Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"[Barriers and facilitators to the use of mental health prevention programs among preschool- and elementary school-aged children].","authors":"Max Weniger, Josephine Kümpfel, Katja Beesdo-Baum, Julia Zink, Cornelia Beate Siegmund, Patricia Theresa Porst, Maria McDonald, Veit Roessner, Susanne Knappe","doi":"10.1016/j.zefq.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.11.002","url":null,"abstract":"<p><strong>Background and aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>In order to increase participation in prevention programs, funding to cover participation fees should be secured through health insurance funds. In addition, adverti","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-11","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}

{"title":"[Information and support needs of women planning an abortion according to counselling regulations in Germany - A qualitative study].","authors":"Caroline Jeltsch, Birte Berger-Höger","doi":"10.1016/j.zefq.2024.09.001","DOIUrl":"10.1016/j.zefq.2024.09.001","url":null,"abstract":"<p><strong>Background: </strong>For women seeking legal abortion care, access to information and care options is not transparent in Germany. This can affect health and complicate the decision-making process. In its guideline, the WHO recommends the use of evidence-based information to enable women to make informed decisions. This qualitative study aims to assess preferences and decisional needs of women in Germany.</p><p><strong>Method: </strong>For the needs assessment, a qualitative study based on semi-structured guided interviews was conducted with pregnancy conflict counsellors and women who terminated a pregnancy in the past five years in Germany. These data were supplemented with social media group postings of women with pregnancy conflict experiences. All data were analysed using content-structuring analysis according to Kuckartz.</p><p><strong>Results: </strong>Three women who had undergone an abortion and two pregnancy conflict counsellors were interviewed. In addition, 89 posts from a closed social media group were analysed. Three main categories were identified: women's categorisation in value systems, factors influencing the experience of the care process and information needs of women facing conflict situations in connection with their pregnancy (\"pregnancy conflict\"). Abortion is considered to be stigmatised, so women rarely use existing counselling services. Overall, there is a high need for information and support among those seeking care. Concerns exist, especially with regard to the methods of abortion. The results of the study also indicate a burden caused by fragmented care, which requires a high degree of self-organisation of women.</p><p><strong>Discussion: </strong>The care situation in Germany does not meet the recommendations of the WHO guideline on safe abortion. The results indicate that care close to home and with an abortion procedure that meets women's individual preferences and thus complies with their self-determination has not yet been achieved in Germany.</p><p><strong>Conclusion: </strong>Neutral and evidence-based information could be helpful to enable women to make informed decisions and reduce anxiety. It would also be desirable to increase the opportunities for women to talk about their experiences in a protected environment.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":"44-52"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548141","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":"[Bridging the know-do gap: Implementation approaches to complex family interventions].","authors":"Saskia Oesch, Torsten Schwalbach, Lotte Verweij, Myrta Kohler, Simone Sutter, Marco Riguzzi, Rahel Naef","doi":"10.1016/j.zefq.2024.09.003","DOIUrl":"10.1016/j.zefq.2024.09.003","url":null,"abstract":"<p><strong>Background: </strong>The introduction of complex family interventions poses a challenge since they consist of various interacting components which affect multiple players and often require changes in behaviour and work processes. Implementation success is strongly influenced by environmental factors. The comprehensive implementation of complex interventions therefore needs a deliberate and systematic implementation process, including its evaluation. Implementation science offers a variety of theories and methods to support the integration and evaluation of complex family health interventions in real-world settings, requiring a broad spectrum of knowledge and skills for clinicians and researchers alike. Hence, specific examples may be relevant to both clinicians and researchers who wish to systematically address know-do gaps in clinical practice.</p><p><strong>Aim: </strong>The aim is to describe and illustrate how complex family interventions can be systematically designed, evaluated and implemented using implementation science frameworks and methods by drawing on two research projects - namely the Family Support in Intensive Care Units (FICUS) and Bereavement Support for Families (B4F).</p><p><strong>Methodical steps to implementation: </strong>Five steps were used to implement and evaluate the interventions across both research projects: 1) engaging key persons and families, 2) identifying gaps in care and developing/adapting the intervention, 3) understanding the implementation context, 4) tailoring implementation approaches, and 5) evaluating implementation progress and success.