Table 5 Data collection in the process domain “context”
Process domain indicator | Topics | Data sources | N (planned number of persons per data collection) | Data collection methods (number of planned data collections where applicable) | Operationalisation/ Parameters | Data type | |
|---|---|---|---|---|---|---|---|
Quant | Qual | ||||||
a. Macro level | German health care system | Ministry of Health, Federal and State Offices of Statistics | n.a | File review | Basic structure of the German health care system | descriptive | |
Legal framework | Legislation relating to primary care and the practice of the nursing profession | n.a | File review | Summary of key features and legislation surrounding nursing practice and health care - Nursing care - Primary care - Delegation - Ambulatory care | descriptive | ||
Geographical conditions | Federal Statistical Office and Statistical Office of Rhineland-Palatinate | n.a | File review | Geographical conditions and unique features of the catchment area | descriptive | ||
Structural context | Federal Statistical Office and Statistical Office of Rhineland-Palatinate Ministry of Social Affairs, Labour, Health and Demography of Rhineland-Palatinate Association of Statutory Health Insurance Physicians Nursing Council | n.a | File review | Health care and health educational structures in Rhineland-Palatinate - Characteristics of hospitals, nursing homes, medical practices and ambulatory care services - Number of nursing/medical degree programmes; number of vocational nursing schools - Number of practicing nurses and GP | descriptive | ||
Relevant literature | n.a | Literature review | Potential fit of new care models into existing structures incl. best-practice examples, barriers and facilitators | descriptive | |||
Principal investigator | 1 | Interviews (2) | Potential fit of the HandinHand care model into existing health care structures, barriers and facilitators | ✓ | |||
EN team leader | 2 | Interviews (3) | ✓ | ||||
ENs | 10 | Interviews (3) | ✓ | ||||
GPs | All GPs | Interviews (2) | ✓ | ||||
PTHV | 2 | Interviews (2) | ✓ | ||||
Health insurance | 2 | Interviews (2) | ✓ | ||||
Other health care professionals from other health care services involved in HiH patient care | 5 | Interviews (2) | ✓ | ||||
EN team leader | 1 | Questionnaires (3) | Characteristics of the catchment area | ✓ | |||
Interprofessional culture | Relevant literature | n.a | Literature review | Summary of the main features that influence cooperation between GPs and nurses in general | descriptive | ||
Narratives | n.a | E-Mail correspondence, annual reports, case studies | descriptive | ||||
Other health care professionals from other health care services involved in HiH patient care | 5 | Interviews (2) | Perception of interprofessional cooperation in primary care | ✓ | |||
b. Meso level | EN Centre | EN team leader | 1 2 | Questionnaires (3), interviews (3) | Description of equipment, staffing and structure of the ENC | ✓ | ✓ |
Setting | EN | 10 | Interviews (3) | Description of features unique to settings (patients home rather than nursing homes) | ✓ | ||
Narratives | n.a | E-Mail correspondence, annual reports, case studies | Description of features unique to settings/region (patients home rather than hospitals) | descriptive | |||
Relevant literature | n.a | Literature review | Description of features unique to settings/region (patients home rather than hospitals) | descriptive | |||
GP/specialist practice | GPs | All GPs | Questionnaires (3) | Characteristics of participating medical practices - number of patients at each practice - staffing and skill mix | ✓ | ||
Association of Statutory Health Insurance Physicians Federal and State Offices of Statistics | n.a | File review | Current main challenges for GP practices - Shortage of GPs - Demographic developments - Ageing society with increasingly complex care needs | descriptive | |||
Relevant literature | n.a | Literature review | Strategies for dealing with the challenges of an ageing society, implications for GPs and care provision | descriptive | |||
Hospital | Federal Statistical Office and Statistical Office of Rhineland-Palatinate; Ministry of Social Affairs, Labour, Health and Demography of Rhineland-Palatinate; Other relevant data sources | n.a | File review | Number of hospitalisations, re-hospitalisations and potentially avoidable hospitalisations with regard to people with chronical diseases Discharge management | descriptive | ||
Community-based support services | EN team leader | 1 | Questionnaires (1) | Type and availability of community-based support services (e.g. hospice care, meals on wheels, support groups) | ✓ | ||
Allied health services | EN team leader | 1 | Questionnaires (1) | Type and availability of allied health services | ✓ | ||
PTHV | Course manual | n.a | Document review | Degree programme overview - degree structure - content of papers | descriptive | ||
Paper coordinators | 2 | Interviews (2) | Perspective of the PTHV with regard to - role development of nurses in general and in context of the project in particular the establishment of the ENC in particular and the HiH intervention in general Extend to which degree personnel supports role development (e.g. clinical reflection, supervision, exemplar writing) | ✓ | |||
Health insurances | Health insurance representatives | 2 | Interviews (2) | Motivation for participation and perspectives on innovative care models with regard to primary care structures in general and the project intervention particular | ✓ | ||
Federal Joint Committee/ Narratives | n.a | Database search/E-mail correspondence with professional networks | Overview of other innovative projects addressing health care restructure in primary care funded by the Ministry of Health | descriptive | |||
c. Micro level | Patients | Relevant literature | n.a | Literature review | Description of - expectations for health care in general - attitudes and expectations of health care by GPs compared to health care provided by nurses | descriptive | |
Relatives | Relevant literature | n.a | Literature review | Description of - patient/caregiver dyad - needs for support services for informal caregivers - attitudes and expectations of health care by GPs compared to health care provided by nurses | descriptive | ||
ENs | ENs | 10 | Interviews (1), questionnaires (1) | Characteristics of EN -professional experience Description of attitudes and expectations of the project/position | ✓ | ✓ | |
Job description | n.a | Document review | Description of formal requirements | descriptive | |||
EN team leader | EN team leader | 2 | Interviews (2) | Attitudes and expectations of the project | ✓ | ||
Relevant literature | n.a | Literature review | Challenges for team leaders regarding change management in health care Challenges of implementing a new role | descriptive | |||
Narratives | n.a | E-mail correspondence with e.g. the EN Team leader/case studies | ✓ | ||||
GPs | Relevant literature | n.a | Literature review | Summary of main challenges of GPs in Germany | descriptive | ||
Medical assistants (NäPa’s) | Federal Medical Council/ National and Federal Association of Statutory Health Insurance Physicians | n.a | File review | Role description and qualifications Overlap with ENs | descriptive | ||
Other health care professionals | Other health care professionals from other health care services involved in HiH patient care | 5 | Interviews (2) | Views on barriers and facilitators for the establishment of the new role | ✓ | ||
COVID-19 | Influence of the COVID-19 pandemic | ENs | 10 | Interviews (3) | Influence on the EN role and the ENC | ✓ | |
EN team leader | 2 | Interviews (3) | Influence on the EN work and the EN management | ✓ | |||
Principal investigator | 1 | Interviews (2) | Influence on the project and the EN work | ✓ | |||
GPs | All GPs | Interviews (2) | Influence on the project and the EN work | ✓ | |||
Patients | 2–4 | Interviews (6) | Influence on own health and care situation | ✓ | |||
Relatives | 2–4 | Interviews (6) | Influence on the patients’ health and care situation | ✓ | |||
PTHV | 2 | Interviews (2) | Influence on the EN studies and their work | ✓ | |||
Health Insurances | 2 | Interviews (2) | Impact on the project | ✓ | |||
Other health care professionals from other health care services involved in HiH patient care | 5 | Interviews (2) | Impact on collaboration | ✓ | |||