aurora mediterranea
Patient commitment at the heart of our strategy
AURORES "Accueil Universitarisé pour la Réadaptation, l'Orientation et la Réinsertion d'Établissement de Santé" was designed, not "by" and "for" the patient, but "with" the patient. " AURORES is first and foremost a synonym for the word 'future', the very principle of rehabilitation," says Ster Santé group director Mark Krugler.
Located in Saint Clément de Rivière, ten minutes from the Montpellier University Hospital and adjacent to the Ster Saint Clément de Rivière clinic, AURORES Méditerranée was born of the desire of a public and a private establishment to work together to meet the rehabilitation needs of the local population. The new center, which opened in 2023, offers three different types of care: oncology, nutrition-obesity and polypathology for the elderly.
Health partnerships: one of the pillars of project design
" AURORES is the fruit of a rather extraordinary public-private cooperation between Montpellier University Hospital and Dr Ster's clinics. From an organizational point of view, getting public and private establishments to work together can be a challenge for some. For us, it was a real opportunity, because we have a common vision and shared strategic orientations. What was interesting about the notion of cooperation was that we systematically worked on a patient-professional-establishment triptych, which reflects the chapters in the certification manual ".
The project design team included patient representatives from both establishments. An initial cooperative effort with healthcare managers enabled the CHU patients to be audited, on the basis of the HAS"patient-tracker" grids. The team collected information on all aspects of a typical patient stay. This was the first design phase of the project, the immersion phase.
" We realized that systematically, even if we approached it with our own profession or culture, our aim was to create the conditions for a facility that was relevant to the patient, so we worked on the patient pathway. We were very quickly supported by the Centre Opérationnel du Partenariat en Santé (COPS), which proposed a project methodology that was very different from what we had been used to up to now.
Group time to build the project
Implementation of the project lasted three years, from 2019 to 2022, with the setting up of working groups by pathology. Three workshops per pathway were co-facilitated by patients, caregivers and patient partners, and support functions were systematically integrated. This was the second phase of the project's co-construction, the ideation phase.
" Our working groups have taken shape through what we call hackathons. These are days away from the school during which we work on a subject using playful tools such as drawings, post-it notes or manipulating objects. We had two hackathons. The first focused on the patient journey and the second on the question of professional posture. Patients were able to express their feelings, as were professionals. The difficulties they could encounter in the exchange of information, in the relationship between caregiver and patient ".
Towards co-construction between caregiver and patient
All the ingredients were there to make this project a success: motivated and convinced governance, mobilized user representatives and a culture of dialogue and trust. " Without medical cooperation and the trust of those involved, dialogue would have been complicated. The fact that doctors were willing to open up a certain number of discussions in front of patients was quite something. We had to open up our chakras in a totally transparent way. In my opinion, it's this transparency that has given this new establishment its specific identity.
To establish the framework for working together, the patient-professional-establishment trio worked on the internal regulations. " It's like a marriage contract. It also enabled us to envisage situations that could potentially go wrong before and after the opening. At every meeting, we had a referent from the Montpellier University Hospital.
But the leitmotiv of the project is the shared medical and social time that the project team wanted to put in place. " Patients told us about the problem of compartmentalization between short and medium stay. We said to ourselves: why not keep the same person who would follow the patient from the moment he or she enters the Montpellier CHU until he or she returns home? So the doctor who receives the patient at the CHU shares medical time with him/her, and tries to monitor the patient throughout his/her stay. The ambition goes even further, since the aim is to continue monitoring the patient when he or she returns home, to avoid a break in support. That's really our guiding principle .
A new management model designed with patients in mind
In addition to creating a favorable ecosystem around employment and a new way of looking at healthcare, AURORES is innovating with an atypical managerial system, by creating the patient recruiter. " In the recruiters' group, there's someone from the HR department, the healthcare manager and a patient representative. This allows us to start thinking with the future professional right away, by saying: this is how we work at Aurores. But the important message to get across is that the patient should have his or her say on the professional posture, on how to approach a care situation, on the question of rhythms and involvement. I think it's a good idea to involve patients in this first phase of meeting future professionals, a time for ideation, as we call it.
A partnership has been set up with Montpellier Business School, which has launched a research program on the notion of partnership in healthcare and new modes of organization. They will monitor AURORES Méditerranée until 2025. " This outside organization also enables us to identify opportunities and potential difficulties. We don't yet have a great deal of experience with this building, so we'll know in one or two years whether this project is relevant and effective. We have high hopes and ambitions for the future!