>> Cardiopilots as such do not yet exist in the canon of health professions. However, people working in various medical assistant professions - medical assistants, but also
Health and nursing staff – acquire this additional qualification as a cardio pilot through a two-month training course. During this time, they will be taught various learning modules such as communication training, internships, data management and coaching. The modules are intended to serve as the basis for any standard qualification as a patient guide in different medical areas. In addition, the Cardiolotsen provides medical expertise with a focus on cardiology.
The two-month qualification of the first cardiopilots began on November 1, 2018 - carried out by cardiologists and cardiological nursing specialists as well as external experts. Since January 2019, eleven cardio pilots have started working at eight clinic locations of Vivan-tes, the largest municipal hospital group in Germany, which covers the care of around 730,000 Berliners insured with AOK Nordost (which makes up 20 percent of Berlin's population). Around 900 patients have already taken advantage of the offer, but during the course of the project a total of around 2,000 heart patients insured by AOK Nordost will be cared for after their inpatient stay, with the cardio guides being available as additional contacts for both the patients and the doctors and therapists .
In the three-year project, the Ludwig Maximilian University of Munich will scientifically investigate the effects of personal patient support using the example of chronic heart disease. If the cardioguide concept is successful, it could develop into an independent job description of a patient guide, which can also be used for other chronic illnesses. Because the cardio pilot model should – if the results are positive – function as a prototype for an independent professional profile. The related curriculum can serve as a basis for other pilot models based on the cardio pilot model, but pilots would have to be trained for each indication. In addition, the current certificate is an in-house development in the project. Recognition by the Medical Association and/or the Association of Medical Professionals should also be sought in the future.
Nevertheless, a possibly new job profile is already being tested at Vivantes clinics in Berlin, as Dr. Andrea Grebe, CEO of Vivantes, explains: “With this innovative approach, our cardio guides ensure better networking of the levels of care after inpatient treatment.” Vivantes expects this to result in a higher effectiveness of the therapy, a better quality of life for the patients cared for at Vivantes, combined with the hope that this – according to Dr. Grebe – “thereby requiring further inpatient treatment less often”. With this goal, the new field of activity of personal patient support goes far beyond the discharge management that has already been established many times. However, this goal is also an evaluative endpoint against which the project must be measured: It is expected (and still needs to be proven) that the intervention by the cardiopilots will lead to a decrease in the re-hospitalization rate and a reduction compared to standard care which leads to mortality.
In the model project funded by the IF, the cardio pilots are employed by the Vivantes network, which includes nine hospitals with around 5,700 beds, 17 nursing homes with around 2,300 full-time inpatient care places, two senior citizens' homes, an outpatient rehabilitation center, twelve medical care centers, a hospice and subsidiaries for catering, Cleaning and laundry are included. It also makes sense that indication-specific controllers are employed at a hospital because patients are addressed directly during their inpatient stay and the controllers introduce themselves as a personal contact at the patient's bedside and continue to do so later after the hospital stay. The contact between Cardiolotse and the patient begins at the bedside, where the content and goals of the project as well as the specific support options are provided in a personal conversation. If patients decide to take part in the project, care begins for at least one year.
At the end of the project, however, the fundamental question arises as to whether - in this case - the cardiologist has to be employed in a hospital, or whether it would be better for him to be employed by general practitioners or specialists (cardiologists) or a management company. It would also be conceivable for the cardio pilots to be employed directly by a health insurance company, since around 37 percent of those insured with AOK Nordost suffer from chronic cardiovascular disease. “The central task of the cardio guides is to inform and advise patients personally and in a way that is easy for them to understand in all matters and on all questions relating to their illness,” says Daniela Teichert, designated chairwoman of the AOK Nordost. The cardio guides have a close relationship of trust with those affected and literally take them by the hand. “From our point of view, this is fundamental so that fears and uncertainties when dealing with the disease can be reduced. In the long term, patients will be able to deal with their illness confidently.” <<
by: MVF editor-in-chief Peter Stegmaier
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