NOVEL
Cross-sector & integrated emergency and disposition management for the last phase of life
Background
Nursing and care for highly vulnerable older people with complex geriatric syndromes and dying patients is increasingly part of the everyday care provided in traditional nursing homes. If the state of health of nursing home residents deteriorates, this often leads to emergency service interventions or contact with the medical on-call service and subsequent hospital referral. However, hospital referrals mean a not inconsiderable interruption in continuous care. Many ambulance call-outs and hospital referrals are classified as potentially avoidable and do not correspond to the treatment wishes of those affected.
As a result, cross-sector care in a nursing home would often be more effective than transportation to an emergency room.
Aims
The aim of the project is to safeguard and ensure the implementation of the patient's wishes through the development and implementation of emergency algorithms (instructions for action) developed across professional groups, which are to be used in long-term inpatient care. The aim is to reduce the number of unnecessary and unwanted emergency service interventions and hospital admissions for residents of inpatient long-term care facilities.
The sub-goals of NOVELLE are
- Rapid detection or reliable exclusion of time-critical treatment needs in potential emergency situations and initiation of the desired measures,
- increasing patient safety, self-determination and legal certainty in emergency care in care facilities and
- increasing the safety of nursing professionals in long-term inpatient care.
This is a pilot project in which a new form of care is initially being developed and tested in the Braunschweig region so that it can then be transferred to other care regions if the evaluation is positive.
Methods
NOVELLE is a longitudinal intervention study with qualitative structural and process evaluation as well as quantitative outcome evaluation with a control group.
The research project is divided into 7 work packages:
- Identification of legal and ethical issues
- Inventory of the current situation in the nursing homes of the city of Braunschweig regarding status and processes
- Formation of an interdisciplinary and cross-professional working group to identify and prioritize the relevant emergency situations in care facilities
- Development of emergency algorithms for the identified medical emergency situations, taking into account the patient's wishes
- Development of training concepts, training of selected multipliers and preparation for implementation
- Implementation of the emergency algorithms in the intervention group
- Testing of the emergency algorithms over a one-year period
Latest news
January - July 2021: Development of recommendations for action
We are currently starting to develop recommendations for action in working groups. These recommendations for action will be aimed at nursing staff, take into account their perception of emergencies and offer practical support for dealing with emergencies.
If you are interested in participating in the working group, please get in touch at any time!
May 2020: Identification of emergency scenarios completed
In 2020, multi-professional group discussions were held with nursing staff, physicians and emergency services staff in Braunschweig. Relevant emergency scenarios in care facilities were identified, which are to be addressed as part of the recommendations for action to be developed.
We would like to thank all participants for their commitment!
Cooperation partner
NOVELLE is a joint project under the consortium leadership of Ostfalia University of Applied Sciences - Braunschweig/Wolfenbüttel University of Applied Sciences - Faculty of Healthcare.
Further cooperation partners are: AOK Lower Saxony, aQua - Institute for Applied Quality Promotion and Research in Health Care GmbH, German University of Administrative Sciences Speyer, Chair of Social Law and Administrative Science, Peter L. Reichertz Institute for Medical Informatics (PLRI) Braunschweig, Ruprecht-Karls University Heidelberg - Institute for History and Ethics of Medicine, City of Braunschweig, University Hospital Jena - Institute for General Medicine.
Funding
The project is funded by the Innovation Fund of the Joint Federal Committee for the area of new forms of care (funding reference: 01NVF18007).
The funding period runs from 01.08.2019 to 31.01.2023.
NOVELLE - Contact at the Hannover site
Contact person:
Dr. Sven Schwabe (Project Manager)
- E-mail: schwabe.sven@mh-hannover.de
Address
Hannover Medical School
Institute ofGeneral Medicine and Palliative Medicine
Carl-Neuberg-Strasse 1
30625 Hanover