la porte ainsi \u00e0 un v\u00e9ritable choix pour le \u00ab\u00a0mourir \u00e0 domicile\u00a0\u00bb.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Un rapport (Teams without walls) du Royal College of Physicians souligne l&rsquo;importance du travail interdisciplinaire et les effets pervers de certains modes de financement des h\u00f4pitaux en \u00ab\u00a0fonction des r\u00e9sultats\u00a0\u00bb. Une meilleure articulation des premi\u00e8re et deuxi\u00e8me lignes avec les ressources dans la communaut\u00e9 de m\u00eame que le leadership que devraient assumer les m\u00e9decins sont &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/gillesenvrac.ca\/carnet\/2008\/04\/hors-les-murs-de-lhopital\/\" class=\"more-link\">Continuer la lecture<span class=\"screen-reader-text\"> de &laquo;&nbsp;hors les murs de l&#039;h\u00f4pital&nbsp;&raquo;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"atmosphere_disabled":false,"atmosphere_custom_text":"","_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[1],"tags":[133,149],"class_list":["post-756","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-prevention","tag-sante-communautaire"],"jetpack_featured_media_url":"","jetpack-related-posts":[{"id":426,"url":"https:\/\/gillesenvrac.ca\/carnet\/2006\/07\/patients-a-risque-de-re-hospitalisation\/","url_meta":{"origin":756,"position":0},"title":"patients \u00e0 risque de r\u00e9-hospitalisation","author":"Gilles Beauchamp","date":"27 juillet 2006","format":false,"excerpt":"Un ensemble d'algorithmes, d\u00e9velopp\u00e9 par le minist\u00e8re de la sant\u00e9 d'Angleterre, pour identifier ceux qui ont le plus de \"chance\" de revenir parmi les personnes quittant l'h\u00f4pital. Disponible sous forme de document Access (14 Mo). En anglais. Rapports et documentation disponibles sur le site du King's fund. \u00c7a pourrait peut-\u00eatre\u2026","rel":"","context":"Dans \"technologie\"","block_context":{"text":"technologie","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/techno\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":8172,"url":"https:\/\/gillesenvrac.ca\/carnet\/2025\/05\/debat-clsc-gmf\/","url_meta":{"origin":756,"position":1},"title":"le vieux d\u00e9bat CLSC-GMF","author":"Gilles Beauchamp","date":"17 mai 2025","format":false,"excerpt":"En relisant les billets d\u00e9j\u00e0 publi\u00e9s sugg\u00e9r\u00e9s par la \"machine\" au bas du dernier billet (m\u00e9decin de famille & hypertension), je me rend compte qu'un des auteurs du rapport sur les services de premi\u00e8re ligne que j'y cite, Mme Breton, a d\u00e9j\u00e0 publi\u00e9 sur la question : L\u2019implantation du mod\u00e8le\u2026","rel":"","context":"Dans \"CLSC\"","block_context":{"text":"CLSC","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/clsc\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/gillesenvrac.ca\/carnet\/wp-content\/uploads\/2025\/05\/ambulance-420x280.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/gillesenvrac.ca\/carnet\/wp-content\/uploads\/2025\/05\/ambulance-420x280.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/gillesenvrac.ca\/carnet\/wp-content\/uploads\/2025\/05\/ambulance-420x280.jpg?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/gillesenvrac.ca\/carnet\/wp-content\/uploads\/2025\/05\/ambulance-420x280.jpg?resize=700%2C400&ssl=1 2x"},"classes":[]},{"id":6875,"url":"https:\/\/gillesenvrac.ca\/carnet\/2022\/04\/autonomie-et-sante\/","url_meta":{"origin":756,"position":2},"title":"autonomie et sant\u00e9","author":"Gilles Beauchamp","date":"14 avril 2022","format":false,"excerpt":"De petites \u00e9quipes (12 max) d'infirmi\u00e8res \u00e0 domicile dans un quartier, fonctionnant de mani\u00e8re autonome, auto-administr\u00e9e, sans hi\u00e9rarchie.","rel":"","context":"Dans \"assurance