Strengthening Communication and Collaboration in the Fragmented German Healthcare System: A Mixed-Method Evaluation of an Interdisciplinary Network for Parkinson’s Disease

Article type: Research Article

Authors: Kerkemeyer, Linda^{a; *} | Claus, Inga^b | Kutscher, Michelle^a | von Stülpnagel, Vanessa^a | zur Nieden, Pauline^a | PNM + steering committee | Huchtemann, Tessa^b | Warnecke, Tobias^{b; c; *}

Affiliations: [a] Institute for Applied Health Services Research (inav), Berlin, Germany | [b] Department of Neurology, University of Münster, Münster, Germany | [c] Department of Neurology and Neurorehabilitation, Klinikum Osnabrück, University of Münster, Osnabrück, Germany

Correspondence: [*] Correspondence to: Dr. Linda Kerkemeyer, Institute for Applied Health Services Research (inav), Schiffbauerdamm 12, 10117 Berlin, Germany. Tel.: +49 30 24 63 12 29; E-mail: kerkemeyer@inav-berlin.de and Prof. Dr. med. Tobias Warnecke, Department of Neurology and Neurorehabilitation, Klinikum Osnabrück –Academic teaching hospital of the University of Münster, Am Finkenhügel 1, 49076 Osnabrück, Germany. Tel.: +49 541 40 56 522; E-mail: tobias.warnecke@klinikum-os.de.

Abstract: Background:To improve Parkinson’s disease (PD) care, interdisciplinary and patient-centered treatment is mandatory. A key problem in many healthcare systems is the limited and unspecific communication among different healthcare professionals. Optimal collaboration between various professionals involved is indispensable. Parkinson’s Network Münsterland + (PNM +) is an interdisciplinary network of medical and non-medical experts involved in the treatment of PD patients in Germany. Objective:The aim of this evaluation was to analyze the network structures of PNM+ as well as communication and collaboration between PNM + partners. Methods:A mixed methods approach was applied consisting of a social network analysis, a validated questionnaire on team effectiveness and semi-structured interviews focusing on perceived barriers and supportive aspects of PNM + . Results:Quantitative and qualitative data suggested increased collaboration between professionals within PNM + . The reciprocity of connections was 0.522 in the network of professional contacts. Regular exchanges in terms of interdisciplinary panel meetings and working groups stimulated knowledge transfer, leading to greater specialization of general neurologists and therapists in PD. The progressive density of the network from 0.136 to 0.279 illustrates the growing cooperation of PNM + partners. Interviewed partners requested more patient-specific collaboration but expected this to happen as the network evolved. Overall, PNM + has already improved both diagnosis and therapy thanks to knowledge transfer. Structured treatment recommendations helped to improve communication between healthcare professionals. Conclusion:PNM+ stimulated exchange between different healthcare professionals involved in the treatment of PD patients. This overcomes specific barriers within Germany’s highly fragmented healthcare system, such as the lack of communication between these disciplines.

Keywords: Parkinson’s disease, community care networks, interdisciplinary health team, interdisciplinary communication

DOI: 10.3233/JPD-213072

Journal: Journal of Parkinson's Disease, vol. 12, no. 4, pp. 1307-1317, 2022