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Ann Pharm Fr ; 78(5): 435-446, 2020 Sep.
Article in French | MEDLINE | ID: mdl-32777296

ABSTRACT

OBJECTIVES: 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. METHODS: 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 3 surgical departments. The cost of each OS filled in the community was collected and the satisfaction of community pharmacists was evaluated. RESULTS: Out of 120 OS collected, 576 NC were detected. The intervention halved the number of DO with at least 1 NC and divided the median number of NC per order by 7. Community pharmacists were 4 times more satisfied with the quality of DO after the intervention. The cost of the multidisciplinary intervention was estimated at 787 euro. This intervention did not change the average cost per prescription. CONCLUSION: 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.


Subject(s)
Surgical Wound/therapy , Aged , Attitude of Health Personnel , Costs and Cost Analysis , Feasibility Studies , Female , Guideline Adherence , Humans , Male , Middle Aged , Patient Care Team , Patient Discharge , Pharmacists , Pharmacy Service, Hospital , Pilot Projects , Professional Role , Prospective Studies , Quality Improvement
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