Projects

The LEX LOTSEN OWL (LLO) project is investigating how care and case management (CCM) can bridge gaps in cross-sector care for high-risk patients. Using a hybrid study design, the project is conducting research in East Westphalia-Lippe (OWL) to determine how CCM can be sustainably established and scaled—to improve coordination, continuity, and the patient experience.

Since January 2024, the German Stroke Foundation, in collaboration with health insurance providers and healthcare facilities, has been testing—as part of the LEX LOTSEN OWL project—how the use of patient navigators can be organized and integrated into standard care. Care and Case Management (CCM) is considered a promising approach for bridging gaps in care for patients with complex needs. However, there is currently a lack of studies examining both the widespread implementation and the effectiveness of this approach for patients. The LEX LOTSEN OWL project fills this gap: In seven counties in the OWL region, a hybrid study design is being used that combines implementation research with a randomized controlled trial (RCT).

Methodology

The project combines two components:

• Implementation Research: In conjunction with the establishment of navigation offices in OWL, qualitative and quantitative methods are being used to identify success factors and barriers (interviews, document analyses, process metrics).
• Effectiveness Research: Patients with complex care needs are randomly assigned to either a CCM group or a control group (standard care). Primary endpoints are relational coordination (Gittell Relational Coordination Questionnaire) related to the coordination office intervention component and perceived quality of care (PEICS) related to the coordinator support intervention component from the patients’ perspective. Secondary endpoints include (re)hospitalizations, mortality, quality of life, self-management, and self-efficacy among family caregivers.

Potential

The study provides evidence on structural and process-oriented factors that influence the implementation of CCM. At the same time, it evaluates the effectiveness of care and case management. The results may demonstrate how indication-independent CCM can be integrated into various care settings. By providing insights into governance structures, organizational strategies, and patient-specific benefits, LEX LOTSEN OWL helps strengthen coordinated, continuous, and participatory care in routine practice. In addition, scaling factors relevant to decision-makers are analyzed.

The LEX LOTSEN OWL pilot project is receiving seven million euros in funding from the Innovation Fund.

LEX LOTSEN OWL has the potential to develop sustainable, patient-centered care models and thereby improve health care in Germany over the long term.

[Click here for the publication]

Here you can learn more about the LEX LOTSEN OWL project: Supporting People—Improving Lives.