Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Integration von Physician Assistants in die hausärztliche Versorgung: Akzeptanz und Bedenken von Hausärzt*innen","authors":"Alessia Dehnen ,&nbsp;Benjamin Borchardt ,&nbsp;Philip Schillen ,&nbsp;Jürgen in der Schmitten ,&nbsp;Christine Kersting ,&nbsp;Angela Fuchs ,&nbsp;Nino Chikhradze ,&nbsp;Dorothea Dehnen","doi":"10.1016/j.zefq.2024.11.008","DOIUrl":"10.1016/j.zefq.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Strategies to counteract the impending and in some places already existing shortage of general practitioners (GPs) are being discussed in Germany. One approach could be to establish interprofessional teams in GP practices by integrating physician assistants (PAs).</div></div><div><h3>Question</h3><div>Can GPs imagine employing a PA in their practice and if so, under what conditions?</div></div><div><h3>Methods</h3><div>In March/April 2023, about 5,000 GPs in North Rhine-Westphalia (NRW), who work in a region with a care level of &lt; 100 %, and about 1,000 GPs from Saxony-Anhalt were asked to take part in an online-based survey. Simultaneously, semi-structured preliminary interviews (one online focus group with four participants, seven individual interviews) were conducted with GPs from NRW.</div></div><div><h3>Results</h3><div>290 GPs participated in the survey (response rate approx. 5 %). Of these, 46.3 % expressed interest in employing a PA in their practice. A majority of 60 % considered assignments such as conducting an open consultation for uncomplicated respiratory tract infections or vaccination consultations to be delegable. As many as 21.9 % would be willing to pay a PA more than 3,500 euro gross monthly salary (based on a full-time position) (8.7 % more than 4,000 euro), while 38.4 % stated that they could not currently afford the cost of employing a PA. The qualitative results underline these findings. One of the respondents’ conditions for the employment of a PA was to abolish the quarterly budget limits for GPs.</div></div><div><h3>Discussion</h3><div>Many GPs already express their interest and willingness to both employ PAs and to delegate medical tasks to them – in spite of unanswered questions and, possibly, by necessity. About a fifth of the participants can even imagine paying from their own budget the same gross salary that PAs employed by hospitals are paid. Reliable clarification of feasibility, safety and cost-effectiveness of the use of PAs as well as effects on the quality of treatment in primary care should be a priority for health policy actors.</div></div><div><h3>Take-home message</h3><div>From the GP’s point of view, the integration of PAs into GP-centred care in terms of an interprofessional team practice has got potential. At the same time, the question of financial feasibility is still unsettled.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 66-76"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient*innenbeteiligung am Beispiel des Innovationsfondsprojekts „integrierte, sektorenübergreifende Psychoonkologie“ (isPO)","authors":"Vera Schiewer ,&nbsp;Anne Klein ,&nbsp;Thilo Dietz ,&nbsp;Hildegard Labouvie ,&nbsp;Michael Kusch ,&nbsp;Hedy Kerek-Bodden ,&nbsp;Michael Hallek","doi":"10.1016/j.zefq.2024.11.004","DOIUrl":"10.1016/j.zefq.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>In the German health care system, the participation of patients (patient representatives) and the consideration of their perspectives in all phases of research and care are being increasingly demanded. How appropriate patient participation (participation of patient representatives) can be designed is illustrated by the example of the project on the new form of care titled “<em>Integrated, cross-sectoral psychooncology</em> nVF-isPO” and funded by the Innovation Fund at the Federal Joint Committee.</div></div><div><h3>Method</h3><div>The realization of patient (representative) participation is presented by the example of the isPO project, taking into account the short form of the Guidance for Reporting Involvement of Patients and the Public (GRIPP2). This is done on the basis of the involvement and participation of patients (patient representatives) in research, care and care evaluation, as well as quality development (1) through the Haus der Krebs-Selbsthilfe – Bundesverband e. V. (HKSH-BV), as the consortium and contract partner in conceptual project work, (2) through the participation of cancer survivors in the role of isPO oncoguides, and (3) through the involvement of cancer patients in the evaluation of the nVF-isPO.