Jean-François Quaranta

Transfusion sanguine : la sécurité de la chaîne

The level of safety attained in blood transfusion now makes this a discipline better managed care activities. This was achieved both by scientific advances and policy decisions regulating and supervising the activity, as well as by the quality system, which we recall that affects the entire organizational structure, responsibilities, procedures, processes and resources in place to achieve quality management. So, an effective quality system provides a framework within which activities are established, performed in a quality-focused way and continuously monitored to improve outcomes. This system quality has to irrigate all the actors of the transfusion, just as much the establishments of blood transfusion than the health establishments.

Evaluation of Professional Practices in Transfusion Medicine: Design and Implementation of a Web-Based and Tutored ePortfolio

In order to manage a nationwide assessment program for certifying professional competence in blood transfusion throughout France, the National Institute of Blood Transfusion and the University of Nice-Sophia Antipolis developed a Web-based and tutored portfolio. The structure of this e-portfolio is based on a matrix of actions defined according to standards of practice. For each action, elements of proof are uploaded by the physician and peer reviewed by an expert before being validated. The electronic portfolio stores all the history of the actions done by users. This tracking feature generates alerts emailed to users according to a list of monitored events. After one year of design and development, the application is used in routine. Based on open-source components, we forecast integration with the CME system in blood transfusion handled by INTS.

Proposition de modélisation de la performance par le biais du management des risques : application au circuit du médicament

Sous les diverses contraintes actuelles, l’organisation des établissements de santé connaît une évolution irréversible. Elle s’inspire pour cela et cherche effectivement à se rapprocher de l’approche industrielle maintenant maîtrisée et reconnue, recentrée autour du client, de la notion de processus organisationnel et d’une cartographie des compétences. Si cela est possible, il faut cependant repenser cette approche pour tenir compte des contraintes propres des systèmes de santé et d’un certain nombre de risques propres auxmétiers mis en jeu. Enfin, le pilotage de cette organisation émergente doit lui aussi s’adapter. Il nécessite plus que jamais des indicateurs adaptés, fiables et pertinents vis-à-vis de l’autorité de tutelle. Cet article décrit et formalise un modèle de pilotage de la performance d’un système de santé crucial, le circuit du médicament hospitalier au travers du management des risques iatrogènes. Ce circuit, processus de soins transversal par excellence, mal maîtrisé aujourd’hui, sera décrit à travers une cartographie dynamique des processus selon une approche d’ingénierie des systèmes aboutissant à une cartographie des risques a priori.