Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Medical leadership requires specific communication skills in order to meet professional demands. Communicative behaviour is usually highly automated and not necessarily conscious. ⋯ Accordingly, competent medical leadership requires the awareness of individual communication habits as well as the knowledge and ability to use conversation techniques suitable for a specific situational context. The training of leadership-related communication techniques requires the de-automation of existing skills and a problem-oriented construction and re-automation of new communication techniques.
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Z Evid Fortbild Qual Gesundhwes · Jan 2009
[GRADE: from grading the evidence to developing recommendations. A description of the system and a proposal regarding the transferability of the results of clinical research to clinical practice].
The Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group represents an international collaboration of guideline developers, clinicians, health services researchers and methodologists. Many leading organizations, including the World Health Organization (WHO), use the GRADE approach because it has led to progress in the assessment of evidence and in the development of healthcare recommendations. The GRADE system distinguishes the quality of evidence from the strength of a recommendation. ⋯ The GRADE system includes a systematic approach to evaluate the generalizability of study results to healthcare practice. Judgments about generalizability, better termed directness, are separated into judgments about the availability of direct comparisons between two alternative management strategies and judgments about differences between the population, intervention, comparator to the intervention, and outcomes (PICO) of interest for a given question, and those included in the relevant studies. In addition to providing an overview of the GRADE system, this article focuses on the approach to assessing directness or generalizability.
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Z Evid Fortbild Qual Gesundhwes · Jan 2009
[General legal conditions for prioritisation within the scope of the German Statutory Health Insurance system].
In setting health care priorities the law, and in particular the constitution, has to be obeyed. The social constitutional state must guarantee minimum access to health care. Members of the Statutory Health Insurance (SHI) shall have access to health care services protecting their life and ensuring their participation in society. ⋯ The decisions of the Federal Joint Committee (Gemeinsamer Bundesausschuss) are sophisticated enough but have to respect the rule of law. There are deficits in research on the prioritisation effects of health care law. Diminishing these deficits is a prerequisite for turning political priorities into effective legal provisions.