</div></div><div><h3>Results</h3><div>Through the constant involvement of the HKSH-BV as a consortium partner, the patients’ perspective informed the development and implementation of the nVF-isPO at an early stage. The nVF-isPO’s isPO-Oncoguide concept, developed in collaboration with the HKSH-BV, made it possible to involve cancer survivors as isPO-Oncoguides in health care. In addition, oncological patients, who are regarded as health benefit recipients in the health care evaluation, were involved in the further development of the quality of care of the nVF-isPO.</div></div><div><h3>Conclusion</h3><div>The involvement and consideration of the expertise of patients (patient representatives) in all phases of development, implementation and evaluation have been realized in the isPO project. The isPO project has been recognized by the HKSH-BV as having a high degree of patient participation; and the nVF-isPO and the concept of the isPO-oncoguide are recognized as relevant, acceptable and of high quality from the perspective of both cancer survivors and cancer patients.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 42-48"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herausgeberkollegium / Editorial Board","authors":"","doi":"10.1016/S1865-9217(25)00036-4","DOIUrl":"10.1016/S1865-9217(25)00036-4","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Page ii"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use and acceptance of video consultation among adults insured by statutory health insurance providers in Germany: A nationwide online survey","authors":"Saskia Muellmann ,&nbsp;Karina Karolina De Santis ,&nbsp;Hermann Pohlabeln ,&nbsp;Hajo Zeeb","doi":"10.1016/j.zefq.2024.12.008","DOIUrl":"10.1016/j.zefq.2024.12.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The increasing digitalization of the healthcare system makes it possible to provide medical services using digital technologies without direct patient–provider contact. This study aimed to investigate 1) the use and acceptance of video consultation and 2) factors associated with the use of video consultation.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was conducted in February 2023. Overall, 20,000 adults insured at a statutory health insurance company in Germany (10,000 users and 10,000 non-users of video consultation) were invited by email to an online survey with 31 items. The items addressed use and acceptance of digital health services with a focus on video consultation, digital health literacy, and sociodemographic characteristics. Data were analyzed using descriptive statistics and factors associated with video consultation use were assessed using binary logistic regression.</div></div><div><h3>Results</h3><div>Among the 1,657 participants, 686 were users and 971 were non-users of video consultation. The participants were aged between 18 and 80 years (M ± SD: 44 ± 13 years), 55% were female, 59% reported a medium subjective socioeconomic status and 69% a good to very good health status. Video consultation was predominantly used following physician recommendations (71%) as part of general medical care (50%). The main reasons for using video consultation were time saving (93%) and flexibility in terms of location (87%). Most video consultation users felt well cared-for during video consulting (93%), would use it again (95%), and would recommend it to others (93%). Factors associated with video consultation use were age from 30 to 49 years, high subjective socioeconomic status, high digital health litercay, and very poor to moderate health status.</div></div><div><h3>Conclusion</h3><div>The acceptance of video consultations in this study was high. Advantages and barriers to offering video consultations from a physician perspective should be investigated to incorporate video consultations in everyday medical practice.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 36-44"},"PeriodicalIF":1.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhalt und Qualität webbasierter Gesundheitsinformationen zur Prävention und Prädiktion von Nahrungsmittelallergien bei Kindern: eine systematische Evaluation","authors":"Madlen Hörold ,&nbsp;Magdalena Rohr ,&nbsp;Maja Beyer ,&nbsp;Theresa Bauer ,&nbsp;Mara König ,&nbsp;Katharina Gerhardinger ,&nbsp;Christian Apfelbacher ,&nbsp;Susanne Brandstetter","doi":"10.1016/j.zefq.2024.11.010","DOIUrl":"10.1016/j.zefq.2024.11.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Web-based health information can support health-related decisions if it is of high quality, i. e. accurate, understandable and barrier-free. Our study systematically searched for German-language, web-based health information on the prevention and prediction of food allergies in children and assessed their content and quality.