Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
-
Z Evid Fortbild Qual Gesundhwes · Jan 2009
[The effectiveness of CME -- quality improvement through differentiated advanced medical education research].
Continuing medical education (CME) increasingly focuses on measurable patient outcomes. Nevertheless, international data on this issue are insufficient, and in Germany the measurable effects of CME in terms of its efficacy and utility for patient care have hardly been subjected to scientific examination. ⋯ Advanced medical training in Germany therefore requires the implementation of a kind of learning and teaching research that should be geared toward individual training needs, personal motivation and the outcomes of medical care. In addition, the definition of educational goals and the advancement of CME in terms of continuing professional development (CPD) should be considered an important component for a reevaluation of CME.
-
Z Evid Fortbild Qual Gesundhwes · Jan 2009
[EUebm--integrating a Europe-wide harmonised training and continuing medical education in evidence-based medicine (BbM) with patient care].
Integrative concepts of teaching and learning with close reference to individual work routines are better suited to bring about attitudinal and behavioural modification--apart from a gain in knowledge and skills--than traditional educational approaches. All the same, the vast majority of continuing training courses in Evidence-based Medicine takes place during weekend courses or evening classes, outside the work environment. To counteract this deficit a modular curriculum framework for Evidence-based Medicine was developed within the scope of the European research project EUebm which aims to achieve both a harmonisation of EbM education and training in Europe and a better integration of education and training with everyday clinical practice. ⋯ On the basis of a survey conducted among all the project partners in Austria, England, Germany, Hungary, Italy, The Netherlands, Poland, Spain and Switzerland the demand for training and continuing education in EbM in the individual countries was identified. Taking into account the results of this survey as well as previous work such as, for example, the curriculum of the German Network for Evidence-based Medicine or material provided by the Centre for Evidence-based Medicine in Oxford, an Internet-based teaching and learning module on systematic reviews and meta-analyses was developed and tested in five of the participating countries. The test demonstrated that in this way harmonisation of EbM education and training and a better integration of training with our everyday clinical work becomes feasible.
-
Z Evid Fortbild Qual Gesundhwes · Jan 2009
[Clinical pathway, quality circle and standard operating procedures as tools for quality management in the trauma suite].
In each hospital the trauma resuscitation room in emergency departments is one of the areas with the highest rate of critical incidents. Delayed and insufficient medical interventions have a high impact on negative patient outcomes. ⋯ In this context some elements of quality management are well-established in clinical practice. In the present study we describe the implementation of a clinical pathway and an interdisciplinary quality circle to improve management of the trauma patient.
-
Z Evid Fortbild Qual Gesundhwes · Jan 2009
[Competition and the legal ramifications of physician advertising].
Various healthcare reforms have spurred the idea of competition among physicians. As physicians compete for a limited pool of patients advertising has become commonplace. ⋯ Especially any advertisement likely to mislead or deceive because of a failure to disclose material facts is prohibited. Important cases of German jurisdiction concerning physician advertising are given.
-
Z Evid Fortbild Qual Gesundhwes · Jan 2009
[Integrative assessment of evidence in healthcare: the GRADE system].
Decisions are a double-edged sword: they always and inevitably come with positive and negative consequences. Decisions in healthcare--from a systems level to the individual patient--are not different. This approach acknowledges that for all recommendations and decisions all the important consequences need to be considered. ⋯ If, for example, the evidence for six of seven critical outcomes is of low quality while moderate quality evidence is available for the other critical outcome, the overall quality of evidence is considered low to avoid a false sense of certainty with the assessment of the evidence for a given topic. A recommendation according to GRADE also requires a considerate judgement about the magnitude of the expected balance of benefits and downsides for the important outcomes, the relative values and preferences associated with these outcomes and considerations about the required resources. The international collaboration and acceptance by many organisations is an indicator of GRADE's innovative nature and advances in the assessment of evidence and development of recommendations in the context of healthcare.