Zeitschrift für ärztliche Fortbildung und Qualitätssicherung
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Z Arztl Fortbild Qualitatssich · Nov 2003
[Clinical practice guidelines for the diagnosis and therapy of depressive disorders in primary care].
The guidelines for diagnosis and treatment of depressive disorders are practice-oriented and evidence-based recommendations for primary care of depressive patients. They were developed in the context of subproject 3.1 "Comprehensive Quality Management in Outpatient Care" within the German Research Network on Depression and Suicidality. The guidelines were developed by research groups from study centres in Freiburg, Duesseldorf and Munich and an external expert group. ⋯ The development process followed the methodological recommendations of the Association of the Scientific Medical Societies in Germany (AWMF) and the requirements of evidence-based medicine. National and international guidelines for depressive disorders as well as Cochrane reviews (CR) and quality-assessed reviews (CRD) were taken into account. The present formulation of the treatment guidelines and the evidence was agreed upon in a consensus process that included all participants.
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Z Arztl Fortbild Qualitatssich · Nov 2003
[Development and evaluation of a basic documentation tool for guideline-oriented ambulatory care of depressive patients].
Quality assurance in the treatment of mental disorders is becoming increasingly significant. In this context, documentation systems are important in order to control the implementation of guidelines, to analyse shortcomings and to reveal improvement possibilities. Up till now there is no specific documentation tool for the outpatient care of depressive disorders. ⋯ The evaluation results demonstrate that the documentation tool is able to assess guideline-oriented treatment measures. Physicians evaluated the usefulness and practicability of the documentation tool positively. And although the documentation efforts required are quite extensive, this documentation tool provides a suitable basis for external or internal quality assurance as well as patient-oriented case-monitoring.
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Z Arztl Fortbild Qualitatssich · Nov 2003
[Risk management from the perspective of the hematologist].
The present paper deals with the physician's accountability during the implementation of hemotherapeutic measures. Since July 1, 1998 a Transfusion Law ('Transfusionsgesetz') regulates the clinical use of blood products in Germany in accordance with the guidelines established by the German Medical Association and the Paul Ehrlich Institute, which are regularly revised and adapted on the basis of current professional knowledge and technology. The therapeutic freedom allowed under the Code of Professional Medical Conduct is taken into account by the fact that the responsibility for hemotherapy in each individual case lies with the attending physician, no matter whether this applies to the diagnosis, the patient counselling or the administration of the transfusion itself. ⋯ Experience to date has demonstrated the success of the Transfusion Law. Whereas previously hospital managements have often failed to respond to suggestions for change or improvement, their attention may now be drawn to this law. This has led to blood products being increasingly used according to the same standards and keeping transfusing physicians on safe legal ground.