Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2010
[Dealing with bottlenecks in health care--ethical issues].
Due to the ageing of our society and the enduring progress of medicine it will no longer be possible to provide universal access to everything health care providers could potentially offer. Therefore, we need a debate on legitimate health care claims and fair distribution of medical resources under conditions of scarcity - hence on matters of social justice. This paper will look at some general ethical aspects and some specific proposals for fair criteria of rationing in health care.
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Z Evid Fortbild Qual Gesundhwes · Jan 2010
[After 15 years of ÄZQ: 10 years of safety for patients].
The German Agency for Quality in Medicine (ÄZQ) has been actively addressing the topic patient safety for ten years. ÄZQ's work in the field has focused on establishing a patient safety expert circle, publishing various articles on the subject, developing a patient safety continuing education curriculum, setting up a patient safety internet forum, and participating in the WHO initiative "Action on Patient Safety: High 5s". Furthermore, "CIRSmedical.de", a reporting and learning system for German medical professionals supported and maintained by ÄZQ, developed into the nationwide "CIRSmedical.de Network". In the following article these activities and how they relate to other national and international patient safety programs are described.
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Z Evid Fortbild Qual Gesundhwes · Jan 2010
[Patient-reported clinical trial endpoints--the current state of affairs in research and practice].
Patient-reported outcomes are increasingly considered as endpoints for clinical studies. Instruments for measuring patient-reported outcomes range from simple assessments of discrete symptoms or signs to complex measures addressing multidimensional constructs such as health-related quality of life. While generic measures are designed to be applicable across a wide range of clinical conditions, disease- or population-specific instruments address health problems which are relevant for a particular disease or target group. ⋯ As predictors and mediators of clinical outcomes they may contribute to the understanding of how patients benefit from treatment. They are included as primary endpoints when treatment effects comprise subjective phenomena such as pain, fatigue or psychological well-being. Current research activities in the field of patient-reported outcomes include the development of new (disease-specific) instruments, head-to-head comparisons of psychometric properties of measures, analysis of the context-dependence of results, and application of patient-reported outcomes in clinical practice.
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Z Evid Fortbild Qual Gesundhwes · Jan 2010
[Doctor rating sites: which of them find the best doctors in Germany?].
Online doctor rating sites have been increasingly discussed in the past few years, but scientific papers on the issue are rare. Results of a recent study could show that online doctor rating sites do not support patients in identifying qualified doctors. ⋯ At present,all German online doctor rating sites are being assessed according to the list of quality criteria by ÄZQ. The results will be published.
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Z Evid Fortbild Qual Gesundhwes · Jan 2010
[Process optimisation in hospitals: from process to business organisation].
Apart from a multidimensional quality definition and the understanding of quality as a company-wide challenge, a third essential element of quality management is prevention. Thus, company quality policy has to be prevention-oriented and requires both customer and process orientation as important prerequisites. Process orientation especially focuses on the critical analyses of work flows as a condition for identifying early intervention options which, in turn, may influence the result. ⋯ The success of management in all industries, including the health care sector, crucially depends on the translation of ideas into practice, among them the critical factor of sustainability. In this context, the support by the management as a role model, a formal frame for the respective project group and the definition of controlling via defined indicators have special importance. The example of the Diagnostic Centre for Internal Medicine and Neurology demonstrates that the result of changed processes may release a cultural change where competition can be replaced by cooperation step by step.