autonomie\"","block_context":{"text":"assurance autonomie","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/assurance-autonomie\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/gillesenvrac.ca\/carnet\/wp-content\/uploads\/2022\/04\/troisieme-voie.jpeg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":3460,"url":"https:\/\/gillesenvrac.ca\/carnet\/2010\/11\/urgences\/","url_meta":{"origin":756,"position":3},"title":"urgences, h\u00f4pitaux et CSSS","author":"Gilles Beauchamp","date":"5 novembre 2010","format":false,"excerpt":"Le rapport Ross, The Patient Journey Through Emergency Care in Nova Scotia (pdf - 104 pages), sur les services d'urgence en Nouvelle-\u00c9cosse, r\u00e9sum\u00e9 ici par Andr\u00e9 Picard du Globe and Mail, soul\u00e8ve des questions (et sugg\u00e8re des r\u00e9ponses) qui, m\u00eame si elles s'inspirent de la situation dans cette province pourraient\u2026","rel":"","context":"Dans \"administration sant\u00e9\"","block_context":{"text":"administration sant\u00e9","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/administration-sante\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.gillesenvrac.ca\/carnet\/wp-content\/uploads\/2010\/11\/urgences1.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":5829,"url":"https:\/\/gillesenvrac.ca\/carnet\/2018\/03\/la-sante-ou-la-medecine-a-lacte\/","url_meta":{"origin":756,"position":4},"title":"la sant\u00e9 ou la m\u00e9decine \u00e0 l&rsquo;acte ?","author":"Gilles Beauchamp","date":"1 mars 2018","format":false,"excerpt":"Le d\u00e9bat entourant la r\u00e9mun\u00e9ration des m\u00e9decins, en particulier les sp\u00e9cialistes, risque fort de se limiter au d\u00e9compte, en dollars et en cents, qui est le plus, qui est le moins pay\u00e9 ? Combien faudrait-il investir de plus en services infirmiers ? Dans un \"Duel \u00e9conomique\" La Presse demandait \u00e0\u2026","rel":"","context":"Dans \"r\u00e9seau sant\u00e9\"","block_context":{"text":"r\u00e9seau sant\u00e9","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/reseau-sante\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/www.gillesenvrac.ca\/carnet\/wp-content\/uploads\/2018\/03\/Visio2MSSS-420x271.png?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":837,"url":"https:\/\/gillesenvrac.ca\/carnet\/2008\/08\/hospitalisation-mentale\/","url_meta":{"origin":756,"position":5},"title":"hospitalisation &amp; sant\u00e9 mentale","author":"Gilles Beauchamp","date":"21 ao\u00fbt 2008","format":false,"excerpt":"L'ICIS, l'Institut canadien d'information sur la sant\u00e9, publiait r\u00e9cemment un rapport sur les Services de sant\u00e9 mentale en milieu hospitalier au Canada, 2005-2006 (pdf, 45p). Les journaux (le Globe & Mail) ont fait \u00e9tat de ce rapport en soulignant la tendance \u00e0 la baisse (importante) de la dur\u00e9e moyenne de\u2026","rel":"","context":"Dans \"administration sant\u00e9\"","block_context":{"text":"administration sant\u00e9","link":"https:\/\/gillesenvrac.ca\/carnet\/tag\/administration-sante\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/gillesenvrac.ca\/carnet\/wp-content\/uploads\/2008\/08\/hospitalisation-300x211.png?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]}],"jetpack_likes_enabled":true,"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/posts\/756","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/comments?post=756"}],"version-history":[{"count":0,"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/posts\/756\/revisions"}],"wp:attachment":[{"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/media?parent=756"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/categories?post=756"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/gillesenvrac.ca\/carnet\/wp-json\/wp\/v2\/tags?post=756"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}