</div></div><div><h3>Methods</h3><div>In July 2022, four researchers conducted a systematic Google search for German-language web-based health information (HI) on the prediction and prevention of food allergies in children. They searched independently of each other with a predefined search algorithm. Two independent reviewers analyzed the data using qualitative and quantitative content analysis (step/analysis 1) and assessed the quality of HI (step/analysis 2) using a comprehensive criteria catalog (transparency, text design, content, language, presentation of frequencies and statistical information, visualization, and accessibility).</div></div><div><h3>Results</h3><div>The systematic search yielded 59 websites, which were provided by nine sectors. The most frequent sectors were “Health portals and expert opinions” and “Guidelines/scientific and medical specialized information” (22% each). The content analysis (step 1) showed, among other things, that the topic of prediction was only implicitly addressed. 49 materials (83%) contained guideline-compliant information. However, there were also 26 materials (44%) whose content was not in line with the current S3 guideline on allergy prevention. Quality assessment (step 2) revealed that only a small number of the 43 HI received good or very good ratings regarding the transparency (n = 3, 7%) and content (n = 9, 21%) criteria. The criterion concerning frequencies and statistical information was rated good or very good quality in only 11 HI (26%). Almost all HI met the quality criteria for language (n = 38, 88%), text design (n = 43, 100%), and visualization (n = 43, 100%). None of the evaluated HI was given a good or very good rating in terms of accessibility criteria. The analysis by sector revealed only minor differences (mean of the seven criteria: 56–69%).</div></div><div><h3>Conclusion</h3><div>The quality of the available web-based health information on the prevention and prediction of food allergies in children is highly heterogeneous. There is need for improvement in terms of accessibility, content (e. g., selective presentation of prevention measures), and transparency (e. g., missing details of contacts). Further research is needed for expanding the user perspective and analyzing social media in the context of prediction and prevention of food allergies in children.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 45-55"},"PeriodicalIF":1.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kleinräumige und soziallagendifferenzierte Betrachtungen der Inanspruchnahme von Früherkennungsuntersuchungen in der Stadt Hamburg – eine Sekundärdatenanalyse","authors":"Denise Kubat ,&nbsp;Nele Meinert ,&nbsp;Susanne Busch ,&nbsp;Enno Swart","doi":"10.1016/j.zefq.2024.12.001","DOIUrl":"10.1016/j.zefq.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Social reporting in Hamburg identifies existing inequalities at the urban area level. These social-contextual variations may potentially influence preventive health behaviors. The aim of this article is to examine correlations between the degree of social regional disadvantage of Hamburg’s population and the utilization of regular screening examinations for children, adolescents, and adults through small-area analysis.</div></div><div><h3>Methods</h3><div>The analyses are based on claims data from 2017 of insured individuals living in Hamburg from three cooperating statutory health insurance funds. A socially contextual indicator (1 = “very low” to 7 = “high”) was assigned to the data at urban area level. Based on this, binary correlations between the social indicator and calculated utilization rates (stratified by gender and age) of early detection examinations were examined using Kendall’s tau correlation analysis.</div></div><div><h3>Results</h3><div>The study population included N = 433,053 individuals (53.7 % female) from the city of Hamburg. Strong positive associations were found between utilization rates and social contextual index classes for U7 to U9 examinations (r &gt; 0.7; p-values &lt; 0.05) as well as cervical cancer screening (r &gt; 0.9; p-values = 0.002), indicating that utilization increases with the rising social status of the urban area level. Additionally, strong positive correlations can be observed in some subgroups for prostate cancer screening (&gt; 59 years: r = 0.905, p-value = 0.004) and colorectal cancer screening (women aged 50–60 years: r = 0.905, p-value = 0.004). No significant correlations were found for other subgroups, as well as for skin cancer screening, breast cancer screening and the J1 examination (p-value &gt; 0.05). Strong negative associations have only been detected for the general health check-up for individuals aged 35 to 59 (women: r = –0.810, p-value = 0.011; men: r = –0.714, p-value = 0.024).