[Staffing of inpatient psychiatric facilities : A patient-oriented and guideline-oriented staffing concept]

Nervenarzt. 2019 Mar;90(3):285-292. doi: 10.1007/s00115-018-0669-z.
[Article in German]


Background and goal: According to § 136a (2) SGB V (volume V of the German Social Security Code) the German legislator instructed the Federal Joint Committee (G-BA) to specify binding minimum standards for the staff needed for the treatment in inpatient psychiatric and psychosomatic facilities. This induced the expert associations/organizations to develop their own conceptional approach as to the future organization of staffing.

Method: Organization of regular expert workshops, the results of which were systematically documented and validated by the experts.

Results: The essential elements of the concept are: the starting points for the calculation are the needs of all patients treated in the institution. The need for treatment has three dimensions: (a) psychiatric psychotherapeutic/psychosomatic psychotherapeutic/pediatric and adolescent psychiatric-psychotherapeutic, (b) somatic and (c) psychosocial needs. The model developed by the platform distinguishes between staff requirements being directly related to the treatment of the individual patient, staff requirements caused by the treatment setting and such staff requirements arising at an institutional level. Minimum staff requirement is understood as the staff structure which is, among others, needed to guarantee the multiprofessional, physician-led treatment and the required medical care services for all patients specified by the existing guidelines or an expert consensus as well as to ensure the protection of the patient, fellow patients and the employees working in the facility against hazards.

Conclusion: This model considers the medical progress within the meaning of the evidence-based guidelines and the modified healthcare practice including sociopolitical standards aimed at the patients' self-determination.

Keywords: Medical guidelines; Psychiatry; Psychosomatics; Staff; Staffing.

MeSH terms

  • Decision Support Techniques
  • Germany
  • Health Planning Guidelines*
  • Hospitals, Psychiatric* / statistics & numerical data
  • Humans
  • Medical Staff, Hospital* / legislation & jurisprudence
  • Medical Staff, Hospital* / supply & distribution
  • Psychotherapy
  • Workforce* / standards
  • Workforce* / statistics & numerical data