</p><p><strong>Discussion and conclusion: </strong>The five illustrated steps allow for a theory-guided but nevertheless pragmatic approach in the implementation of complex family interventions. This approach may serve as a guide to integrate complex interventions and evidence-based practices into routine care and to close know-do gaps.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":"101-107"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689183","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":"[Long-/Post-COVID symptoms in a hotspot collective of the first wave of the SARS-CoV-2 pandemic in Germany].","authors":"Anna Wolfschmidt, Stephan Ott, Steffi Richter, Johannes Schmidt, Wolfgang Uter, Hans Drexler, Thomas Finkenzeller","doi":"10.1016/j.zefq.2024.10.002","DOIUrl":"10.1016/j.zefq.2024.10.002","url":null,"abstract":"<p><strong>Introduction: </strong>Despite a high number of long/post-COVID cases and an enormous psychological strain on the part of the patients, no scientific consensus has yet been reached on a clearly defined disease entity. The comprehensive media coverage has made the public more sensitive to this topic, which makes it more difficult to take an objective perspective.</p><p><strong>Methods: </strong>We report on long/post-COVID symptoms in a hotspot collective of the first SARS-CoV-2 wave of infections in Germany; these infections began in Spring 2020 and therefore preceded the start of an intensive media coverage. In June/July 2021, 122 employees of the Kliniken Nordoberpfalz AG who tested positive for SARS-CoV-2 during the first wave of the pandemic were asked about their infection and its consequences using a standardised questionnaire.</p><p><strong>Results: </strong>82 participants (67 %) complained of persistent symptoms (post-COVID: 29 %). Long/post-COVID symptoms occurred more frequently in those who had experienced symptoms during the acute phase of the infection. Patients with stomach pain as an acute symptom more frequently reported a symptom duration of > 12 weeks. The probability of symptoms persisting > 12 weeks was reduced if throat pain or sniffling had been reported as an acute symptom. Emergence and duration of symptoms were independent of any demographic or occupational factors or of pre-existing conditions.</p><p><strong>Discussion: </strong>Due to having been infected in a hotspot region during the first wave of the pandemic, the study collective exhibits certain peculiarities which must be considered when interpreting the results. The lack of evidence for many risk factors discussed in the literature, together with the challenges facing scientific studies, seems to suggest a more differentiated approach to dealing with post-COVID.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":"13-19"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689186","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":"Implications of living evidence formats for coverage decisions in the German health care system.","authors":"Susann Conrad, Jelka Hartwig, Lydia Jones, Robert C Lorenz, Matthias Perleth","doi":"10.1016/j.zefq.2024.10.001","DOIUrl":"10.1016/j.zefq.2024.10.001","url":null,"abstract":"<p><p>Decision-makers consult systematic reviews and clinical guidelines to make informed coverage decisions based on the current state of evidence. Outdated recommendations in rapidly evolving areas such as lung cancer treatment, are challenging. The COVID-19 pandemic highlighted the need for good decision-making under uncertainty. The descriptive analysis of two samples of evidence bases for evidence synopses to prepare the decision on appropriate comparators shows that living systematic reviews and living clinical guidelines are rare (41/5,463; 0.75%) but present, with COVID-19 being the most common indication. We also describe some characteristics and quality issues of these living formats in the German context. We note an overlap between living and rapid formats, where updates may not adhere to methodological standards in evidence selection, appraisal and formulation of recommendations, or may lack transparency in their methodological processes. The need for critical appraisal of living formats is highlighted as crucial aspect. The production of living systematic reviews and clinical guidelines requires considerable resources and expertise. While there is a need for timeliness in decision making, especially in situations of high uncertainty such as the COVID-19 pandemic, the trade-off between time and quality needs to be balanced. The focus should therefore be on how best to select and process recommendations that are relevant for updating and those that are not. Regularly updated systematic reviews and clinical guidelines that adhere to recommended standards are important for decision-making bodies such as the Federal Joint Committee (G-BA). Transparent documentation of the process and methods used increases confidence in decision-making, even when the evidence base is not perfect.