</div></div><div><h3>Discussion and Conclusion</h3><div>The results indicate inequalities in the use of early detection examinations provided by statutory health insurers for children and adults to the disadvantage of urban areas ranking lower in social status. This socially selective utilization may lead to an accumulation of health problems in urban areas that are already disadvantaged socially, which would result in an exacerbation of existing social and health inequalities. Small-scale and socially differentiated analyses of healthcare provision should be seen as a regular component of regional healthcare provision. They provide starting points for a more needs-oriented further development of the healthcare system and secondary prevention services.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 74-81"},"PeriodicalIF":1.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unerfüllte Behandlungswünsche jüngerer und älterer Menschen mit geistiger, psychischer und mehrfacher Behinderung: eine Pilotstudie in einer Einrichtung im Ruhrgebiet","authors":"Sarah Heidenreiter,&nbsp;Michael Lauerer,&nbsp;Eckhard Nagel","doi":"10.1016/j.zefq.2024.12.004","DOIUrl":"10.1016/j.zefq.2024.12.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Unmet health care needs are seen as a key indicator of equity in access to health care. With younger people, they can lead to poorer health outcomes in adulthood, and in older people they can be associated with an increased risk of mortality. The presence of a disability is considered a risk factor for unmet needs. Against this background, unmet health care needs of younger and older people with intellectual, mental and multiple disabilities in Essen were examined as part of a qualitative pilot study in a facility in Essen.</div></div><div><h3>Method</h3><div>The interview study includes the perspectives of adolescents and older people living in a residential facility for people with intellectual, mental and multiple disabilities, as well as assessments of their caregivers and managers of the institution. We conducted semi-structured guided interviews with clients and managers, and unstructured interviews with care assistants. After transcription, a qualitative content analysis and a supplementary frequency analysis were carried out. The reporting is based on the Standards for Qualitative Research (SRQR).</div></div><div><h3>Results</h3><div>A total of eleven interviews – five with people with intellectual, mental and multiple disabilities, four with care assistants, and two with managers – were subjected to analysis. Fourteen interviews conducted with people with intellectual, mental and multiple disabilities and one interview with a care assistant had to be excluded due to high cognitive impairment or lack of insight, amongst other reasons. The clients reported unmet needs, particularly in outpatient care: waiting times, shortcomings in both treatment and doctor-patient interaction play a decisive role. The latter manifests itself in disregarding the patients’ wishes and the patients’ feeling of not being taken seriously. The most frequently cited consequence of unmet needs is a change of physician. Care assistants and managers unanimously confirmed their clients’ experiences in the areas mentioned and added: lack of opportunities for their clients to participate in medical consultations and lack of medical information. In addition, their clients’ problems often start with accessing health care since their ability to identify and articulate complaints or treatment requests is often limited.</div></div><div><h3>Conclusions</h3><div>Using one residential facility in the Ruhr region as an example, the results provide indications of deficits in the health care of younger and older people with intellectual, mental and multiple disabilities as well as priorities for a sustainable improvement in their health-related living situation. One specific field of action is to increase the competencies of service providers regarding the care of people with intellectual, mental and multiple disabilities and their specific needs. In addition, doctor-patient interaction must be adapted and target group-specific communication introdu","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 56-65"},"PeriodicalIF":1.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital health technologies enabling the transition from pregnancy to early parenthood: A scoping review","authors":"Alexander Hochmuth ,&nbsp;Alisa M. Hochmuth ,&nbsp;Christoph Dockweiler","doi":"10.1016/j.zefq.2024.11.013","DOIUrl":"10.1016/j.zefq.2024.11.013","url":null,"abstract":"<div><h3>Background</h3><div>Pregnant women and their families, especially those navigating chronic illness or challenging life situations, often seek information and counseling. The pregnancy period and the transition to parenthood can exacerbate these circumstances, leaving families particularly vulnerable. Addressing stressful situations becomes a hurdle in this context. Digital health technologies (DHTs), encompassing mobile apps, wearable devices and online platforms, present a valuable avenue for pregnant women and their families to access health information, educational parenting resources and personalized recommendations. The aim is to analyze the current research of digital health interventions designed to support parents throughout the transition from pregnancy to parenthood.