Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Randomized Controlled Trial Multicenter Study[Does implementation of benchmarking in quality circles improve the quality of care of patients with asthma and reduce drug interaction?].
The purpose of this cluster-randomised controlled trial was to evaluate the efficacy of quality circles (QCs) working either with general data-based feedback or with an open benchmark within the field of asthma care and drug-drug interactions. ⋯ General practitioners seem to take a critical perspective about open benchmarking in quality circles. Caution should be used when implementing benchmarking in a quality circle as it did not improve healthcare when compared to the traditional procedure with anonymised comparisons.
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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 2010
Multicenter Study[Emergency medical treatment of paediatric palliative care patients: a problem for emergency medical care services? A retrospective, multicentre observational study].
In Germany a few specialised palliative care teams (PCTs) enable paediatric palliative care patients to stay at home in the final stage of their life. During this stage patients often experience episodes of acute symptoms requiring rapid medical intervention. In this case care-giving relatives can call emergency medical care services. The present investigation aims to show the meaning of emergency medical care services in treating paediatric palliative care patients in a home-care setting. Moreover, mental strain of emergency medical staff in paediatric medical emergencies and end-of-life care will be discussed. ⋯ Our data demonstrate that emergency medical treatment is less frequently provided to paediatric than to adult palliative care patients. However, these paediatric patients also need help that is based on the principles of palliative care like adult patients do. In the context of quality standard optimisation, specialised PCTs should get more involved in paediatric palliative home and pre-hospital care, even in cases of medical emergencies in these patients. After end-of-life decisions relating to paediatric patients, psychological support to the emergency medical team seems to be both helpful and reasonable.