PowerPointPrsentation

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Description
description

• Social Health Insurance of Styria
• approx. 835.000 insured
• approx. 1.079 m expenses in the year 2003
• 267 m medical services
• 288 m hospitalisation
• 261 m medication and disability aids

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Description
description

• Social Health Insurance of Styria
• access to certain benefits is only possible, when
  a prior approval was given by a Chief Medical
  Officer

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Description
description

• Social Health Insurance of Styria
• delivery of disability aids, other medical
  devices, nutritional products and incontinence
  needs directly to patients
• time of delivery48 hours from the time of
  ordering

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Description
description

• Social Health Insurance of Styria
• case management for
• stoma patients
• incontinent patients
• patients withchronic wounds

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Description
description

• Hartberg
• a Styrian district
• population 67.778

Styria 1,183.303 inhabitants
from 2001 statistics
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Description
description

• Hartberg
• district main town
• population 6.547

from 2001 statistics
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Description
description

• medical care
• 33 general practitioners
• 32 specialists
• 16 dentists
• 3 internists
• 3 gynaecologists
• 2 paediatrics
• 2 ophthalmologists
• 1 radiologists
• 1 dermatologists
• 1 otorhinolaryngologist
• 1 pneumotologists
• 1 orthopaedic specialist
• 1 neurologist

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Description
description

• Regional Hospital Hartberg
• Marien Hospital Vorau

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Description
description

• Hospital Hartberg
• 207  beds
• departments with beds
• surgery
• internal medicine
• gynaecology and maternity
• intensive care
• anaesthetic
• internal medicine
• medical director Prim. Dr. Manfred Resch chief
  nursing officer Pfl.-Dir. Brigitte Hahn
  administration director Bdir. Klaus Dietrich

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Description
description

• Hospital Vorau
• 134  beds
• departments with beds
• surgery
• internal medicine
• intensive care
• anaesthetic
• medical director Prim. MR.Dr.J. Wutte chief
  nursing officer Pfl.-Dir.Oberin Sr.M.Schuh
• administration director Sr.Dipl.KH-Bw.A.Schaffler

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Project
project
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Project

• target groups
• severely ill patientsneeding extensive care
  after being dischargedfrom the hospital

project
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Project

• aimon discharge
• all the necessary items required to nurse the
  patients at home have to be organised
• no waiting time for the patients in regards to
• allowance for medication
• disability aids and other medical devices
• pain therapy pump (CADD-pump), oxygen
• incontinence needs, dressing etc.
• satisfied and informed patients and relatives

project
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Project
project
organisations involved
Styrian state government
operating project team general practioners home
nursing care hospital doctorshospital
nurses StGKK
Styrian Hospitals Authority Ltd.
Styrian Medical Council
Styrian Red Cross
hospital Hartberg doctors nurses
hospital Vorau doctors nurses
A
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Project

• methods of analysis
• interviews with patients (identification of
  actual standard and evaluation)
• interviews with general practitioners and
• hospital doctors in Hartberg and Vorau
• recording the actual stage of process
• admission and
• discharge
• project team workshops

project
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Project

• Care Coordinator
• employee of the Social Health Insurance
• makes visits at the hospital
• coordinates the needs of the patients
• does not take over the work of the staff involved
  in the discharge procedure

project
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Project

• Care Coordinator
• case management of the Social Health Insurances
  services
• provides information about other services

project
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Project

GP
project
patient
intramural
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Project

GP
project
patient
intramural
SocialSHI PI
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Project

SocialSHI PI
GP
project
intramural
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CC Job Description

• Principal solutions - Care Coordinator
• is integrated to minimize obvious deficiencies
  such as
• insufficient management of individual situation
• insufficient support of patients / relatives
• partly badly organised service structure and
  costs
• a delayed or incoordinated introduction of care
  and benefits
• differences in services offered by various Social
  Health Insurances

CCjob description
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CC Job Description

• Care Coordinator
• ?makes visits at the hospital twice a week
• all departments with beds
• ? attends to the insured of all Social
  Health Insurances
• ? contacts patient (relations) during
  his/her stay in hospital

CCjob description
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CC Job Description

• Care Coordinator

• discharge check list

CCjob description
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CC Job Description

• Care Coordinator

• disability aids, other medical devices
• allowance for medication
• management of the application for rehabilitation
• advice to patients and relatives
• application for nursing allowance
• information about home nursing care and home help
• information about claim for benefits (S.H.I.)

• discharge check list

CCjob description
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CC Job Description

• Care Coordinator

• maintains contact with the nursing team (social
  worker)
• information for the general practitioner (fax)

CCjob description
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CCjob description
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CC Job Description
Figure 2003 discharge from Hospital Hartberg
9.677 attended cases 400
project
CCjob description
Implementation
results
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Implementation
KH Vorau
KH Vorau
KH Schladming
implementation
hospitals already served by CC
expansion until end of 2004
expansion until end of 2005
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Implementation

• Care Coordinator
• job specification
• standardized training
• service range of Social Health Insurance
• application procedure for grant
• disability aids and medical devices
• dressing
• incontinent needs etc.
• standardized introduction process of CC

implementation
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Implementation

• standardized introduction process of CC

• HospitalInformation about the Care Coordinator
  and the relevant check lists given to doctors and
  nurses
• general practitionerswritten information and if
  necessary a presentation from CC / StGKK

implementation
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Implementation

• standardized introduction process of CC

• Social servicesinformation from CC / StGKK
• Nomination of the main teamthe participants
  will be announced by the groups involved

implementation
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Implementation

• standardized introduction process of CC

implementation
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Results

• benefit for patients and relatives
• a competent contact person
• no discontinuity of therapy due to the timely
  delivery of the required products
• information and assistance regarding the
  application for extramural services, selfhelp
  groups ...
• through personal communication with CC fear and
  uncertainty before discharge can be minimized
• positive effect on the recovery process as a
  result of an improved communication between all
  parties involved in the discharge process

results
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Results

• benefit for hospital doctors and nurses
• relief for the nursing staff
• numerous telephone calls not necessary any more
• transparence
• which services are paid
• under what conditions
• motivation boost
• report of the recovery process

results
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Results

• benefit for GPs and home nursing care
• timely information about
• the discharge
• the completed applications
• the introduced therapy or management
• better informed patients / relatives
• time saving
• more patients claim professional help due to
  information about nursing allowance

results
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Results

• benefit for the Social Health Insurance
• realise the weak points with regards to internal
  transaction and work processes within Social
  Health Insurance
• introduce improvements
• gain time so that the necessary products can be
  supplied by the contract partners in time for
  discharge

results
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Results

• benefit for the Social Health Insurance
• valid applications and prescriptions mean fewer
  inquiries
• fewer applications of non-available benefits
  mean fewer rejections
• earlier rehabilitation means better treatment
  quality and (possibily) lower consequential costs
• a friendly customer service means better
  information about Social Health Insurance and a
  better image of Social Health Insurance

results
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Results

• We thank you for your attention.
• Dr.Harald Klier Ewald Gspurning

results