Zeitschrift für ärztliche Fortbildung und Qualitätssicherung
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Z Arztl Fortbild Qualitatssich · Sep 2000
[Certification of an ambulatory gastroenterologic service fulfilling ISO Law 9001--criteria and national guidelines of the Gastroenterologic Association].
The objectives of certification and accreditation are the deployment and examination of quality improvement measures in health care services. The quality management system of the ISO 9001 is created to install measures and tools leading to assured and improved quality in health care. Only some experiences with certification fulfilling ISO 9001 criteria exist in the German health care system. ⋯ National guidelines of the German Society of Gastroenterology and Metabolism and the recommendations of the German Association of Physicians for quality assurance of gastrointestinal endoscopy were included in the documentation and internal auditing. This pilot quality management system is suitable for the first steps in the introduction of quality management in ambulatory health care. This system shows validity for accreditation and certification of gastrointestinal health care units as well.
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Z Arztl Fortbild Qualitatssich · Sep 2000
[Accreditation of hospitals in the USA according to the standards of the Joint Commission of Healthcare Organizations (JCAHO)--reflections on the transferability of these procedures to Germany].
The Accreditation-Process of the Joint Commission on Accreditations of Healthcare Organisations (JCAHO), specially the new international arm of the Joint Commission International Accreditation (JCIA) is also in Germany already in use. Some decades of experiences with the accreditation of healthcare institutions in the USA, generally recognized standards as well as a transparent process of survey are best conditions for an international transfer. The current legal requirements will be fulfilled by the system. Finally the JC-Process defeats the philosophy of a continuous quality improvement.
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Z Arztl Fortbild Qualitatssich · Sep 2000
[From data entry to data presentation at a clinical workstation--experiences with Anesthesia Information Management Systems (AIMS)].
Anesthesia Information Management Systems (AIMS) are required to supply large amounts of data for various purposes such as performance recording, quality assurance, training, operating room management and research. It was our objective to establish an AIMS that enables every member of the department to independently access queries at his/her work station and at the same time allows the presentation of data in a suitable manner in order to increase the transfer of different information to the clinical workstation. Apple Macintosh Clients (Apple Computer, Inc. ⋯ This additional information is of great advantage in comparison to previous working conditions. The implementation of an AIMS allowed to greatly enhance the quota but also the quality of documentation and an increased flow of information at the anesthesia workstation. The circuit between data entry and the presentation and evaluation of data, statistics and results directly available at the clinical workstation was put into practice.
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Z Arztl Fortbild Qualitatssich · Sep 2000
[Consideration, assessment and treatment of difficulty in breathing in palliative medicine].
Next to pain, the most frequent fear of dying patients, their relatives and doctors in attendance is to suffocate, even if there is no significant dyspnoea. During their progress of disease, around half (40-60%) of all tumour patients suffer from difficulty in breathing. This is due to many reasons, which include the entire differential diagnosis of dyspnoea as well as psychological and social aspects. ⋯ Besides application of demand drugs as morphine and lorazepam the most important therapy against asphyxia is the individual treatment of symptoms. All people involved should be educated in general treatment, nursing and psychological care to reduce the dying patient's fear of suffocation. This will result in the reduction of the patients states of panic and therefore allow them to die in a more peaceful way.