gms | German Medical Science

19. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

30.09. - 01.10.2020, digital

Implementation of nursing-led Care Management in Austria – a qualitative analysis

Meeting Abstract

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  • Alessandra Gessl - Institut für Pflegewissenschaft, UMIT – Private Universität für Gesundheitswissensch., med. Informatik und Technik Ges.mbH, Hall in Tirol, Österreich
  • Angela Flörl - Institut für Pflegewissenschaft, UMIT – Private Universität für Gesundheitswissensch., med. Informatik und Technik Ges.mbH, Hall in Tirol, Österreich
  • Eva Schulc - Institut für Pflegewissenschaft, UMIT – Private Universität für Gesundheitswissensch., med. Informatik und Technik Ges.mbH, Hall in Tirol, Österreich

19. Deutscher Kongress für Versorgungsforschung (DKVF). sine loco [digital], 30.09.-01.10.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. Doc20dkvf106

doi: 10.3205/20dkvf106, urn:nbn:de:0183-20dkvf1061

Veröffentlicht: 25. September 2020

© 2020 Gessl et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background: Nursing-led Case Management (CsM), an individualized case approach, and Care Management (CrM), an overarching network approach, are part of a two-pronged integrated care strategy [1]. It has the potential to increase access to health and social services and improve outcomes of clients, especially those with complex care needs [2]. In 2018, a collaboration between the Tyrolean government and research institutions implemented the first CrM initiative in Tyrol, tasked with piloting, expanding and strengthening mobile CsM services, supporting local mobile care providers on cases with complex care needs, and reporting care shortages to governmental bodies.

Research question & aim: The study’s objective was to conduct an analysis of current CsM services, the commitment of local mobile care providers towards utilizing the CrM services, and implementation of CrM in the pilot region. Thefore the research question was defined as: What are the demands for and barriers to the implementation of CsM in mobile nursing and community care providers and a local CrM service in the region?

Method: Semi-structured guideline-based interviews (n=28) were conducted with experts from five local mobile and community care providers, Care Managers, and discharge managers of the local hospital. Data was collected from August to September 2019.

Results: Researchers identified five factors that influence the demand and implementation of CsM & CrM. Results showed an increased need for CsM & CrM services due to factors such as supply-induced demand and increased social-care complexity due to client behavior, the fragmented care environment and changing care practices within families. Mobile care nurses spoke to dealing with social, financial and legal tasks in addition to their primary nursing duty and feeling overwhelmed by the complexity and time-intensity of cases. It became evident that local providers will have to adapt their care approach from fragmented, solitary care provision towards coordination of care across multiple providers.

Discussion: Due to fragmented services and a shift towards outpatient care, Tyrol is looking to Case and Care Management (CCM) to support those with complex care needs residing in their own homes. There is a lack of locally-embedded CsM in mobile care providers and a lack of systemic CrM at the regional level. CCM services have the potential to reach a larger target population than traditional mobile care services in the area; however, a significant change in practice and thinking must take place within the organizations.

Practical Implications: Based on the results of the piloting, the Tyrolean government decided to expand the CrM Modell to all nine regions by 2022. The results show, that CCM can provide the necessary support for mobile organizations and other healthcare providers, especially when it comes to complex care that spills over the boundaries of an institution’s primary mission or expertise.


References

1.
Österreichische Gesellschaft für Care und Case Management – ÖGCC. Grundlagenpapier. 2016.
2.
Baxter S, Johnson M, Chambers D, Sutton A, Goyder E, Booth A. The effects of integrated care: a systematic review of UK and international evidence. BMC Health Serv Res. 2018 May;18(1):350. DOI: 10.1186/s12913-018-3161-3 Externer Link