CONTEXT: In France, nearly 100.000 people live with a stoma. This medical procedure disrupts about 25.000 people’s lives each year. Indeed, the stoma has been created as a result of a serious pathology, most often cancer or inflammatory bowel disease. Develop a global management care of stoma patients is key to reduce the impact of physical alteration, nutritional, psychological and social consequences.

OBJECTIVES: SHIELD (Strategic Healthcare Initiative for Easier Life Days) is a unique initiative started in 2019 to optimize the management care of stoma patients through the coordination of each health actor, especially in hospital discharge and follow-up in community.

METHODS: Guidelines have been developed based on a targeted literature research and expert opinions from a national multidisciplinary expert committee representing different healthcare actors, including patient associations involved in stoma care pathway. The committee’s work followed three defined phases. First, description of the current state of patient care at each stage of the pathway. Second, identification of major hurdles at each stage of the pathway, particularly on hospital discharge and community follow-up. Finally, definition of the most important areas for improvement and recommendations for practice.

RESULTS: In total, SHIELD expert committee provides three main areas for improvement: 1. Better coordination between health care providers in hospital discharge and follow-up in community. 2. Better access to medical devices that have demonstrated a significant improvement in patients' quality of life. 3. Personalized care and follow-up in community in compliance with patients and regulations. In each area, the committee describes 14 practical recommendations.

CONCLUSIONS: These guidelines will improve the global management care of stoma patients and contribute to efficiency of healthcare system.