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Research article
Rieka von der Warth
Section of Health Care Research and Rehabilitation Research, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2445-8019
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
With increasing numbers of the elderly living in nursing homes in Germany, the need for on-site primary care increases. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. Therefore, project CoCare (“coordinated medical care”) implements a complex health intervention in nursing homes, using among others regular medical rounds, a shared patient medical record and medication checks, aiming to improve the coordination of medical care. This study reports the results of a process evaluation assessing the perceived acceptance and barriers of the project by stakeholders.
Methods
Focus group interviews were held between the fall of 2018 and the fall of 2019 with nursing staff, general practitioners and medical assistants working in or consulting a participating nursing home. A half-structured modular guideline was used to ask participants about their opinion on different aspects of CoCare. Focus groups were analyzed using qualitative content analysis.
Results
In total, N=11 focus group interviews with N= 74 participants were conducted. Ten main themes with seven subthemes were identified, encompassing all aspects of CoCare. The overall acceptance of the project was good. Participants elected to talk most often about the project modules “communication and collaboration” and “medical rounds”, with participants concluding CoCare had prevented unnecessary hospitalizations. Main barriers were understaffing and complexity of the program.
Conclusion
Implementation of CoCare in nursing homes is complex and holds some barriers. However, the overall acceptance was good and first positive results were reported by participants. Furthermore, the project provides a good structure to overcome potential barriers.
Trial Registration: German Clinical Trial Register (DRKS00012703)
Keywords
process evaluation, nursing homes, focus groups, qualitative study, coordinated medical care, elderly, primary care, complex health intervention, implementation research
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CURRENT STATUS: Published
View the published article at BMC Geriatrics.
No community comments so far
Review #2 received
Received 07 Feb, 2021
Editorial decision: Major revision
On 07 Feb, 2021
Review #1 received
Received 03 Jan, 2021
Reviewer #2 agreed
On 09 Dec, 2020
Reviewer #1 agreed
On 06 Dec, 2020
Reviewers invited
Invitations sent on 29 Nov, 2020
Editor assigned
On 17 Nov, 2020
Submission checks complete
On 17 Nov, 2020
Editor invited
On 17 Nov, 2020
Version 1
Posted 06 Aug, 2020
No comments provided
Review #1 received
Received 06 Oct, 2020
Editorial decision: Major revision
On 06 Oct, 2020
Review #2 received
Received 16 Sep, 2020
Reviewer #2 agreed
On 26 Aug, 2020
Reviewers invited
Invitations sent on 21 Aug, 2020
Reviewer #1 agreed
On 21 Aug, 2020
Editor assigned
On 03 Aug, 2020
Submission checks complete
On 02 Aug, 2020
Editor invited
On 02 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Geriatrics.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Rieka von der Warth
Section of Health Care Research and Rehabilitation Research, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2445-8019
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Geriatrics.
No community comments so far
Review #2 received
Received 07 Feb, 2021
Editorial decision: Major revision
On 07 Feb, 2021
Review #1 received
Received 03 Jan, 2021
Reviewer #2 agreed
On 09 Dec, 2020
Reviewer #1 agreed
On 06 Dec, 2020
Reviewers invited
Invitations sent on 29 Nov, 2020
Editor assigned
On 17 Nov, 2020
Submission checks complete
On 17 Nov, 2020
Editor invited
On 17 Nov, 2020
Version 1
Posted 06 Aug, 2020
No comments provided
Review #1 received
Received 06 Oct, 2020
Editorial decision: Major revision
On 06 Oct, 2020
Review #2 received
Received 16 Sep, 2020
Reviewer #2 agreed
On 26 Aug, 2020
Reviewers invited
Invitations sent on 21 Aug, 2020
Reviewer #1 agreed
On 21 Aug, 2020
Editor assigned
On 03 Aug, 2020
Submission checks complete
On 02 Aug, 2020
Editor invited
On 02 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Geriatrics.
Background
With increasing numbers of the elderly living in nursing homes in Germany, the need for on-site primary care increases. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. Therefore, project CoCare (“coordinated medical care”) implements a complex health intervention in nursing homes, using among others regular medical rounds, a shared patient medical record and medication checks, aiming to improve the coordination of medical care. This study reports the results of a process evaluation assessing the perceived acceptance and barriers of the project by stakeholders.
Methods
Focus group interviews were held between the fall of 2018 and the fall of 2019 with nursing staff, general practitioners and medical assistants working in or consulting a participating nursing home. A half-structured modular guideline was used to ask participants about their opinion on different aspects of CoCare. Focus groups were analyzed using qualitative content analysis.
Results
In total, N=11 focus group interviews with N= 74 participants were conducted. Ten main themes with seven subthemes were identified, encompassing all aspects of CoCare. The overall acceptance of the project was good. Participants elected to talk most often about the project modules “communication and collaboration” and “medical rounds”, with participants concluding CoCare had prevented unnecessary hospitalizations. Main barriers were understaffing and complexity of the program.
Conclusion
Implementation of CoCare in nursing homes is complex and holds some barriers. However, the overall acceptance was good and first positive results were reported by participants. Furthermore, the project provides a good structure to overcome potential barriers.
Trial Registration: German Clinical Trial Register (DRKS00012703)
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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