Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2014
Review[Review: Patient safety as a national health goal: current state and essential fields of action for the German healthcare system].
For some years patient safety has been an important topic for the design of the healthcare systems in many countries. In Germany we are still in the starting phase of this development. ⋯ Slowly, some find their way into the clinical routine in Germany. This paper summarises the state of development of patient safety from a trans-sectoral point of view and outlines essential fields of action for the German healthcare system.
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Z Evid Fortbild Qual Gesundhwes · Jan 2014
Review[Interdisciplinary teamwork in the OR: Identification and measurement of teamwork in the operating room].
Effective teamwork is one of the essentials in conducting successful and safe surgical procedures in the operating theatre (OT). The present paper aims to provide a selective review of various approaches describing effective interdisciplinary teamwork in the OT. Furthermore, it covers observational methods to assess OT teamwork with particular focus on Germany. ⋯ Those methods should entail the special characteristics of the OT team. They should include all phases of the surgical procedure and incorporate all the professions involved (surgeons, surgical nurses, and anaesthetic staff). We conclude that research into methods for the assessment of OTs in Germany needs to be undertaken as a prerequisite to investigating the relationship between OT teamwork and its effects on patient safety and surgical quality.
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Z Evid Fortbild Qual Gesundhwes · Jan 2014
Comparative Study[Comorbidity in medical guidelines: comparison of the current state, epidemiologic models and expert opinion].
Medical guidelines focusing on monomorbidities can be associated with adverse events in multimorbid patients. This study investigates how comorbidities are actually particularised in a set of German guidelines. In addition, it evaluates whether two epidemiologic approaches (disease combinations or clusters of comorbidities) can be used to systematically integrate multimorbidity in guideline development. ⋯ Methodological support is needed for addressing comorbidities in guidelines in a more consistent way. The currently existing epidemiologic approaches should not be used in their current form without being further developed and re-evaluated. Expert opinion of physicians involved in the care of multimorbid patients should be systematically included in methodological refinement studies.
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Z Evid Fortbild Qual Gesundhwes · Jan 2014
[Experiences with synopses of clinical guidelines using the example of synopses for Disease Management Programmes (DMP)].
Guideline synopses, i.e. the systematic synthesis of clinical practice guidelines, are used as a basis for Disease Management Programmes (DMPs) in Germany. One of the responsibilities of the German Institute for Quality and Efficiency in Health Care (IQWiG) is the preparation of guideline synopses for DMPs. The article describes the experiences with this methodology. ⋯ A guideline synopsis is an established tool for identifying health care standards as a basis for developing and updating DMPs. Further methodological development, particularly in collaboration with guideline providers, appears to be reasonable. It should be examined whether guideline synopses are suitable not only for guideline and DMP development, but also for other health care issues.
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Z Evid Fortbild Qual Gesundhwes · Jan 2014
[Patient-relevant outcomes and surrogates in the early benefit assessment of drugs: first experiences].
The Act on the Reform of the Market for Medicinal Products (AMNOG) became effective in Germany on January 1, 2011. Since then, the assessment of the added benefit of new drugs versus a therapeutic standard on the basis of dossiers submitted by pharmaceutical companies has been required by law. The Federal Joint Committee (G-BA) generally commissions the Institute for Quality and Efficiency in Health Care (IQWiG) with this task. ⋯ The first experiences with AMNOG have shown that in principle an early benefit assessment of drugs based on patient-relevant outcomes is feasible. The companies' and IQWiG's evaluations regarding patient relevance and surrogate validity of outcomes partly deviated from each other. By increasingly considering patient-relevant outcomes in approval studies, pharmaceutical companies can create the necessary data basis for the early benefit assessment.