To care for seriously and terminally ill patients until the end is a core task of general practitioners and family doctors. A research team from the Hannover Medical School (MHH) is exploring, how doctors can accomplish this task and what potential for improvement there is.
Close cooperation between general practitioners and specialists required
"Our goal is to develop strategies and specific treatment options that enable doctors to integrate the complex care for critically ill patients into their daily routine," says Dr. Saskia Jünger, Head of the Research Group at the MHH Institute for General Medicine. In order to provide patients with the best possible care in their home environment, GPs have to face tough challenges – such as frequent and time-intensive visits and the demanding clarification of existential psychological and social issues for patients and their relatives. In addition, they should prepare patients for potential problems, for example in case of nocturnal breathing difficulties or pain attacks. "This requires a high degree of cooperation between general practitioners and specialists, such as teams of the so-called specialized outpatient palliative care," says Professor Dr. Nils Schneider, Head of the MHH Institute for General Medicine. "Palliative care needs coordination in the team, for example case meetings with other care providers. This problem is not systematically solved in the German outpatient sector."
Project planning
First of all, the researchers examine the challenges of outpatient care for people with palliative care needs. Then, in cooperation with relevant protagonists – family doctors, patient advocates, representatives of cost-bearers and specialist associations – they develop strategies of action for specific adjustments and medical appliances. They then examine how the program affects patient care. "I hope that this project will help," says Dr. Jünger. "It is a very important goal to bridge the gap between general and special care and to enable patients and relatives to talk openly about life and death. This is a sensitive process that takes time."
The Federal Ministry of Education and Research (BMBF) subsidizes this project in the field of palliative outpatient care by funding a group of young researchers working within the "Plan of Action for Health Services Research" with around 900,000 Euros over the course of five years.