Reforming Healthcare: what can we learn from Quebec?

32 members of the board of directors of the FHP-SSR participated in an international study mission organized by Dialog Health in Montreal in October 2018. While the French Healthcare System is getting ready for structural reforms (care coordination for patients with chronic diseases, new payment methods, populational responsibility), the State of Quebec is frequently cited as an example by French leaders.

The directors of French private readaptation hospitals have therefore decided to take a step ahead by exploring the international health systems that inspire the French Ministry of Health, to understand and anticipate the trends that influence the reforms of health care delivery.

During a week of visits, delegates gained a global vision of the Quebec health system and its issues:
- The coordination of care pathways within the framework of Integrated Health and Social Services Centers, resulting from the 2015 reform that reduced the number of public health groups from 132 to 33.
- The improvement of the management of chronic diseases at the National Institute for Excellence in Health and Social Services (INESSS), whose experts identify and disseminate best practices validated internationally.
- The architectural modernization of institutions, particularly at the ultra-modern facilities of the University Hospital Center of Montreal (CHUM) and the McGill Health Center.
- The place given to the human, both in resources (rehabilitation based mainly on specialized paramedical teams, with daily durations of 3 to 5 hours of care per day) than in the organization (with a central place of volunteers at the heart of healthcare facilities).

The meetings with the leaders of the two private rehabilitation centers in Quebec (Villa Médica and Marie-Clarac Hospital) enabled the representatives of the FHP-SSR to discover their development strategy in a market dominated by a public healthcare offer. The delegates were struck by the omnipresence of management methods aimed at involving health care teams in the transformation of practices and organizations, such as the Planetree method. A webinar is planned to capitalize on the achievements of the study mission.