Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Using quality indicators to measure the quality of general practice care in Germany].
The publication of two German systems of quality indicators for ambulatory care (AQUIK and QISA) in 2009 stimulated a discussion in German general practice about how to appropriately measure the quality of care in general practice / family medicine. The basic properties and requirements of quality indicators (QIs) in the international literature are discussed in terms of their ability to measure the specific processes of care in general practice. ⋯ In addition, the context of application and usage of QIs in primary care and the quality control they may provide are discussed. We conclude that important methodological problems have yet to be solved, particularly with measuring 'horizontal' dimensions of quality in primary care (such as comprehensiveness, co-ordination and person-centredness), but that the use of QIs may increase the visibility of general practice in Germany.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Analysis and evaluation of the QUALIFY tool for assessing quality indicators with structured group interviews].
Quality indicators are used world-wide to monitor the quality of health care. For these indicators to be effective they also have to meet certain quality criteria. The QUALIFY tool is used for assessing the quality criteria themselves against a scientific background. ⋯ QUALIFY, and thus the assessment of quality indicators, has entered virgin territory. Since quality assessment will be gaining relevance the further evaluation and development of these tools is warranted. In this context group interviews could provide an applicable approach to evaluating acceptance and implementation problems.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Comparative Study[Primary care practices in Germany: a model for the future].
In its 2009 report the Federal Advisory Council on the Assessment of Developments in the Health Care System developed a model of Primary Care Practices for future general practice-based primary care. This article presents the theoretical background of the model. ⋯ Developments of the elements comprising the health care system may be compared to the developments and proposals observed in other countries. In Germany, however, the pace of these developments is relatively slow.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Patient participation and shared decision making in Germany - history, agents and current transfer to practice.
The main focus of the present paper is to describe 1) the healthcare system specific influences on patient participation in medical decision making and 2) the current state of research and implementation of shared decision making (SDM) after ten years of substantial advances in health policy and research in this field. WHAT ABOUT POLICY REGARDING SDM? The "Medical Patients Rights Act" is to standardise all the rights and responsibilities within the scope of medical treatment. This also comprises the right to informed decisions, comprehensive and comprehensible information for patients, and decisions based on the partnership of clinicians and patients. ⋯ The development and implementation of decision support tools for patients and professionals as well as the implementation of trainings for healthcare professionals require stronger efforts. WHAT DOES THE FUTURE LOOK LIKE? With the support of health policy and with the utilisation of scientific evidence, the transfer of shared decision making into practice is considered to be meaningful in the German healthcare system. The translation into routine care will remain an important task for the future.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[The user oriented hospital - chances and challenges for the healthcare industry].
Hardly any other part of the healthcare sector is under such a pressure to change as the hospital sector. Hospitals are high-performers in coping with complex changes in modernising patient care, process design, quality, cost-effectiveness and service orientation. But, what really makes value to the patient? Currently, this question is raised with new seriousness. ⋯ In terms of business development, user orientation does not only yield important impulses for stronger patient centred care, but also opens up chances for better quality and competitive advantages. Nevertheless, it requires a new understanding of innovation processes which considers value for patients and quality of results and outcome as a relevant scale for measuring effects of change management. Finally, the methods of the assessment of user oriented healthcare delivery are an essential challenge for the evaluation of cooperative healthcare services.