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":"119-124"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629992","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":"The SLIPPS Learning Event Recording Tool for students in Advanced Practice Nursing: A translation and content validation study.","authors":"Lisa Pointner, Alison Steven, Piret Paal, Manela Glarcher","doi":"10.1016/j.zefq.2024.11.001","DOIUrl":"10.1016/j.zefq.2024.11.001","url":null,"abstract":"<p><strong>Introduction: </strong>Patient safety is crucial in healthcare, yet over three million people die annually worldwide due to adverse events. To learn from adverse events and patient safety incidents, they need to be identified, examined, and reflected upon. Therefore, the SLIPPS Learning Event Recording Tool (SLERT) was developed to promote learning from patient safety events, both negative and positive. This study aimed to translate and validate the SLERT, which is already available in seven languages, for German-speaking countries.</p><p><strong>Methods: </strong>The validation study involved a structured 4-phase blind-back translation to ensure cross-cultural equivalence of the translated tool. This was followed by a cognitive validation to determine content validity, a pilot survey with nursing students, and an evaluation of user-friendliness based on the System Usability Scale (SUS). Data was analysed qualitatively with Mayring's method using MAXQDA and quantitatively with descriptive analysis in Excel.</p><p><strong>Results: </strong>Five nurses participated in the group meeting on cognitive validation (Ø age = 28.8; Ø years of professional experience = 4.7). The German SLERT comprises sections underpinned by theory, which prompt students to describe, reflect upon, and learn from patient safety events. The pilot survey with 15 students (80 % women) indicated acceptable user-friendliness, with 50 % scoring between 80 and 100 on the SUS. The incidents described in the pilot exclusively indicated adverse events, near misses, or hazards from the sub-areas \"medication management\", \"using medical devices\", \"confusion of patients\", \"staff problems/errors\" and \"self-harm of patients\".</p><p><strong>Discussion: </strong>For the first time, the German-language version of the SLERT was used to record and reflect on patient safety events among nursing students.</p><p><strong>Conclusion: </strong>Standardised reporting and reflective practices are critical to improving patient safety. The SLERT provides a user-friendly way to contribute valuable data for targeted quality and risk management measures and prepare future healthcare professionals for advanced practice.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":"37-43"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751611","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":"[Advance care planning for the end of life: How prepared are homes for adults with disabilities in Bavaria?]","authors":"Malte Klemmt, Franziska Zehl, Silke Neuderth, Tanja Henking","doi":"10.1016/j.zefq.2024.09.004","DOIUrl":"10.1016/j.zefq.2024.09.004","url":null,"abstract":"<p><strong>Introduction: </strong>Autonomy at the end of life is associated with the ability to make self-determined decisions. The heterogeneous field of inpatient integration assistance poses particular challenges in this context. Advance care planning (ACP) is now available to people with disabilities. Nevertheless, little is known about the institution-related needs and the current status with regard to ACP in integration assistance homes.</p><p><strong>Methods: </strong>A survey of all 850 inpatient homes providing integration assistance for adults in Bavaria was carried out. The survey was conducted online and addressed to home managers. In total, data of 96 homes (11.3% of all homes) was included in the descriptive and categorizing text analysis.</p><p><strong>Results: </strong>Residents die in 60% of the homes surveyed. 73.7% of the homes offer ACP for their residents, with 62.9% of these homes using standardized procedures. One of the reasons given by the participants for not offering ACP is a better qualification of employees. Barriers include the residents' lack of ability to participate in ACP meetings or relatives' reluctant attitude towards ACP.</p><p><strong>Discussion: </strong>End-of-life care is a relevant topic for inpatient homes providing integration assistance. Accordingly, ACP is already being addressed by a large proportion of homes. Here, special needs of residents due to existing impairments can pose challenges.</p><p><strong>Conclusion: </strong>The study enables us to draw conclusions about the optimization of ACP from the perspective of care homes, which relate to structural (e.g., adaptation of existing concepts), personal (e.g., qualification) and emotional (e.g., de-tabooization) aspects.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":"63-71"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629989","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":"Nursing research at German university hospitals: A descriptive, cross-sectional study on the current status of nursing research activities and challenges for ethical approval.","authors":"Anna-Henrikje Seidlein, Helga E Breimaier, Franziska Wefer, Jennifer Luboeinski, Astrid Stephan, Andreas Kocks, Peter Nydahl","doi":"10.1016/j.zefq.2024.10.005","DOIUrl":"10.1016/j.zefq.2024.10.005","url":null,"abstract":"<p><strong>Introduction: </strong>Nursing research is an integral part of nursing science and essential for evidence-based nursing practice. Research conducted by nursing scientists employed at university hospitals is shaped by the specific prevailing conditions. It is largely unclear to what extent these nursing scientists are engaged in research and which difficulties they have to face. The purpose of the study was to gain insight into nursing scientists' research activities in German university hospitals and to assess the challenges they encounter in gaining ethical approval from institutional review boards.