Julia Strupp1, Christina Dose2, Ulrike Kuhn3, Maren Galushko4, Anne Duesterdiek4, Nicole Ernstmann5, Holger Pfaff6,7, Christoph Ostgathe8, Raymond Voltz4,7,9,10, Heidrun Golla4. 1. Department of Palliative Medicine, Medical Faculty of the University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. julia.strupp@uk-koeln.de. 2. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany. 3. Catholic University of Applied Sciences, Cologne, Germany. 4. Department of Palliative Medicine, Medical Faculty of the University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. 5. Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany. 6. Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany. 7. Center for Health Services Research Cologne (ZVFK), Cologne, Germany. 8. Department of Palliative Medicine, Comprehensive Cancer Center CCC Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany. 9. Center for Integrated Oncology Cologne / Bonn (CIO), University Hospital, Cologne, Germany. 10. Clinical Trials Centre Cologne, University Hospital, Cologne, Germany.
Abstract
PURPOSE: Palliative care (PC) involves many health care providers leading to a high complexity of structures that requires efficient coordination as provided by case management (CM). Our study aimed to evaluate the effects of CM newly implemented in a specialised palliative care unit by evaluating team members' tasks and time resources before (T0) and after implementation (T1). It was hypothesised that team members would be able to spend less time on organisational and administrative tasks and more time on patient care. METHODS: A prospective pre-post study design was used. Time distribution of different tasks at T0 and T1 was compared between three different professional groups: physicians, nursing staff and social work. To document their tasks and time required, a documentation form with several items for each profession was developed. Data was analysed using t tests for independent samples. RESULTS: After Bonferroni correction, a significant pre-post difference was found for the time spent on "discharge interview and discharge" as rated by the physicians (p < .001) with less time spent on this activity after CM implementation. The nursing staff had significantly more time for "conversations with patients" (p < .001) after CM implementation. Moreover, they spent significantly less time on "patient-related requests/advice by telephone" (p < .001) and "discussions with relatives/participation in family discussions" at post-assessment (p < .001). The social worker had significantly more time for "patient advice and support services" (p = .013) after CM implementation. CONCLUSIONS: Integrating CM can be time efficient and ensures team members to spend more time on their core tasks in patient care.
PURPOSE: Palliative care (PC) involves many health care providers leading to a high complexity of structures that requires efficient coordination as provided by case management (CM). Our study aimed to evaluate the effects of CM newly implemented in a specialised palliative care unit by evaluating team members' tasks and time resources before (T0) and after implementation (T1). It was hypothesised that team members would be able to spend less time on organisational and administrative tasks and more time on patient care. METHODS: A prospective pre-post study design was used. Time distribution of different tasks at T0 and T1 was compared between three different professional groups: physicians, nursing staff and social work. To document their tasks and time required, a documentation form with several items for each profession was developed. Data was analysed using t tests for independent samples. RESULTS: After Bonferroni correction, a significant pre-post difference was found for the time spent on "discharge interview and discharge" as rated by the physicians (p < .001) with less time spent on this activity after CM implementation. The nursing staff had significantly more time for "conversations with patients" (p < .001) after CM implementation. Moreover, they spent significantly less time on "patient-related requests/advice by telephone" (p < .001) and "discussions with relatives/participation in family discussions" at post-assessment (p < .001). The social worker had significantly more time for "patient advice and support services" (p = .013) after CM implementation. CONCLUSIONS: Integrating CM can be time efficient and ensures team members to spend more time on their core tasks in patient care.
Entities:
Keywords:
Case management; End-of-life care; Multi-professional; Palliative care
Authors: Annicka G M van der Plas; Bregje D Onwuteaka-Philipsen; Marlies van de Watering; Wim J J Jansen; Kris C Vissers; Luc Deliens Journal: BMC Health Serv Res Date: 2012-06-18 Impact factor: 2.655
Authors: Ulrike Kuhn; Anne Düsterdiek; Maren Galushko; Christina Dose; Thomas Montag; Christoph Ostgathe; Raymond Voltz Journal: BMC Res Notes Date: 2012-11-01
Authors: Heidrun Golla; Kim Dillen; Martin Hellmich; Thomas Dojan; Solveig Ungeheuer; Petra Schmalz; Angelika Staß; Vanessa Mildenberger; Yasemin Goereci; Veronika Dunkl; Julia Strupp; Gereon R Fink; Raymond Voltz; Stephanie Stock; Oliver Cornely; Alexander Stahmann; Anne Müller; Peter Löcherbach; Lothar Burghaus; Volker Limmroth; Eckhard Bonmann; Kathrin Gerbershagen; Gereon Nelles; Thomas Joist; Judith Haas; Herbert Temmes; Clemens Warnke Journal: BMJ Open Date: 2022-01-25 Impact factor: 2.692