Schwarz, Julian, Bechdolf, Andreas, Hirschmeier, Constance, Hochwarter, Stefan, Holthoff-Detto, Vjera, Muhlensiepen, Felix, Richter, Christoph, Rout, Sandeep, Weinmann, Stefan, Heinze, Martin and von Peter, Sebastian . I Indeed Consider it to be a Temporary Solution - A Qualitative Analysis of the Conditions and Obstacles to Implementation of Psychiatric Home-Treatment in Berlin and Brandenburg. Psychiatr. Prax.. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-0876

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Abstract

Zusammenfassung Ziel Untersucht werden die Bedingungen und Hurden der Einfuhrung von Stationsaquivalenter Behandlung nach 115d SGB V (StaB). Methode Qualitative Analyse von Interviews und Fokusgruppen mit Mitarbeitenden (n=43) an 11 psychiatrischen Kliniken in Berlin/Brandenburg. Ergebnisse Auf Systemebene wird die Implementierung u.a. durch eine inadaquate Leistungsdefinition, fehlende Vorgaben auf Landesebene, Personalmangel und MDK-Prufungen erschwert. Dies fuhrt bei Kliniken zu zuruckhaltender Umsetzung mit teilweise unzureichender personeller Ausstattung der StaB-Teams. Weitere Barrieren betreffen das Fehlen mobiler Losungen zur Dokumentation und Teamkommunikation. Auf Ebene der Mitarbeitenden wirken sich ein Mangel an Information und Kooperation sowie unklare Aufgaben und Rollen hinderlich aus. Schlussfolgerungen Fur eine bedurfnisorientierte, flexible und flachendeckende Einfuhrung von StaB sind Nachbesserungen an den Rahmenbedingungen sowie weitere Forschung zur Wirksamkeit und Implementierung notwendig. Abstract Objective The obstacles to implementation of a German variation of psychiatric Home-Treatment (HT), called Inpatient Equivalent Home-Treatment (IEHT) are examined. Method 43 employees from 11 psychiatric hospitals in the federal states of Berlin and Brandenburg were questioned using interviews and focus groups. A thematic analysis was conducted using the socio-institutional theoretical model. Results At system-level, implementation is hampered by an inadequate service definition, staff shortages, as well as performance assessments by health insurances. This leads to reluctant implementation at hospital-level with insufficient staffing of the teams. Other barriers include a lack of mobile devices for documentation and team communication. At the level of employees, poor information, and cooperation as well as unclear assignment of tasks are impeding factors. Conclusion For a more needs-oriented, flexible, and nationwide introduction of HT according to IEHT, improvements to the underlying framework conditions and further research addressing efficacy, effectiveness and implementation are necessary.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Schwarz, JulianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bechdolf, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hirschmeier, ConstanceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hochwarter, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holthoff-Detto, VjeraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muhlensiepen, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Richter, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rout, SandeepUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weinmann, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heinze, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Peter, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-308254
DOI: 10.1055/a-1274-3662
Journal or Publication Title: Psychiatr. Prax.
Publisher: GEORG THIEME VERLAG KG
Place of Publication: STUTTGART
ISSN: 1439-0876
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
PsychiatryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/30825

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