Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Randomized Controlled Trial Multicenter Study[General practitioners' opinion and attitude towards DMPs and the change in practice routines to implement the DMP "diabetes mellitus type 2"].
Effective implementation of disease management programmes (DMPs) in primary care practices often requires changes in practice workflows and responsibilities and acceptance by the parties involved. Within the ELSID study (evaluation study of the DMP diabetes mellitus type 2) the physicians' attitudes toward DMPs were obtained and an optimised implementation of DMPs was developed by conducting a quality management cycle with primary care practice teams. The aim was to investigate which practice workflows will have to be changed and what kind of barriers to implement these changes are perceived. ⋯ The majority of surveyed practices perceived some need for improvement. But sufficient resources (time, staff and money) are required to ensure efficient implementation of DMPs in primary care practices and their integration with routine processes. A redefinition of responsibilities for DMPs will strengthen the role of medical assistants and promote high-quality implementation of these programmes.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Randomized Controlled Trial Multicenter Study[Benchmarking in patient care: depression in Parkinson's disease].
Depression is the most common mental disorder in patients suffering from Parkinson's disease (PD) with an average prevalence of about 40% to 50%. Depression in PD has a major impact on the patient's health-related quality of life and caregivers' distress. Although common depressive symptoms in PD are under-diagnosed and therefore often untreated in clinical practice. ⋯ This study provided important data on the treatment of patients with PD and depression in Germany. There are a number of reasons for the observed lack of efficacy in this study. More studies are needed to develop an appropriate approach to performing benchmarking for the treatment of neurological disease.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Quality indicators for National Disease Management Guidelines using the example of the National Disease Management Guideline for "Chronic Heart Failure"].
Together with an expert committee a structured approach to determining quality indicators for National Disease Management Guidelines has been developed. The key steps of this approach include: introducing guideline authors to the methodology at an early stage of the process of guideline development, pre-selecting recommendations of the guideline which are potentially measurable by means of quality indicators, assessing the potentially measurable quality indicators in written form using five criteria (including their importance for the health care system and clarity of definitions) and approving them in a formal consensus process. For lack of a database these quality indicators must be regarded as preliminary. ⋯ In a second step, the quality indicators have to be validated within a pilot project. The determination and assessment of the potential quality indicators have revealed room for improvement of guideline development. In particular, there is a need for more health care data and for specification of recommendations.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Vocational training in general practice in Germany: a nation-wide survey among trainees].
The increasing shortage of (primary care) physicians in Germany is currently being discussed within and outside the profession. A national survey among general practice trainees aimed to explore their perspectives of vocational training (VT). ⋯ These results provide clues to improving VT in General Practice with respect to organisation and content including the consideration of gender-related living conditions. Furthermore, improvement and further development of VT programmes should ideally be part of an area-wide, interdisciplinary and intersectoral approach.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Needs assessment of a longitudinal training course in vocational training within the Verbundweiterbildung(plus)].
In Germany content-related vocational training mostly is the responsibility of the trainees themselves. The aim of this needs assessment is to explore the requirements of a longitudinal training course in vocational training. ⋯ The results of this needs assessment demonstrate the importance of vocational trainees' needs and the findings of health services research for improvement of content-related vocational training. Furthermore, the results form the basis for longitudinal training courses in vocational training, as shown in the approach of the training course within the training programme Verbundweiterbildung(plus).