2024-11-05 16:56:00
Developed in close consultation with professionals and the people concerned, CAP 28, the new establishment project of Vinatier – University Psychiatry Lyon Métropole, sets new strategic directions in the field of care, management and daily support for users. This is part of the continuity of the major transformations carried out within the establishment since 2019. Press release.
Between 2019 and 2023, Le Vinatier – Psychiatrie Universitaire Lyon Métropole has radically transformed its care offering, by deploying practices geared towards the recovery of the people concerned, in line with the priorities of the Rhône Territorial Mental Health Project.
These changes have resulted in a reduction in hospitalization durations in favor of the deployment of outpatient care. To support this development, case management and the mobility of caregivers in patients’ living environments have been developed, in order to deliver more intensive, flexible and individualized care.
Psychosocial rehabilitation care and psychoeducation are now part of each sequence of the course. Peer helpers have entered healthcare services, optimizing the therapeutic alliance.
New systems have been put in place to simplify access to care and identify emerging psychological disorders, with the creation of dedicated orientation platforms and Adult Reception, Assessment and Orientation Centers (CADEO) .
The emergency sector has also gained in efficiency with shorter stay times in Rhône Métropole psychiatric emergencies, rapid referral to a post-emergency system and the availability of treatment alternatives, provided in particular by mobile teams intervening at residence.
In addition to adult psychiatry, the provision of care dedicated to children and adolescents and specific systems for the elderly have also been marked by major changes.
Finally, the care offering has been expanded with new specialized systems, such as for example in addiction, perinatal care or for the management of suicidal behavior (device 3114).
The establishment now has a homogeneous, high-quality general psychiatric care offering, regardless of the patient’s place of residence.
During this same period, the participation of the people concerned – patients and caregivers – increased, with in particular the creation of a user collective, the reinforced role of peer caregivers in rehabilitation care, as well as the systematization of assistance to caregivers.
“This systemic transformation of the care offering, carried out in a short time across the entire establishment, makes our structure a laboratory for experimenting with new organizations, but also a model that can be a reference for the transformation of care psychiatrists in France”, underlines Pascal Mariotti, general director of Vinatier- Psychiatrie Universitaire Lyon Métropole.
Building on the changes already underway, the development of the new establishment project was based on a series of observations:
• The Covid crisis, among other things, has revealed the growing mental health needs of the population,
• Professionals advocate for more collaborative management, a better work/life balance and aspire to a true feeling of belonging to a collective within the hospital
• The people concerned want their experience to be better taken into account and claim a role as stakeholders in the organization of care and pathways.
An exemplary development method, focused on consultation and transversality
The CAP 28 project was built by addressing each theme according to the dual vision of patients and professionals. A large number of professionals and users were involved in this development work within the framework of seminars, co-construction workshops, field meetings, café debates, working groups: the people concerned intervened on 40% of the themes of the project. The establishment and more than 600 professionals participated in its construction.
Each axis was treated from a transversal angle, without dichotomy between a medical, nursing, social, user, quality project.
A global and transversal project
The CAP 28 guidelines cover and link together managerial fields, care practices, the participation of users, actors in their care, and the quality of care.
The priority ambitions of the establishment are structured around 6 axes:
Promote the power of action, promote proximity and participation
Vinatier intends to give voice and the power to act to the teams and people concerned, whenever possible. The establishment also wishes to promote initiative by professionals, co-construction with users, exchanges on a horizontal level and cultivate proximity with its professionals and users.
Strengthen the social and environmental sustainability of the establishment
Recognizing the strong links that unite mental health and environmental health in a global health approach (One Health), Le Vinatier intends to promote a care policy that is both respectful of the environment and makes reconnection with nature a real therapeutic tool. The establishment thus launched its strategic roadmap and distributed a charter for the promotion of global health. This will result in particular in the implementation of a plan to raise awareness and train professionals on the issues of ecological transition, and the integration of global health criteria into any new project and the collective engagement system. Vinatier will endeavor to offer ways to reconnect patients with nature, such as therapeutic gardens, animal mediation activities, or even the development of health trails in the hospital campus park.