</div></div><div><h3>Methods</h3><div>We conducted a scoping review and analyzed MEDLINE via PubMed, CINAHL, Cochrane Library, IEEE Xplore Digital Library, ScienceDirect and PsycINFO. Relevant German and English articles from 2004 to 2023 referring to DHTs to improve the time before and after birth were included.</div></div><div><h3>Results</h3><div>In 78 articles, pregnant women and parents utilized various DHTs such as mobile applications, multi-functional digital platforms, social media, videos and health websites during the transition from pregnancy to parenthood. Mobile apps and multi-component digital interventions were most frequently used in these studies. A large proportion of the studies employed experimental designs such as randomized controlled trials (RCTs) and quasi-experimental methods. DHTs empower healthcare professionals to enhance parental health education for expecting and new parents in areas such as breastfeeding, preterm birth risks and mental health. DHTs provide accessible support, instruction, counseling and health services, including care for premature infants and guidance on baby-care practices. These DHTs also enable innovative monitoring of pregnancy progress, women’s health, breastfeeding and mental wellbeing, thereby revolutionizing healthcare support for pregnant individuals and young families.</div></div><div><h3>Conclusion</h3><div>DHTs allow pregnant women and their families to access health information, participate in parenting training, and receive personalized recommendations. This can contribute to increased self-care and a sense of control over the pregnancy journey. There is also a need for research to understand the effectiveness and feasibility of implementing and evaluation existing digital health interventions.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 82-92"},"PeriodicalIF":1.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“We are doing it together, don’t worry” – A qualitative study on the implementation of electronic medical records in German hospitals","authors":"Kerstin Dittmer ,&nbsp;Mi-Ran Okumu ,&nbsp;Marina Beckmann ,&nbsp;Natalia Cecon-Stabel ,&nbsp;Paola Di Gion ,&nbsp;Till Jes Hansen ,&nbsp;Julia Jaschke ,&nbsp;Ute Karbach ,&nbsp;Juliane Köberlein-Neu ,&nbsp;Maya Nocon ,&nbsp;Carsten Rusniok ,&nbsp;Jessica Schmara ,&nbsp;Florian Wurster ,&nbsp;Holger Pfaff","doi":"10.1016/j.zefq.2024.11.009","DOIUrl":"10.1016/j.zefq.2024.11.009","url":null,"abstract":"<div><h3>Background</h3><div>The ongoing implementation of electronic medical records (EMRs) in German hospitals is currently slow. Implementation science widely acknowledges the barriers and facilitators to implementation. Thus, specific preconditions are necessary to address the former and to support an effective EMR implementation. However, a lack of knowledge exists about these necessary preconditions in Germany. This study aims to gain insight into key stakeholders’ experiences with implementing EMR systems in German hospitals to identify preconditions for embedding EMRs in this social context.</div></div><div><h3>Methods</h3><div>Expert interviews were conducted with members of hospital-wide implementation teams concerning EMR implementation. The interviewees belonged to the nursing, IT, medical, and pharmaceutical professions and worked in hospitals with different contextual characteristics. The interview guideline was based on the practical Consolidated Framework for Implementation, which supports the systematic assessment of potential barriers and facilitators to identify implementation strategies and necessary adaptations. Data was collected between May 2021 and September 2022, and the interviews were analyzed using qualitative content analysis.</div></div><div><h3>Results</h3><div>Thirteen interviews were conducted with employees from eleven hospitals. Five critical preconditions emerged for EMR implementation based on our analysis: 1) adaptation, where the clinical context and EMRs are aligned; 2) stakeholder co-production, where all relevant stakeholders (e. g., professional groups, departments, and hierarchical levels) are involved in planning, implementing, and evaluating; 3) end-user participation, where end-users are involved in the implementation through close support and training; 4) integration into daily routines, where EMRs are integrated into daily work, including work processes that initially require additional effort but are necessary to experience the relative advantages; and 5) the continuous Plan-Do-Check-Act cycle, where the EMR implementation process is continuously reviewed and adjusted. In addition, activities to enact these preconditions were derived based on the interview data.