Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Triage ("sorting") will only be necessary in the setting of mass casualties and lack of sufficient paramedical and medical specialists as well as equipment. Triage means that the victims will be divided into four categories denoting urgency of treatment and chance of survival. The most experienced medical doctor or officer is responsible for the triage.
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Incidents with a large number of diseased and injured people (i.e., mass casualty incidents) require special medical logistics. Due to the disproportion between the unknown number of patients and the limited number of medical personnel and equipment, there is an urgent need to use available resources to their full extent so that the largest possible number of patients can receive the emergency care they need. ⋯ This process of prioritising is the primary task of the senior emergency physician. The result of this so-called triage is being documented on triage tags.
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Z Evid Fortbild Qual Gesundhwes · Jan 2009
[The effectiveness of CME -- quality improvement through differentiated advanced medical education research].
Continuing medical education (CME) increasingly focuses on measurable patient outcomes. Nevertheless, international data on this issue are insufficient, and in Germany the measurable effects of CME in terms of its efficacy and utility for patient care have hardly been subjected to scientific examination. ⋯ Advanced medical training in Germany therefore requires the implementation of a kind of learning and teaching research that should be geared toward individual training needs, personal motivation and the outcomes of medical care. In addition, the definition of educational goals and the advancement of CME in terms of continuing professional development (CPD) should be considered an important component for a reevaluation of CME.
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Z Evid Fortbild Qual Gesundhwes · Jan 2009
[EUebm--integrating a Europe-wide harmonised training and continuing medical education in evidence-based medicine (BbM) with patient care].
Integrative concepts of teaching and learning with close reference to individual work routines are better suited to bring about attitudinal and behavioural modification--apart from a gain in knowledge and skills--than traditional educational approaches. All the same, the vast majority of continuing training courses in Evidence-based Medicine takes place during weekend courses or evening classes, outside the work environment. To counteract this deficit a modular curriculum framework for Evidence-based Medicine was developed within the scope of the European research project EUebm which aims to achieve both a harmonisation of EbM education and training in Europe and a better integration of education and training with everyday clinical practice. ⋯ On the basis of a survey conducted among all the project partners in Austria, England, Germany, Hungary, Italy, The Netherlands, Poland, Spain and Switzerland the demand for training and continuing education in EbM in the individual countries was identified. Taking into account the results of this survey as well as previous work such as, for example, the curriculum of the German Network for Evidence-based Medicine or material provided by the Centre for Evidence-based Medicine in Oxford, an Internet-based teaching and learning module on systematic reviews and meta-analyses was developed and tested in five of the participating countries. The test demonstrated that in this way harmonisation of EbM education and training and a better integration of training with our everyday clinical work becomes feasible.
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Z Evid Fortbild Qual Gesundhwes · Jan 2009
[Clinical pathway, quality circle and standard operating procedures as tools for quality management in the trauma suite].
In each hospital the trauma resuscitation room in emergency departments is one of the areas with the highest rate of critical incidents. Delayed and insufficient medical interventions have a high impact on negative patient outcomes. ⋯ In this context some elements of quality management are well-established in clinical practice. In the present study we describe the implementation of a clinical pathway and an interdisciplinary quality circle to improve management of the trauma patient.