Le Vinatier is also committed to sustainable social organization. It intends to pursue an ambitious policy of attractiveness and loyalty of its professionals which is based on well-being at work, the personal balance of its employees, and recognition of their commitment. Considering the development of the skills of its professionals as the keystone of the transformation of care practices, it will devote an unprecedented effort to it.
As such, Le Vinatier promotes medical delegation both through the development of cooperation protocols and advanced nursing practice. Cooperation protocols between doctors and caregivers which broaden the scope of intervention of caregivers, make it possible to both reduce treatment times and refocus doctors on complex and specialized activities.
The deployment of advanced practice nurses aims to better meet care needs.
Adapt practices and care pathways
Continuing what has been initiated, Le Vinatier will endeavor to amplify the development of ambulatory and inclusive care, making it possible in particular to anchor recovery-oriented care in the practices of each team.
Care must be more personalized and specialized according to the patient’s pathology. They should also be more intensive for patients with beginning disorders. Each patient must have an individualized follow-up plan.
Particular attention will be paid to optimizing the treatment of borderline personality disorders, severe psychotrauma, certain neurodevelopmental disorders (ASD/ADHD) and mental states at risk in a logic of access to the greatest number to this specialized care.
It will invest more resources in the 15-25 year transition period during which the first signs of pathologies must be identified and treated quickly.
Vinatier will also endeavor to improve the connection between its offer of local specialized psychiatric care (level 2) and expert referral care (level 3) in order to better direct patients in need towards level 3.
Finally, the objective is that each patient can access psychosocial rehabilitation and psychoeducation care at each stage of their care.
Access to care remains a major concern. A mobile SAS Psy team (LIVE) will be deployed as well as an unscheduled care system near psychiatric emergencies.
Among the main new features in the care offering, we can cite the opening of a complete level 2 addiction center including a complete hospitalization unit and a day hospital. To complete the emergency sector, a crisis and orientation unit will soon be opened. The provision of care for adolescents will be supplemented by a mobile team intervening in the living environment to prevent recourse to emergencies, better connect adolescents to care and shorten hospitalizations as much as possible.
Major real estate operations will make it possible to offer a tailor-made care environment for patients treated in the neurodevelopment unit. On an outpatient basis, a new integrated child and adolescent psychiatry platform will be built in Rillieux, to serve the population in the north of our territory.
The establishment continues to develop resource centers with a broader reach: it will constitute a national support center for caregivers co-piloted with UNAFAM, capitalizing on the BREF nugget project. To meet the growing needs of the geriatric sector, he wishes to promote a regional resource center in psychiatry for the elderly.
Innovate and promote research
Research in mental health, one of Vinatier’s areas of excellence, will continue to develop. Clinical research is expected to become more structured, particularly on emerging research subjects (new biomarkers of psychiatric pathologies, the impact of non-drug interventions such as physical activity) and research on medicines. At the same time, the establishment will structure and strengthen its institutional and scientific partnerships with the universities and research laboratories of the Lyon metropolitan area and will continue to ensure its role as pilot of psychiatric research on a regional scale.
Furthermore, Le Vinatier will continue to promote organizational, technological and digital innovation approaches, by involving professionals, users and ecosystem partners. In this context, the establishment hosts the first third place dedicated to digital innovation in psychiatry and more broadly in mental health.
Take care every day
Improving the daily lives of teams and users constitutes an area of progress in its own right. This translates into improving the reception of patients and those around them on the one hand, and the establishment of integration pathways for professionals.
The daily well-being of everyone will be improved with improvements making the premises more comfortable and friendly. Work on care environments will be undertaken gradually on all hospitalization units. Daily irritants will be subject to specific management, from their identification to their treatment.
In order to simplify administrative tasks, a new computerized patient file will be created by 2028.
Families and caregivers will also be better informed at all stages of the patient journey, particularly at pivotal moments such as discharge from hospitalization.
Finally, Vinatier is deploying a multi-year action plan to combat gender-based and sexual violence that can affect both patients and professionals.
Further assert your place
Vinatier intends to assert its place as a mental health player at national and European, and sometimes international, level. He also wishes to make his model a factor of internal cohesion around the values defended by the establishment.
• Communiqué : www.ch-le-vinatier.fr
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