«Shadow accounting» in a crisis resolution home treatment team – about tacit knowledge and hidden practices.

Various models for crisis resolution and home treatment teams have been established as part of community services in recent years. The objective is to offer citizens available and accessible assessment and treatment, strengthen the person’s capacity to deal with their situation, as well as offer support for the family and the patient’s social network. This development of new services, in addition to demands for quality standards and evidence based practice, require comprehensive evaluation studies. In this paper we present a study based on registered telephone contacts to a crisis resolution/home treatment team over an 18 months period. The total number of telephone contacts as well as the cohort being registered as patients with medical case reports are included. A considerable number of telephone contacts did not result in patient status with medical case report. This material, here called «shadow accounting», is the focus of the present paper. Documentation like this is not an integral part of standard documentation in the public health system. In this study we explore and describe some of the characteristics of these telephone-contacts regarding 1) gender, age and contact body; 2) the problems and issues focussed on, and 3) the assessments and actions of the team.