Interdisciplinary assessment teams in municipal home care services – a sustainable service innovation that meets the needs of the patient?
Background
Access to home-based health and care services in Norway has traditionally been universal, broad and generous for new applicants. Typical needs of users of the services are to get help with personal hygiene, dressing, meals, use of medication, as well as other health and care-related tasks. After the year 2000, however, the allocation process in most municipalities has been characterized by increasing professional formal case management, and decision-making from a distance. The investigation process has been carried out by one needs assessor, and with the allocation of permanent home services as the most common result. In the last five years, however, in some Norwegian municipalities there has been a significant change in how new applicants are assessed in the first month after applying for assistance. In order to adapt the service offer to the applicants' actual personal needs, some municipalities have designed a new model for intensive assessment and follow-up of applicants' needs, where interdisciplinary assessment and follow-up teams are used - for up to four weeks. The teams then decide whether the applicant should be awarded further assistance or not; based on collected data, assessments and the initial follow-up, the team concludes in relation to what assistance the applicant will need in the future. The new interdisciplinary assessment and follow-up teams are so far considered innovative and promising by the municipalities themselves. Bergen municipality, for example, has calculated that 38% of their new applicants do not need long-term home-based services beyond the four-week assessment period. However, no scientific studies have yet been carried out that examine experiences with the new model and its consequences. In other words, there is no research into the effects and consequences of this new model for early assessment, intervention and allocation. Processes related to access and allocation of home-based health and care services are important both for users, their families, and for health professionals who are responsible for assessing and defining the need for public health and care services in the home. This doctoral project has a gender perspective and will particularly investigate the relationship and tensions between the service recipients' and service providers' approach to care needs, and how the assessment and follow-up team relate to the applicants' needs. The study will identify effective and successful components of this new model for early public intervention, and document critical and vulnerable elements of the model and its possible unintended, unfortunate side effects – as experienced by the applicants, their family, and the assessment and follow-up teams themselves. The study can therefore contribute to increased knowledge about whether this model, as a service innovation, can be a sustainable model that can meet the needs of new applicants for home-based services.
About the project
The project's partial studies and research questions
The project consists of three sub-studies with the following three research questions - where the experiences and perspectives of people with dementia, relatives, volunteers and volunteer coordinators are explored.
Substudy 1
How do the applicants for home-based health and care services, and their relatives, experience being met with their health and care needs immediately after the assessment period of the interdisciplinary assessment and follow-up teams has ended - and how do they experience their own role in the design of the service offer?
Part study 2
How do the applicants for home-based health and care services, and their relatives, experience that their health and care needs are met 6-12 months after the early assessment phase by the interdisciplinary assessment and follow-up teams has ended?
Part study 3
What is the interdisciplinary assessment and follow-up teams' assessment basis when they make decisions about the applicants' need for services - and how do they collaborate with the applicants and their relatives in this process?
Cooperation
Høgskulen i Bergen
Senter for omsorgsforskning vest, Høgskulen på Vestlandet
Funded by Høgskulen på Vestlandet
Link to the project:
Prosjekt #2582968 - Interdisciplinary assessment teams in municipal home care services – a sustainable service innovation that meets the needs of the patient? - Cristin