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„Nicht Zuständig Und Tschüss Gibt Es Nicht“ Konzeption Eines Community Response Teams Im Politischen Bezirk Melk

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„Nicht Zuständig Und Tschüss Gibt Es Nicht“ Konzeption Eines Community Response Teams Im Politischen Bezirk Melk „Nicht zuständig und tschüss gibt es nicht“ Konzeption eines Community Response Teams im politischen Bezirk Melk Lena Kaufmann, BA Lisa Krähan, BA Sophie Nix, BA MA Masterthese Eingereicht zur Erlangung des Grades Master of Arts in Social Sciences an der Fachhochschule St. Pölten Im September 2019 Erstbegutachter: FH-Prof. DSA Mag. (FH) Dr.PhDr. Christoph Redelsteiner, MSc und Florian Zahorka, BA MA Zweitbegutachter: FH-Prof. Dr. Tom Schmid Abstract „Nicht zuständig und tschüss gibt es nicht“ Konzeption eines Community Response Teams im politischen Bezirk Melk Kaufmann Lena, Krähan Lisa, Nix Sophie Ausgangspunkt dieser Arbeit ist die vermehrte Frequentierung des Gesundheits- und Rettungswesens durch Fälle, welche durch andere (soziale) Instanzen besser versorgt werden könnten. Im Fokus steht der Best Point of Care. Dies bedeutet, für Personen die bestmögliche Betreuungs- und Versorgungsinstanz zur Verfügung zu stellen. Da dies für Personen, die nicht primär akut-medizinisch betreut werden müssen, nicht immer gewährleistet ist, wird in dieser Arbeit das Konzept einer zusätzlichen Betreuungs- und Versorgungseinheit entworfen. Dazu wurde zunächst mit einem von der Notruf Niederösterreich GmbH zur Verfügung gestellten Datensatz gearbeitet. Ergänzend dazu wurden Interviews mit verschiedenen ExpertInnen aus dem Rettungs-, Gesundheits- und Sozialwesen in Niederösterreich geführt, welche nach der qualitativen Inhaltsanalyse nach Mayring kategorisiert und ausgewertet wurden. Folgende Forschungsfrage ist für diese Masterthese leitend: Wie kann ein Community Response Team aussehen / aufgestellt werden, am Beispiel des politischen Bezirks Melk? Durch die im Forschungsprozess gewonnenen Erkenntnisse wurde ein Modell eines Community Response Teams theoretisch entwickelt. Außerdem wurde eine Übersicht über die vorhandene Gesundheits- und Soziallandschaft im Bezirk Melk erstellt, welche bei der Konstruktion des Modells Berücksichtigung fand. Haupterkenntnisse dieser Arbeit sind, dass ein Community Response Team im Bezirk Melk idealerweise multiprofessionell sowie haupt- und ehrenamtlich aufgestellt, rund um die Uhr erreichbar, niederschwellig, mobil und standortgebunden sein sollte, um die Versorgungslücken in der Sozial- und Gesundheitslandschaft minimieren zu können. Schlüsselwörter: Community Response, Primärversorgung, Notruf Niederösterreich, Rettungswesen, Gesundheitswesen, Sozialwesen, psychosozial, Gemeinwesenarbeit, Nachbarschaftshilfe, Ehrenamt und Professionalität, Case und Care Management, Out of Hours, politischer Bezirk Melk, Regionalität, Sozialarbeit im ländlichen Raum, aufsuchende und nachgehende Sozialarbeit, Empowerment, Best Point of Care, Niederschwelligkeit 2 Abstract ”There is no such thing as not responsible” Conception of a community response team in the political district of Melk Kaufmann Lena, Krähan Lisa, Nix Sophie Currently there is an increasing number of cases served by health and rescue services, which could be better served by other regional (social) authorities. The focus is on the Best Point of Care, meaning the ultimate goal is to reach the best possible instance of care and service. This is not always the case for people who are not in acute need of medical treatment. Therefore, the concept of an additional care and service unit is designed in this paper. For this purpose a dataset provided by Notruf Niederösterreich GmbH was used at first. In addition, interviews were conducted with various experts from rescue, health and social services in Lower Austria, which were categorized and evaluated according to the qualitative content analysis according to Mayring. The following research question guided us through this master thesis: How can a Community Response Team look like / be set up, using the example of the political district of Melk? Through the insights gained in the research process, a theoretical model of a Community Response Team was developed. Additionally, an overview of the existing health and social landscape in the district of Melk was created and taken into account during development of the model. The main findings are that a community response team in the district of Melk should ideally be multiprofessional, full-time and voluntary, accessible 24/7, low-threshold, have a fixed location and be mobile in order to minimize the gaps in social and health care. Keywords: Community Response, Primary Care, Notruf Niederösterreich, Rescue Service, Health Care, Social Work, Psychosocial, Community Work, Neighborly Help, Volunteering and Professionalism, Case and Care Management, Out of Hours, Political District of Melk, Regionality, Social Work in Rural Areas, Outreach and Following Social Work, Empowerment, Best Point of Care, Low-Threshold 3 Inhalt 1 Einleitung ............................................................................................................. 