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La sécurité des soins obstétricaux, une affaire de travail d’équipe ; l’expérience canadienne du programme AMPROOB/MOREOB

The safety of obstetrical care, a matter of teamwork; the Canadian experience of the MOREOB/AMPROOB program

  • Et Chez Vous, C’Est Comment ? / How Is It Dealt With in Your Country?
  • Published:
Revue de médecine périnatale

Résumé

Objectifs

Décrire la mise en oeuvre du programme AMPROOB (Approche multidisciplinaire en prévention des risques obstétricaux) ainsi que son impact sur les résultats cliniques, médicoéconomiques et la satisfaction des professionnels de santé (PS) formés.

Le programme

D’une durée de trois ans, il est centré sur l’apprentissage collectif, la communication, le travail d’équipe et sur l’analyse multidisciplinaire des pratiques. Au Canada, différentes cohortes d’hôpitaux ont été suivies à long terme, et l’impact du programme a été apprécié à l’aide de comparaisons avant/après à partir du taux de morbidité maternelle et néonatale grave, des dépenses liées aux réclamations et de la perception des conditions de travail.

Résultats

En Alberta, une réduction significative de la morbidité néonatale grave (OR: 0,82, IC 95 %: 0,69 à 0,97) et des lacérations périnéales du troisième ou quatrième degré (OR: 0,76, IC 95 %: 0,64 à 0,92) a été observée. En Ontario, au niveau de l’assurance responsabilité hospitalière, une réduction des dépenses d’indemnisation a été mise en évidence. Le stress était diminué pour 68 % des PS formés.

Conclusion

En établissant une nouvelle culture de sécurité des patients, ce programme a été associé à une réduction de la morbidité maternelle et néonatale grave ainsi que des dépenses associées.

Abstract

Objectives

To describe the implementation of the Managing Obstetrical Risk Efficiently (MOREOB) program and its impact on clinical outcomes and satisfaction of health care professionals.

The program

Of 3 years duration, it is focused on collective learning, communication, teamwork and the multidisciplinary analysis of practices. In Canada, several hospital cohorts have been followed for the long term and the impact of the program was analyzed with a before/after method in terms of maternal and neonatal severe morbidity, claims-related expenses and the perception of working condition.

Results

In Alberta, a significant reduction of 3rd or 4th degree perineal tears (OR: 0.76, CI 95%: 0.64 to 0.92) and of serious neonatal morbidity (OR: 0.82, CI 95%: 0.69 to 0.97) was observed. In Ontario, at the level of hospital liability insurance, a reduction in compensation costs was highlighted. The stress was reduced for 68% of health care professionals.

Conclusion

By establishing a new culture of patient safety, this program was associated with a reduction of severe maternal and neonatal morbidity and the costs associated with it.

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Authors and Affiliations

  1. 444, avenue Beatty, Montréal, Qc, Canada, H4H 1X6

    G. P. Gagné

  2. 3417, rue Boisclair, Boisbriand, Qc, Canada, J7H 1M3

    A. Goubayon

  3. Hospices civils de Lyon, laboratoire « santé, individu, société » — EAM 4128, faculté de médecine Laënnec, F-69372, Lyon, France

    C. Dupont

  4. Hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, F-69004, Lyon, France

    C. Dupont

Authors
  1. G. P. Gagné
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  2. A. Goubayon
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  3. C. Dupont
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Correspondence to G. P. Gagné.

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Gagné, G.P., Goubayon, A. & Dupont, C. La sécurité des soins obstétricaux, une affaire de travail d’équipe ; l’expérience canadienne du programme AMPROOB/MOREOB . Rev. med. perinat. 5, 3–11 (2013). https://doi.org/10.1007/s12611-013-0226-8

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  • DOI: https://doi.org/10.1007/s12611-013-0226-8

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