RESUMO
BACKGROUND: With the beginning of the Covid-19 vaccinations in primary care, a new and work-intensive responsibility arose for medical assistants (MA). In addition to their existing duties and the challenges posed by Covid-19, they had to organize, plan, and in some cases carry out the vaccinations and follow up on the documentation. METHODS: A total of 21 semi-structured interviews were conducted with MA between April and September 2021. Particularly considering the timing of the interview, questions were asked about the daily work routine and the associated vaccine organization. The interviews were then analyzed using MAXQDA software based on Kuckartz's qualitative content analysis. RESULTS: The MA criticized a lack of organization and transparency in the planning and implementation of vaccinations. Each vaccination had to be pre- and post-processed, resulting in an immense bureaucratic effort. Additional work and stress were the results. Also, MA had to deal with difficult patients. CONCLUSION: The experience of MA must be taken into consideration in the future to create guidance for dealing with an increased demand for vaccinations. The guidelines for the future must ensure that MA are relieved and supported by a meaningful organization during such events.
RESUMO
INTRODUCTION: Since 2015, the Federal Joint Committee (G-BA)'s Innovation Fund has been supporting projects in health services research and new health service models ("Neue Versorgungsformen", NVF). By the end of 2022, 211 projects in the NVF category had been funded. A key objective is the transfer of successful projects into standard care. This article analyzes previous projects regarding their incorporation into routine care based on transfer recommendations of the Innovation Fund Committee ("Innovationsausschuss" IA). METHOD: Descriptive analysis of all projects completed by August 1, 2023 with transfer recommendations in the "NVF" funding stream. Presentation by topic, project duration, time until IA transfer decision, categorization, and number of institutions and organizations (recipients) addressed per project, their feedback published on the G-BA website, response rates per recipient group, and a content classification and interpretation of exemplary feedback. Recommendations based on the results and their discussion in an expert workshop. RESULTS: Out of 57 NVF projects, 17 had a transfer recommendation. A total of 57 feedback responses were received from a total of 431 recipients addressed by the IA across these projects. Response rates varied significantly. One-third of inquiries to the G-BA and its member organizations received a response (31%), while only every fifth inquiry to federal states (18%) and professional societies (18%) got a response. Less than one in ten inquiries to the Federal Ministry of Health (8%), administrative bodies (6%), and the German Medical Association (0%) received a response. Project-specific feedback within a recipient group was often contradictory or limited to regional scope. DISCUSSION AND CONCLUSION: The transfer process reveals significant structural and procedural obstacles regarding the incorporation of projects evaluated as successful into routine health care. To ensure that funding from the innovation fund is most effectively used, there needs to be a realistic chance of successful transfer of positive project outcomes into routine care. The DNVF recommends stronger involvement of rule-competent institutions, mandatory publication of responses, structured moderation of the transfer process, expanding types of selective contracts, financing of implementation phases and of studies drawing on results across successful NVF projects.