7 1.1 Problemaufriss .............................................................................................................7 1.2 Ziel der Forschung .......................................................................................................7 1.3 Community Response Team – eine Begriffsannährung ..............................................8 1.4 Forschungsprozess ......................................................................................................9 1.5 Vorangegangene Forschungsarbeiten ...................................................................... 10 1.6 Ausgangslage und Kontextualisierung des politischen Bezirks Melk – Grunddaten 15 1.7 Forschungsleitende Fragestellungen ........................................................................ 19 1.7.1 Forschungsleitende Hauptfrage .................................................................... 19 1.7.2 Forschungsleitende Unterfragen ................................................................... 19 1.8 Aufbau der Arbeit ...................................................................................................... 20 2 Kontextbegriffe zur Konzeption eines Community Response Teams ........... 21 2.1 Sozial-, Gesundheits- und Rettungswesen. Gemeinsamkeiten, Unterschiede, Schnittstellen ............................................................................................................. 22 2.1.1 Sozialwesen .................................................................................................. 22 2.1.2 Gesundheitswesen ........................................................................................ 23 2.1.3 Rettungswesen .............................................................................................. 25 2.1.4 Schnittstellen und Diskussion ....................................................................... 27 2.2 Primärversorgung als niederschwelliger Zugang zum Gesundheits- und Sozialwesen ................................................................................................................................... 29 2.3 Gemeinwesenarbeit .................................................................................................. 31 2.3.1 Aufsuchende und nachgehende Soziale Arbeit ............................................ 32 2.3.2 NachbarInnenschaftsarbeit ........................................................................... 33 2.3.3 Aktivierung der Zivilgesellschaft und BürgerInnenschaftliches Engagement 34 2.3.4 Hintergrund: Organisationsformen von Individuen ........................................ 36 2.4 Case und Care Management .................................................................................... 37 3 Forschungsdesign ............................................................................................ 41 3.1 Mixed Methods Research.......................................................................................... 41 3.2 Erhebungs- und Auswertungsmethodik .................................................................... 41 3.2.1 Recherchearbeit ............................................................................................ 41 3.2.2 Geoinformationssysteme............................................................................... 42 3.2.3 Leitfadeninterview ......................................................................................... 42 3.2.4 Inhaltsanalyse ............................................................................................... 43 3.3 Beschreibung der InterviewpartnerInnen .................................................................. 44 3.4 Weitere Anfragen ...................................................................................................... 46 4 Auswertung und Interpretation ........................................................................ 49 4.1 Einstieg in die Thematik ............................................................................................ 49 4.2 Kategorien ................................................................................................................. 52 4.2.1 A Organisationale Aspekte ............................................................................ 53 4.2.2 B Umgang mit Heavy Usern .......................................................................... 56 4.2.3 C Rettungsdienst als scheinbar einzige Versorgungsinstanz ....................... 58 4 4.2.4 D Psychosozial .............................................................................................. 59 4.2.5 E Ehrenamtlichkeit ........................................................................................ 61 4.2.6 F
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