The start of the new school year has changed nothing for the emergency services, which remain in difficulty faced with the influx of patients to the point that in Ardèche, the Annonay hospital had to close direct access to the service at night for the whole the month of September. Everywhere, it is still recommended to first call 15 before going to the emergency room. The Montélimar hospital may have found the solution: redirect non-urgent patients thanks to slots freed up by city doctors. The head of emergencies, doctor Sylvain Trichard, was our guest this Tuesday morning on France Bleu Drôme Ardèche.
How does the collaboration with general practitioners work?
Doctor Trichard: Since mid-August and since the reforms proposed for the emergency services, we have collaborated with the general practitioners in our area of activity. There are about 90 general practitioners. We asked them to book us two consultation slots per week for each of them through a shared schedule. When patients are received in the emergency room and they are assessed by the reception nurse -in collaboration with the doctor if necessary-, that their reason for consultation does not require hospital resources but rather that they are in a course of general medicine care, they can be assigned a general medicine appointment directly. This helps to relieve hospital activity in the emergency room and to correctly direct these patients who actually need to see a general practitioner. The appointment is then within 24 to 48 hours.
Is it suitable for general practitioners?
Doctor Trichard: Actually, yes. It is a formula that is being tested. The project has been authorized by the ARS [Agence régionale de santé]. And the GPs were very much in favor of this formula. For those who are currently taking part in the project, they gave us these famous appointments during the week, there was no reluctance, there is a great collaboration.
Has this new formula changed emergency room life?
Doctor Trichard: The systematic call to 15 is a good thing, it’s a good start, but it’s not enough and it didn’t have much effect. On the other hand, this reorientation system put in place from mid-August is very encouraging. We have interim analyses. We can’t wait until the end of September to have the final figures. But actually, it’s a device that looks effective and we really want it to be sustainable over time.
Has this freed up time for the staff working in the Montélimar emergency room?
Doctor Trichard: Obviously, the staff is under pressure, this is nothing new. Medical staffing is difficult, and that’s nothing new either. It didn’t give us extra staff. However, It helps a lot to reduce the load. since these are patients who will not be admitted to the emergency room but who will be redirected to a general practitioner. Instead of telling them “no you don’t take care of emergencies, you can leave the service”the idea is not to leave patients in nature but that there is support with this possibility of giving them a general medicine appointment quickly.
And the patients, what do they say?
Doctor Trichard: This was one of my big questions when setting up this system, the problem of tension that it could create or even the risk of incivility in the emergency room. And in the end, it’s going pretty well. Patients who arrive with a specific complaint are assessed at reception. Things are explained to them, that there are no emergency criteria, that their treatment can be slightly delayed, but delayed by 24 or 48 hours, that’s fast. And in fact, people understand it very well. In fact, what they needed was to be reassured by nursing staff regarding their grounds for appeal, which were not serious. On the other hand, they had to see a doctor and by managing to find them an appointment for general medicine, things went well and peacefully.