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Table 1 Operationalization of FIT components

From: Evaluation of new flexible and integrative psychiatric treatment models in Germany- assessment and preliminary validation of specific program components

No. Component Operationalisation Assessment
I Shifting in- to outpatient setting
Shift of treatment from I 1 towards D 2 and/or O 3
• Number of outpatient SoF4/total number SoF4 during EP5  
II Flexible care management across settings
Unproblematic shift of SoF 4 (prompt, little bureaucracy
• Number of CoT6 using all three SoF4 during EP5/ total number CoT6
• Treatment D2, I1, and/or O3 in the same unit (ward, level etc.)
• Systematic steering of treatment beyond all SoFs4
• Application of SoF4 spanning roster and therapy plans
Rating scale (0–2)
• Number SoF4-spanning sessions (meetings etc.) Rating scale (1–3)
III Continuity of treatment team
Implementation of team- and individual-related continuity
• Percentage of staff working in more than one SoF4 (on a regular basis)
• Coordinated admission (coordinating staff member)
• Coordination of treatment by e.g. case manager, SoF4-spanning care
• Home treatment by I1- and D2- teams
• Outsourced PIA (outpatient department) team (not working in I1 or D2)
Rating scale (0–2)
IV Multiprofessional Cooperation
Intense multiprofessional cooperation
• Absolute number of mandatory sessions across all occupational groups Absolute number
• Measure/action to optimize cooperation across all occupational groups Rating scale (0–1)
• Training sessions multiprofessional cooperation
• Number occupational groups working in home treatment (on a regular basis) Rating scale (0–2)
V Therapeutic group sessions across all settings
Therapeutic groups with members from all SoF 4
• Number of group sessions open for all SoFs4 Rating scale (0–2)
VI Outreach home care
Multiprofessional treatment at home ≥ 1 week
• Number CoT6 with home-treatment/ all I1-cases during EP5  
• Cars for home-visits Rating scale (0–2)
VII Involvement of informal caregivers
Informal caregivers as therapeutic tool
• “Network” or other forms of systemic dialog with informal caregivers and/or “carer-conference” and/or “caregiver groups” Rating scale (0–1)
• Number of groups open for informal caregivers Rating scale (0–1)
• Percentage of systemic training for staff/employees (e.g. open dialogue) Percentage
VIII Accessibility of services
Geographical accessibility and accessibility of teams
• Accessibility of services within one-hour drive
• 24-h-accessibility of multiprofessional mental health team (not doctor on call or the like)
• Shuttle service for services users
Rating scale (0–2)
• Waiting list Reverse rating scale (1–0)
IX Sovereign steering of services
Freedom of therapeutic decisions
• Number of exeats ≥2 nights in a row/all exeats during EP
• Number of exeats per service user/ calendar week during EP
• Daypatient treatment as well during the night
• Rules according to contract in all matters concerning setting of treatment and length of treatment
Rating scale (0–2)
X Cooperation across Sectors
Cooperation with ambulant care systems
• Mutual scheduling and realizing of treatment with ambulant care systems (SGB V)
• Mutual scheduling and realizing of treatment with social welfare system (SGB XII)
Rating scale (0–2)
• “Community psychiatric network” Rating scale (0–1)
XI Expansion of professional expertise
Professionalisation of staff
• Multiprofessional training of staff concerning FIT models
• Measures to multiply knowledge about FIT models
• FIT models as part of appraisal interviews
Rating scale (0–1)
• Percentage of nurses/caregivers moderating group sessions Percentage
  1. NOTE: 1I inpatient, 2D day-patient, 3O outpatient, 4SoF setting of treatment (outpatient, day-patient, inpatient), 5EP evaluation period, 6CoT case of treatment