</div></div><div><h3>Discussion</h3><div>Our findings indicate that overall contextual adaptation is required. The five preconditions include essential activities to facilitate the integration of the EMR into daily routines. Participation, communication, and support are fundamental, as described in the international literature. Failure to comply with these preconditions can lead to challenges during implementation, such as end-user resistance.</div></div><div><h3>Conclusion</h3><div>Considering social and technical aspects is paramount in implementing EMRs, which may also apply to future digital innovations’ change management processes.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 66-73"},"PeriodicalIF":1.4,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barrieren und Förderfaktoren der Inanspruchnahme von Präventionsprogrammen zur Förderung der seelischen Gesundheit bei Kindern im Vor- und Grundschulalter","authors":"Max Weniger ,&nbsp;Josephine Kümpfel ,&nbsp;Katja Beesdo-Baum ,&nbsp;Julia Zink ,&nbsp;Cornelia Beate Siegmund ,&nbsp;Patricia Theresa Porst ,&nbsp;Maria McDonald ,&nbsp;Veit Roessner ,&nbsp;Susanne Knappe","doi":"10.1016/j.zefq.2024.11.002","DOIUrl":"10.1016/j.zefq.2024.11.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and Aims&lt;/h3&gt;&lt;div&gt;Emotional and behavioural problems occur frequently in childhood and are usually associated with burdens on children, families, and society. Preventive interventions could reduce these burdens, but are rarely used despite their availability and effectiveness. The aim was to identify general, individual, structural, and family-related barriers/facilitators to potential and actual participation in prevention programs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;As part of a prospective implementation study, n = 3,231 project folders were handed out to parents in 28 paediatric practices in Dresden and surrounding area during routine health check-ups (U9–U11) for children aged 5 to 10 years. In addition to screening for mental health problems, a questionnaire was used to identify potential barriers/facilitators to participation in prevention programs. Of n = 2,844 families agreeing to participate in the study n = 2,122 (74.6 %) completed the questionnaire at least partially. Regression analyses were used to test associations between potential barriers/facilitators and actual participation in (a) a pre-intervention interview (PII; in order to check indications with the program provider) or (b) the prevention program among children with a prevention recommendation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the participating families, 1.8 % reported that they had already participated in a prevention program to improve mental health or had received a recommendation for it before. 59.5 % of the families expressed their general interest in such programs, and 95.7 % would participate if their paediatrician recommended it. At the structural level, a lack of knowledge about mental health prevention programs was identified as a barrier to potential participation; as only 9.2 % of the families were aware of such programs before participating in the study. 65.8 % of all the families considered full reimbursement of the participation fees after paying in advance a prerequisite for their potential program participation, and 56.7 % wanted to receive a voucher from their health insurance fund entitling them to participate without prepayment. At the individual level, the parents’ attitude towards the usefulness of prevention programs predicted the actual utilisation of the PII after the paediatrician's recommendation. At the structural level, the acceptance of longer travel times (up to 60 minutes) as well as the assumption/reimbursement of the entire course fees were relevant predictors. Furthermore, male sex (of the children) and higher screening scores were also important predictors at the family-related level. After the PII, the only factor associated with actual participation in prevention programs was efficient public transport accessibility.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;In order to increase participation in prevention programs, funding to cover participation fees should be secured through health insurance funds. In addit","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"194 ","pages":"Pages 94-107"},"PeriodicalIF":1.4,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}