New German care model prioritizes patient autonomy over fixed tasks

The Caritasverband Westerwald-Rhein-Lahn and AOK Rheinland-Pfalz/Saarland launched a pilot project in Rheinland-Pfalz, Germany, to change how outpatient nursing care is delivered.

Instead of billing for specific, pre-defined tasks like washing or dressing, the "Pflege ganz aktiv" model pays for a set time budget. This allows nurses to tailor their support to the immediate needs and desires of the patient during each visit. The model aims to help patients regain independence.

For example, a 78-year-old woman who suffered a fall due to a tumor previously required daily help with personal care. Under this new system, her nurse spent 45 minutes providing guidance and emotional support rather than just performing routine physical tasks. As a result, the woman can now move independently with a walker and only requires nursing assistance once a week. Stefanie Krones and her team designed the model in 2022 to improve both patient outcomes and worker satisfaction.

The project uses small, self-organized teams with flat hierarchies. Krones says the model has led to high staff satisfaction and low turnover because nurses can provide more holistic care. The project will undergo a two-year scientific evaluation starting in December to determine if it can be made permanent and expanded to other facilities across Germany.