Topic | Level | Domain | Variable |
---|---|---|---|
Structure quality | Macro | Workforce availability | Recruitment situation for nursing and care staff |
Regulations | Reimbursement regulations (health insurance, client co-payments, residual financing and methods of financing) | ||
Requirements for and content of an operating license | |||
Requirements for and content of a service agreement | |||
Requirements for reimbursement | |||
Geographic characteristic | Catchment area (rural, suburban, urban) | ||
Agency’s service area (population size, numbers of physicians, pharmacies and hospitals) | |||
Meso | Service provision | Number of full-time equivalent posts | |
Total number of clients and hours of care provided in 2020 | |||
Range of service (e.g., nursing care, domestic tasks, meal service, specialized care) | |||
Availability of services (e.g., only by day, day and night, on the weekend) | |||
Financing | Profit status (non-profit, for-profit) | ||
Percentage of financial contributions from different contributors (e.g., health insurance, client, canton/municipalities) | |||
Obligation to supply or service agreement with municipalities and cantons | |||
Workforce | Numbers of full-time equivalent positions differentiated according to educational background | ||
Turnover rate | |||
Staffing and skill mix (percentage of RNs and number of visits conducted by RNs within the last 50 visits) | |||
Work environment | Leadership | ||
Perceived staffing | |||
Teamwork | |||
Workload | |||
Overtime | |||
Predictability | |||
Role clarity | |||
Role conflicts | |||
Social support | |||
Sense of community | |||
Client characteristics | Age | ||
Gender | |||
Living situation (e.g., alone / with partner / with children) | |||
Type of services used (nursing care, domestic services or both) | |||
Service intervals (daily / weekly / monthly) | |||
Services covered by health insurance | |||
Place of care (e.g., apartment, house) | |||
Minutes of professional care per visit | |||
Prior hospitalizations | |||
Care needs (e.g., regular / palliative / psychiatric) | |||
Employee characteristics | Age | ||
Gender | |||
Employment percentage | |||
Experience in their profession | |||
Experience in their current homecare agency | |||
Job / position | |||
Country of education | |||
Educational background | |||
Process quality | Meso | Resources and time allocation | Organization of the last seven working days (e.g., number of nurses, number of visits, travel times, amount and type of services, time for coordinative and administrative work) |
Intra- and/ or interprofessional case discussions and/or team meetings | |||
Communication channels/technologies in place | |||
Planning according to a reference person system Number of cases for which each nurse is responsible | |||
Financial tasks | Requirements for reimbursement | ||
Conflicts with health insurance companies and municipalities pertaining to the financing of services | |||
Experienced cost pressure | |||
Time and costs not billable to health insurance | |||
Planning or realization of cost saving measures. | |||
Workforce recruitment and training | Presence of nurses with case responsibilities / case managers / care managers | ||
Provision of care worker training (e.g., regarding service availability, interprofessional care coordination) | |||
Presence of standards, checklists and guidelines for selected procedures (e.g., medication management, wound therapy, emergency situations) | |||
Clear task/role descriptions | |||
Process of care | Presence of interprofessional care goals | ||
Evaluation and adaption of care and treatment plans | |||
Coordination activities | Communication and information exchange | ||
Communication channels used | |||
Accountability, predictability, common perspective | |||
Familiarity with the healthcare system | |||
Communication between providers and clients (client perspective) | |||
Extent of coordinator role of homecare nurses (client perspective) | |||
Coordination through homecare agency (client perspective) | |||
Micro | Coordination | Alignment of work within the care team | |
Alignment of client care with nominated providers | |||
Care coordination gaps (from employee and client perspective) | |||
Overall rating of coordination (from client and relative perspective) | |||
Role clarity and coordination between settings (from client perspective) | |||
Outcome quality | Micro | Quality of care | Rating of care provided by the agency (from employee, client and relative perspective) |
Health care service use |