One would have thought that the approach was common in France, at a time of pooling of all kinds. But in reality, this is rare. Among other things because no legal text truly governs it (except in the status of hospital directors, which opens the breach). However, since the middle of the month, it has been official: the hospitals of Menton, Breil and Sospel, as well as the nursing homes of Saorge and La Brigue are now sailing under the same flag. The joint direction has just been adopted – after two years of in-depth work.
Validated in June 2022
“When I arrived at the head of La Palmosa, in March 2021, we had discussions with the Regional Health Agency (ARS). The latter mentioned the difficulties encountered by establishments in the high country, particularly on the administrative level . It was about putting in place actions to help them, with the ultimate idea of a common direction.”asks Mylène Ezavin, director, to date, of the five establishments – after an interim period.
But difficult to respond to this request without delay; the desire and need to get to know each other having been clearly formulated. It was therefore decided, initially, to work on a territorial health project.
“In July 2021, a day of seminar was organized with doctors and managers of the establishments concerned. To introduce themselves and lay the foundations of the areas of work. The afternoon was devoted to an informal discussion, in order to ‘talk about what we needed and how to respond to it together’, continues Mylène Ezavin. Specifying that five major axes emerged.
The departure of Thierry Loirac, until then responsible for the Roya-Bévéra health center, will have precipitated things. Presented to trade union organizations, elected officials and the entire hospital community, the common management of the French Riviera was thus unanimously validated in June 2022. All that remained was to resolve administrative details to definitively implement it. endorse.
“Before that, we had to reassure that the hospital will remain autonomous. There is no mix-up for financial questions: the treasuries are very distinct”, slips the director. Reporting on the new organizational chart.
Stéphanie Trombetta is responsible for human resources. Marc Wendling, logistics and monitoring of support functions. Stéphane Jannes is the administrative and financial director. Candice Vanbiervliet is responsible for organizing care, in conjunction with healthcare executives. Vanessa Ratajczak is deputy director. “This is the conductor, in connection with me. I will continue to participate, to go there regularly for questions of policy and strategy”, summarizes Mylène Ezavin. Determined not to lose sight of the valleys. And to think in terms of territory.
“With this new management, we are organizing the network. To the east of the department, there are only establishments with a common management – with the exception of the Tende hospital. It is up to us to coordinate everything.”
A territorial health project broken down into five points
The main objective of the joint management is to implement the territorial health project built upstream. A project which is based on five distinct axes.
It was an observation: there were deficiencies in the high country which could have led to renunciation on the part of the inhabitants. “At the same time, private doctors reported the difficulties encountered in referring patients to specialists. We thought about what the hospital could provide. And we managed to set up, in Menton, consultations for all specialties – including imaging. says Mylène Ezavin.
Menton hospital already offers advanced consultations. Which allow, in areas where there is a shortage of specialist doctors, to organize appointments in more accessible health places – health homes, local hospitals. Teleimaging is also well used. As is tele-expertise, very useful for a professional keen to get the opinion of a colleague. But teleconsultations remain more complex to set up. “In some cases, such as diabetes, there are clinical signs that cannot be seen from a distance…”
Common social project
From the perspective of a common management, it was a question of providing professionals in the region with the same working conditions. The same career development, the same hours… A leveling that particularly concerns nurses and caregivers.
Territorial HR policy
A replacement system between establishments on the French Riviera has been designed to meet staffing needs when no solution can be found internally. Professionals thus use shared software, on which volunteer agents register. “When a mission is published, they receive it and can apply. It works very well in Breil and Sospel.”
Quality and sustainable development
At the time of discussions concerning the territorial health project, the Menton hospital was in the middle of the certification process (it has since received the THQSE gold label – Very high health, social and environmental quality). The idea therefore emerged to share the protocols with other establishments. Particularly with regard to transport, to gradually move towards a reduction in the carbon footprint. Via group appointments, for example.
“We want the next certification to be common; we would apply the standard to all establishments.”
Several concrete consequences are to be expected. For the patients, first. Because common management results in a strengthening of the healthcare offering across the entire territory. “This will be reinforced as the bond strengthens. When I recruit, I warn that you will have to be ready to go into the valleys, particularly in pulmonology. But it’s not prohibitive at all.”, says Mylène Ezavin. Slipping that a senior health executive was even recruited to be half in the hospital, half in the high country.
“This will also change in the fluidification of the hospital circuit, increasing capacities. Last week, for example, we had an influx in the emergency room in Menton, we needed beds. Result: three patients – who agreed – were hospitalized in Sospel.”
For professionals? They are given the opportunity to diversify their experience and have career development opportunities. “Nurses interested in the idea of becoming healthcare executives will not necessarily find a position in Menton. But in Breil or Sospel, yes.”