Kaiser Vanessa, Reese Christina, Sehlbrede Matthias, Brühmann Boris A, Farin-Glattacker Erik
Institut für Medizinische Biometrie und Statistik, Sektion Versorgungsforschung und Rehabilitationsforschung (SEVERA), Universitätsklinikum Freiburg, Freiburg, Germany.
Gesundheitswesen. 2023 Apr;85(4):305-313. doi: 10.1055/a-1806-0861. Epub 2022 May 6.
The model project "CoCare - Extended coordinated medical care in long-term care homes" (funding: Innovation Committee of the Federal Joint Committee) aspired to improve on-site medical care in nursing homes by introducing a new form of care. Participating nursing homes implemented a number of intervention elements designed to facilitate interprofessional collaboration. We surveyed nursing staff and attending physicians as part of the project's summative evaluation.
The intervention group (IG) participated in our survey once before the implementation of the intervention (T0) as well as 12 months after implementation had started (T1). The control group (CG), in which residents received usual treatment ("usual care"), completed one survey. We investigated whether IG participants rated interprofessional collaboration more positively after the intervention, and attempted to detect advantages in their assessment at T1 as compared to the CG. Additionally, we analyzed if IG participants perceived improvements in on-site medical care from T0 to T1 and to what extent they evaluated the intervention and its components as beneficial.
N=836 participants (678 nursing staff and 158 physicians) took part in the surveys. IG nursing staff demonstrated significant improvements in assessment of interprofessional collaboration from T0 to T1, while we found only partially significant improvements among IG physicians. Additionally, IG nursing staff rated interprofessional collaboration significantly better at T1 as compared to the CG. No such differences were found in the physician sample. Both nursing staff and physicians in the IG indicated significant improvements in on-site medical care after the intervention was implemented. They rated the overall intervention as overwhelmingly beneficial. Both professions found the regularly scheduled, weekly ward rounds and the appointment of fixed contact points particularly valuable.
The implementation of the "CoCare" measures can improve nursing staff's and physicians' assessments of interprofessional collaboration and on-site medical care. However, participation in the survey was limited, especially among physicians, which reduced the statistical power of calculations.
“CoCare——养老院扩展协调医疗护理”示范项目（资金来源：联邦联合委员会创新委员会）旨在通过引入一种新的护理形式来改善养老院的现场医疗护理。参与项目的养老院实施了一系列旨在促进跨专业协作的干预措施。作为该项目总结性评估的一部分，我们对护理人员和主治医生进行了调查。
干预组（IG）在干预实施前（T0）以及实施开始12个月后（T1）分别参与了一次我们的调查。对照组（CG）的居民接受常规治疗（“常规护理”），该组只完成了一次调查。我们调查了干预组参与者在干预后是否对跨专业协作给出更积极的评价，并试图找出与对照组相比，干预组在T1评估中的优势。此外，我们分析了干预组参与者从T0到T1是否察觉到现场医疗护理有所改善，以及他们在多大程度上认为该干预及其组成部分是有益的。
836名参与者（678名护理人员和158名医生）参与了调查。干预组的护理人员在从T0到T1对跨专业协作的评估上有显著改善，而我们发现干预组医生的改善仅部分显著。此外，干预组的护理人员在T1时对跨专业协作的评价明显高于对照组。在医生样本中未发现此类差异。干预组的护理人员和医生均表示干预实施后现场医疗护理有显著改善。他们认为总体干预非常有益。两个职业都认为定期的每周病房查房以及指定固定联络点特别有价值。
“CoCare”措施的实施可以改善护理人员和医生对跨专业协作及现场医疗护理的评价。然而，参与调查的人数有限，尤其是医生，这降低了计算的统计效力。
