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How are Concepts of Delegation in Family Practices Implemented?

DOI: 10.3238/zfa.2016.0402-0407

Eine Analyse am Beispiel der VERAH in der HzV

How are Concepts of Delegation in Family Practices Implemented?

An Analysis Based on VERAHs in FP-Centered Care as Example

german translation / full article

Corina Guethlin, Ferdinand Michael Gerlach, Martin Beyer

Keywords: Health Care Assistant Family Practice Family Practice Team Primary Care

An Analysis Based on VERAHs in FP-Centered Care as Example

Background: Various qualification systems for health care assistants in family practices have been developed and implemented in recent years. Since 2008, the VERAH (specially qualified health care assistant in the family practice) qualification model has received financial support within the GP-centered health care program (HzV) in the German state of Baden-Wuerttemberg. It is largely up to practices how they implement the concept. As part of a project to assess the GP-centered care, we asked VERAHs and physicians how they implemented the delegation concept in their practices and what factors enabled or hindered the process.

Methods: VERAHs and family doctors were interviewed by means of structured telephone interviews. The provided interview guideline was developed on the basis of previous assessments. The evaluation of the transcribed interviews was carried out by qualitative content analysis according to Kuckartz and using the MAXQDA11 assessment program.

Results: Interviews with 26 VERAHs (Ø 27 Min.) and 11 family doctors (Ø 16 Min.) were conducted in March/April 2015. It transpired that VERAHs were mostly employed for routine home visits, for assessing medical importance and for preparatory tasks. Within the practice team, existing human resources and the amount of time available to VERAHs were regarded as important. The implementation process was supported when these were considered to be sufficient and hindered when it was not.

Conclusions: Certain tasks are transferred to VERAHs, of which home visits are the most important. This relieves the time pressure on physicians. The majority of factors that support the implementation process can be influenced by the practice team itself. When planning innovative health-care models in the future, the role of all non-physician staff in the practice must be clearly defined if a positive result (e.g. physicians have more time for their patients) is to be achieved.


(State: 17.10.2016)

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