[Securing the therapy management during the leave permissions for the elderly patients]

Leave permission can be granted over a limited period of hospitalisation during which the patient can return home under the responsibility of the hospital. Despite its frequency, this practice is not evaluated in terms of maintaining the security of medication. This complex process involves several actors, processes and locations. In that case, the drug iatrogenic risk is not at all negligible, especially for the elderly. Patient comprehension of medication is not always easy and must be evaluated before leaving the hospital. Therefore, a risk analysis has been initiated to ensure the medical practice's security of our geriatric hospital. Multidisciplinary working group meetings were dedicated to analyse and overcome 21 unacceptable failure modes. The establishment of traceability nurse/patient for the medication intake, information and evaluation of drug monitoring allowed the patient's medication compliance. In the meanwhile, the role of the working group on the security of the internal drug circuit in the hospital has integrated the harmonization of practices, a unique source of information and a variety of comprehensible, readable and informative materials to propose to the patients. These preventive actions have been formulated to secure, optimize and to individualize drug management during the leave permission. In the context of optimization during transit period home/hospital, this process reorganized by the working group can be integrated in a public health approach to reduce the number of preventable readmissions.