[Impact on professional practices of a care protocol implemented between usual hospital care and hospital at home]. / Impacts sur les pratiques professionnelles d’un protocole de soins mis en place entre l’hospitalisation avec hébergement et l’hospitalisation à domicile.

ABSTRACT

BACKGROUND: Implementation of a care protocol between usual hospital care and hospital at home (HAH) could improve the quality of care and decrease fragmentations of the French healthcare system. This study evaluated the impact on professional practices of a care protocol implemented between a surgery unit and hospital at home. METHODS: Twenty healthcare professionals (nurses, head nurses, physicians) from HAH and a Paris public hospital urology unit were interviewed by a public heath physician. Semistructured interviews were analyzed using the grounded theory. RESULTS: Professional practices were modified with better traceability of care, greater safety for professionals and for patients, standardization of practices and improved continuity of interventions between hospital and hospital at home. However, these changes in practices appeared to be limited to the protocol itself and indicated potential enhancement of technical aspects to the detriment of human contact. CONCLUSION: This care protocol has an encouraging impact on the quality of care. These results demonstrate the value of extending this approach to other wards to improve continuity of care between usual hospital care and hospital at home.