Network orientation in digital hospital social services (NodiKs)

For patients with mental disorders, continuity between inpatient and outpatient care is essential. However, the inpatient-outpatient care interface is characterized by discontinuities. Up to 50% of patients with mental disorders do not receive guideline-compliant care after discharge from hospital, and the mortality risk in this group is more than three times higher. Embedding in social networks is relevant for continuity of care and positive course of illness. The structure of social networks influences the level of experienced social support and through this, for example, recovery, course of illness, quality of life or access to care. However, the structure of social networks is not systematically recorded during hospital stays. There is a need for optimization in order to support embedding in social networks associated with social support and to avoid discontinuities. According to german jurisdiction (§ 112 SGB V), the hospital social service is responsible, but there is a lack of instruments for scientific network analysis that can be used in routine care to record social networks and social support and identify patients with mental disorders at risk of discontinuity of care and insufficient social support at the inpatient-outpatient care interface. In the project “Network orientation in digital hospital social services” (NodiKs), a scientific network analysis tool (Löwenstein & Frank 2023) already used to analyze social networks of patients with mental disorders is to be further developed with regard to the inpatient-outpatient care interface and qualified for routine care. Based on this, a procedure is then to be implemented at the five participating clinics of Oberberg GmbH with which patients with a risk outlined in this way are identified and a tailored, digitally supported aftercare can be provided from the hospital social service in order to support a successful transition of care after discharge from inpatient treatment.