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Table 4 Quotes for theme “The needs of medically complex patients”

From: Practicality of Acute and Transitional Care and its consequences in the era of SwissDRG: a focus group study

Quote (Q) Quote from participants
Q13 I think it’s a bit delicate because geriatric centres and long-term care [nursing homes] receive every type [of patients]. Well we have a lot of psychiatric [patients]. Then from the hospitals too, we get all [types of patients], complex oncological radiotherapy and chemotherapy-break, accident surgical cases, (…) Then we also have palliative transfers… (…) and we just have every type [of patients] and that makes it so difficult. (P4, FG4)
Q14 After all, most nursing care facilities are geared towards long-term care. Out of history, out of tradition. Whether there really is the idea of curing people, mobilizing them, letting them become independent in activating care and what other concepts there are. It’s a bit of a question mark for me. I’m not so sure. [if nursing homes have these goals]. (P1, FG4)
Q15 The nursing homes are basically geared towards long-term care in terms of their nature, their facilities, their infrastructure. (...) And of course such a temporary stay has completely different requirements. We don’t do ATC. But the temporary residents have completely different demands, they want a furnished room, their goal is to get well and home as soon as possible, that is their goal. (P3, FG6)
Q16 And I see, when I do the review of the medical reports, I get registrations, where I first need to organize all the equipment. Then we have a tracheostomized patient, who we need to aspirate, may need artificial respiration and sometimes need monitoring because they are still very unstable. Then I have to organize all the material, then we need to have trainings on the handling/use of those equipment, and have to train the personnel. Then we have to think through what we do at night, when the whole house with six stations have only two qualified persons [registered nurses] and the rest are nursing associates. When we then have a tracheostomized to aspirate… yes, how do we manage that? (P4, FG4)
Q17 Well it is really challenging. We have difficulties with reimbursement [from insurance], the expectations for the infrastructure are clearly higher. They want fitted beds like in the hospital with TV and with all the [additional things]. It’s not good for the community [nursing home because], they are here [in nursing home], they leave again [after meeting their health needs]. No, it’s really… The planning security, the economic planning security of the positions in nursing with such a big proportion [of temporary residents] it’s not good, not very good. (P3, FG6)
Q18 If every 14 days someone new is being admitted, who needs to be registered with the whole thing or one has to look at what this person, the resident needs to go back home again. That is a really complex situation. […] One has to do the care plan together with the doctor, together with the resident and so, we have to have very very early a lot of conversations. Because 14 days passes very quickly. So once someone is there, we already start to plan the discharge. (P4, FG3)