Greifswald (Germany), July 18th, 2017. The research project “Supporting elderly people with cognitive impairment during and after hospital stays – Intersectoral Care Management“ headed by the Rostock/Greifswald Site of the German Center for Neurodegenerative Diseases (DZNE) will be funded by the support initiative “Stay healthy for a lifetime” of the Federal Ministry of Education and Research (BMBF) with 1.7 million euros. Researchers of DZNE Site Rostock/ Greifswald, University Medicine Greifswald, University Medicine Jena, University Medicine Düsseldorf, and evangelical hospital Bethel will develop and test a collaborative care management for people with cognitive impairment to improve treatment and care across the in-hospital and primary care sector.
DZNE heads research project on support for people with dementia
In emergency hospitals, more than 40 per cent of patients aged 65 and older show cognitive impairments that may cause problems during their hospital stay. “People with Dementia often feel disoriented and fearful due to the new setting in an emergency hospital and thus, it might worsen their cognitive impairments during their hospital stay: Therefore, the likelihood of hospital readmission and institutionalization is reinforced,” explains the project manager, PD Dr. René Thyrian, DZNE Site Rostock/Greifswald.
A major challenge of the German health care system is the sectorisation with health service providers offering a) outpatient treatment and care, b) inpatient treatment and care or c) rehabilitation. While treatment and care within these sectors can be considered to be of high quality, there is a lack of widely available approaches to deliver treatment and care across sectors.
Treatment paths for people with chronic diseases or the requirements of elderly people suffering from multimorbidity need frequent transitions between sectors. “However, in Germany boundaries of sectors are considered rigid and transitions between sectors are a threat to treatment continuity, which results in inefficient treatment, high expenses and dissatisfaction of patients and health providers,” says Dr. Stefan Kreisel from evangelical hospital Bethel.
The main goal of this project is to develop a comprehensive discharge management to overcome the challenges caused by the sectored German health care system. “The project focusses on the interface of the in-hospital and primary care sector of people with cognitive impairments as one of the most common medical conditions in the elderly,” emphasizes PD Dr. René Thyrian.
The basis of comprehensive discharge management is the dementia care management (DCM) concept that was developed and efficiently tested in the “DelpHi-MV trial”. DCM aims to provide optimum care by integrating multi-professional and multimodal strategies to individualize and optimize treatment and care. The comprehensive discharge management will be conducted by nurses with dementia-specific training. Based on a comprehensive assessment of the treatment and care situation, a treatment and care plan is developed tailored to the individual conditions, implemented and monitored by the specific trained nurses. They employ a computerized Intervention-Management-System (IMS) that is a rule-based expert decision support system that matches individual patient characteristics to a computerized knowledge base. “The IMS has proven to be beneficial to the delivery of the intervention in terms of improving the systematic identification of unmet needs and improving their subsequent and systematic addressing” explains Prof. Dr. Wolfgang Hoffmann, site speaker of DZNE Site Rostock/Greifswald.
The research partners, Dr. Adina Dreier-Wolfgramm from the University Medicine Greifswald and Prof. Dr. Horst Christian Vollmar from University Medicine Jena will conduct a a 360°-evaluation with all relevant stakeholders and patients of the trial to identify facilitators and barriers for implementation in routine care.
Prof. Wolfgang Hoffmann emphasized that the BMBF funding is an honor and recognition of health care research at the DZNE. “By successfully conducting the DelpHi-MV trial and the DemNet-D project, which was funded by the Federal Ministry of Health, the DZNE provides an important contribution to optimize care and treatment of people with dementia in primary care. The project Intersec-CM will enhance these concepts in the new setting of emergency hospitals.”
The project will start in August 2017.