title: [Organisational diagnosis of a home care-coordinating unit in oncology: which choices for the comprehensive cancer center of Lyon?].
abstract: Lyon comprehensive cancer center developed a home care-coordinating unit (HCCU) allowing a wide range of cancer care at home. We present the results of an organisational and strategical analysis of the unit, in relation with internal and external contexts. We describe the functioning of the unit, modelled from the daily follow-up of professionnels. Patient discharge is initiated by the oncologist at the inpatient clinic, at the day-hospital or at outpatient visit. After consent of the patient and relatives, the HCCU (nurses and medical oncologists) evaluates patient's needs, organises hospital discharge (contacts with community nurses and general practitioner, supply of medical appliances and drugs), and provides follow-up and counselling to patient and caregivers. The HCCU works in a challenging environment, with both partners and competitors. Within the hospital, it collaborates with all other units. Outside the hospital, partners are, besides patients themselves; general practitioners and community nurses home care agencies and network services, private medical appliance providers, and public health authorities. The unit might evolve towards formal home hospitalisation or community-hospital network. Collaboration of both structure closely associated with hospital could allow to provide continuous and graduated care by the same caregivers even if administrative structures change.
authors.affiliation: Coordination des Soins à Domicile (CSAD), Centre Léon-Bérard, 28, rue Laennec, 69373 Lyon Cedex 8. chvetzoff@lyon.fnclcc.fr
authors.forename: Gisèle
authors.initials: G
authors.lastname: Chvetzoff
authors.forename: Roland
authors.initials: R
authors.lastname: Chvetzoff
authors.forename: Yves
authors.initials: Y
authors.lastname: Devaux
authors.forename: A
authors.initials: A
authors.lastname: Teil
authors.forename: J
authors.initials: J
authors.lastname: Chalencon
authors.forename: L
authors.initials: L
authors.lastname: Lancry
authors.forename: V
authors.initials: V
authors.lastname: Kante
authors.forename: C
authors.initials: C
authors.lastname: Poncelas
authors.forename: P
authors.initials: P
authors.lastname: Sontag
authors.forename: C
authors.initials: C
authors.lastname: Tretiakoff
authors.forename: T
authors.initials: T
authors.lastname: Philip
mesh_terms: D019058:Community Networks / Q000458:organization & administration / Q000706:statistics & numerical data; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D010346:Patient Care Management / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D010351:Patient Discharge