[Challenges and opportunities of the Intensive Care and Rehabilitation Strengthening Act (GKV-IPReG): Opinion survey and interprofessional cross-sector dialogue].

Abstract

The implementation of the requirements of the "Intensivpflege- und Rehabilitationsstärkungsgesetz (IPReG)" requires the establishment of new cross-sectoral care structures. As part of an online survey and a multi-professional panel discussion, which took place on April 27, 2024 at the Thorax Clinic of Heidelberg University, this topic was highlighted from various perspectives. Medical representatives from the fields of intensive care medicine and weaning, respiratory therapists and representatives of the WeanNet board, the AOK Baden-Württemberg and the head of an outpatient intensive care service took part in the discussion. The participants in the survey and the panel discussion still saw potential for optimisation in practical implementation to make the task of assessing weaning or decannulation potential more attractive for appropriately qualified doctors, as implementation currently depends very much on the motivation of individuals. Some patients and their relatives also have reservations about ventilator weaning and decannulation, as it often involves a change of care facility. Optimisation potential was seen mainly in including respiratory therapists and using telemedical options; furthermore, a structural, nationwide provision of care would be desirable, but this does not seem feasible everywhere from an infrastructural standpoint. Although telemedicine could be a good option to improve coverage, especially in more rural areas, the legal framework for this, as well as for potential assessment conduction by respiratory therapists, is not sufficient yet. These legal regulations need to be discussed and developed in constructive collaboration with all involved professions and patient representatives. In general, the law was seen as an opportunity to identify patients with weaning and decannulation potential and to improve the situation of patients with long-term ventilation in Germany due to its requirement of regular on-site visits by professionals with expertise in weaning.