"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

被引：14

作者：

Schwarz, Julian ^{[1
]}

Bechdolf, Andreas ^{[2
,3
,4
,5
]}

Hirschmeier, Constance ^{[6
]}

Hochwarter, Stefan ^{[7
,8
]}

Holthoff-Detto, Vjera ^{[9
,10
]}

Muehlensiepen, Felix ^{[7
,11
]}

Richter, Christoph ^{[12
]}

Rout, Sandeep ^{[13
]}

Weinmann, Stefan ^{[14
]}

Heinze, Martin ^{[1
,7
]}

von Peter, Sebastian ^{[1
]}

机构：

[1] Immanuel Klin Rudersdorf, Hsch Klin Psychiat & Psychotherapie, Med Hsch Brandenburg, Seebad 82-83, D-15562 Rudersdorf, Germany

[2] Charite Univ Med Berlin, Kliniken Psychiat Psychotherapie & Psychosomat, Vivantes Klinikum Urban, Berlin, Germany

[3] Charite Univ Med Berlin, Akad Lehrkrankenhauser, Vivantes Klinikum Urban, Berlin, Germany

[4] Univ Klinikum Koln, Klin & Poliklin Psychiat & Psychotherapie, Cologne, Germany

[5] Univ Melbourne, Natl Ctr Excellence Youth Mental Hlth, ORYGEN, Melbourne, Vic, Australia

[6] Charite Univ Med Berlin, Klin Psychiat & Psychotherapie, Campus Charite Mitte, Berlin, Germany

[7] Zentrum Versorgungsforsch Brandenburg, Med Hsch Brandenburg, Neuruppin, Germany

[8] Norwegian Univ Sci & Technol, Trondheim, Norway

[9] St Hedwig Kliniken Berlin, Alexianer Krankenhaus Hedwigshohe, Klin Psychiat Psychotherapie & Psychosomat, Berlin, Germany

[10] Techn Univ Dresden, Klin & Poliklin Psychiat & Psychotherapie, Univ Klinikum Carl Gustav Carus, Dresden, Germany

[11] Fak Gesundheitswissensch Brandenburg, Potsdam, Germany

[12] Vivantes Klinikum Kaulsdorf, Klin Psychiat Psychotherapie & Psychosomat, Berlin, Germany

[13] Vivantes Klinikum Neukolln, Klin Psychiat Psychotherapie & Psychosomat, Berlin, Germany

[14] Rudolf Sophien Stift, Klin Psychiat Psychotherapie & Psychosomat, Stuttgart, Germany

来源：

PSYCHIATRISCHE PRAXIS | 2021年 / 48卷 / 04期

关键词：

home-treatment; crisis resolution teams; implementation science; interprofessional cooperation; organizational health services research;

D O I：

10.1055/a-1274-3662

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

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.

引用

页码：193 / 200

页数：8

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