Julian Schwarz1, Andreas Bechdolf2,3,4, Constance Hirschmeier5, Stefan Hochwarter6,7, Vjera Holthoff-Detto8,9, Felix Mühlensiepen6,10, Christoph Richter11, Sandeep Rout12, Stefan Weinmann13, Martin Heinze1,6, Sebastian von Peter1. 1. Hochschulklinik für Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg, Immanuel Klinik Rüdersdorf. 2. Kliniken für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Akademische Lehrkrankenhäuser der Charité - Universitätsmedizin Berlin. 3. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Köln. 4. ORYGEN, National Center of Excellence of Youth Mental Health, University of Melbourne, Melbourne, Australien. 5. Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité - Universitätsmedizin Berlin. 6. Zentrum für Versorgungsforschung Brandenburg, Medizinische Hochschule Brandenburg, Neuruppin. 7. Norwegian University of Science and Technology, Trondheim, Norwegen. 8. Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Alexianer Krankenhaus Hedwigshöhe, St. Hedwig Kliniken Berlin. 9. Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Dresden, Deutschland. 10. Fakultät für Gesundheitswissenschaften Brandenburg, Potsdam. 11. Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Kaulsdorf, Berlin. 12. Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Neukölln, Berlin. 13. Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Rudolf-Sophien-Stift, Stuttgart.
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. Thieme. All rights reserved.
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. Thieme. All rights reserved.
Authors: Sebastian von Peter; Lena Göppert; Jenny Ziegenhagen; Timo Beeker; Rosa Glück; Birte Groth; Uwe Groß; Arne Reinholdt; Robin Boerma; Matthias Heißler; Juri Habicht; Julian Schwarz Journal: Front Psychiatry Date: 2021-04-23 Impact factor: 4.157
Authors: Sebastian von Peter; Helene Krispin; Rosa Kato Glück; Jenny Ziegenhagen; Lena Göppert; Patrick Jänchen; Christine Schmid; Anne Neumann; Fabian Baum; Bettina Soltmann; Martin Heinze; Julian Schwarz; Timo Beeker; Yuriy Ignatyev Journal: Front Psychiatry Date: 2022-01-27 Impact factor: 4.157
Authors: Julian Schwarz; Yuriy Ignatyev; Fabian Baum; Anne Neumann; Bettina Soltmann; Andrea Pfennig; Jürgen Timm; Martin Heinze; Sebastian von Peter Journal: Nervenarzt Date: 2021-12-07 Impact factor: 1.297