Par Maxence Dourlen
Published on June 24 ’22 at 10:20
The crisis of emergency room is spreading and solutions are starting to run out for many services in France. The hospitals of Montauban et Moissac (Tarn et Garonne) are unfortunately not immune to this major disruption, which has already been observed for several months in services.
From the 1is Julythe two establishments will choose the system of the Access to Care Service (SAS) in order to regulate emergency visits without loss of chance for patients throughout the territory “while preserving the working conditions of emergency doctors still present and paramedical professionals”.
A necessary reorganization
Several actions have been carried out in recent months on both sites:
• Closing of emergencies at night in Moissac with maintenance of the SMUR H24;
• Removal of the second line of SMUR H24 on the Montauban site.
It is clear that this is not enough. The Care Access Service, already experienced in many departments in France, should make it possible to avoid a closure – which would be dramatic – and above all to refocus the activity of emergency physicians and caregivers within the department itself. Efforts are notably transferred to vital emergencies.
Concretely, what does it change?
But concretely, what does this change for patients? First of all, admission to the emergency department will not be systematic, day or night. A phone call will be needed to assess the situation.
“All admissions to the emergency room will be made on referral from the attending physician or by telephone call to 15 or 3966. The patient will thus be directed to the structure adapted to the request for care: attending physician, Medical Center for Immediate Care (CMSI) in Montauban, emergency or intervention of the SMUR (vital emergencies). »
Recruitments will be made quickly to facilitate the processing of these calls. The Montauban hospital specifies that “particular vigilance will be provided to the most vulnerable patients through a reinforced partnership with the devices of the territory: home care service, medico-social establishments for which specific communication on the addressing circuits will be made”.
This reorganization project follows several months of crisis and major difficulties encountered, particularly in the recruitment of emergency physicians (15 vacant positions out of the 38 in the Federation of Hospital Emergencies 82). And contrary to what we can hear in other French services, the arrival of the summer period would not be at the heart of the problem encountered for months.
“The so-called emergency crisis is not specific … to emergencies and is also not linked to the summer period. It is the entire organization of care (unscheduled care) that must be rethought in conjunction with the various players in the health system. »
The Montauban Hospital Center specifies that “this project to reorganize access to emergencies has been thought out with all the health actors in the territory, relying on professionals in the field who know the health needs of the Tarn-et- Garonne. »
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