</p><p><strong>Methods: </strong>We conducted a descriptive, cross-sectional study. Data was collected among nursing scientists at university hospitals in Germany with an online survey using closed and open questions.</p><p><strong>Results: </strong>The response rate was 68 %. In total, the answers of n = 31 nursing researchers could be analysed. The majority of participants (58.1 %) stated that they worked as project leaders on several research projects and estimated the time they spent on research at up to 25 % of their working time. The most frequently used research methodology was qualitative research (45.2 %) with employees (54.8 %) and patients (22.6 %) as study participants. Prior to performing research projects, most of the respondents submitted their study protocols to the local institutional review board (35.5 %). Half of the nursing researchers (48.4 %) had been faced with challenges in this process which were mostly due to board members being unfamiliar with qualitative designs and nursing research.</p><p><strong>Discussion: </strong>Nursing scientists employed at German university hospitals carry out a considerable number of research projects. However, time constraints and lack of funding in particular pose a challenge not only for productivity in the clinical setting, but also for the process of ethical clearance. The requirements of applying for ethical clearance at the local research ethics committees, the costs and the time required for gaining approval are very heterogeneous and thus lead to uncertainty and complicated processes.</p><p><strong>Conclusion: </strong>A good cooperative relationship, the adaptation of structural requirements with regard to the assessment of nursing research projects in favour of increased transparency and, finally, better integration of nursing scientists in local research ethics committees should be established in order to better support nursing research activities.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":"5-12"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689189","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":"Health issues of young adults with hearing loss or deafness: A basis for the development of a chatbot.","authors":"Miriam Meng, Hannele Hediger, Alexandre de Spindler, Daniela Händler-Schuster","doi":"10.1016/j.zefq.2024.09.002","DOIUrl":"10.1016/j.zefq.2024.09.002","url":null,"abstract":"<p><strong>Background: </strong>The loss of hearing and thus communication affects the well-being of millions of people worldwide. Digital tools for coping with everyday life are becoming increasingly important and can have a positive impact on health literacy, especially among young adults. This raises the question of which issues such apps should specifically address in order to meet the needs of young adults with hearing loss or deafness.</p><p><strong>Methods: </strong>The aim was to identify the health issues of young adults (aged 18-28 years) with hearing loss or deafness in order to derive specific recommendations for a conversational agent (chatbot). A multiple embedded case study design consisting of chat interviews (n = 8) and an online-based expert survey (n = 14) was used.</p><p><strong>Results: </strong>The central phenomenon focuses on \"The sense of belonging and feeling well in spite of hearing loss\", which is influenced by two main categories: a. the ability to be oneself despite one's vulnerability; b. the desire to be strong despite one's vulnerability. Important health issues include depression, drug use, diet, exercise, isolation due to COVID measures and HIV prophylaxis.</p><p><strong>Conclusion: </strong>Written information must be provided in simple and accessible language supported by images and symbols. Conversation agents developed to support people with hearing impairment should be easy to install and self-explanatory to use.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":"20-28"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548142","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":"[Alternative care concepts for low-acuity emergency medical service missions in the German ambulance service: Descriptive results of an online survey].","authors":"Johanna Sophie Lubasch, Syrina Beierle, Viktoria Sirkku Marewski, Cassandra Rehbock, Stefan Thate, Hanna Schröder, Stefan K Beckers, Anja Sommer, Insa Seeger","doi":"10.1016/j.zefq.2024.07.008","DOIUrl":"10.1016/j.zefq.2024.07.008","url":null,"abstract":"<p><strong>Introduction: </strong>In Germany, the number of emergency missions has been rising for several years. At the same time, it can be observed that the amount of missions involving emergency physicians is decreasing, while the number of outpatient treatments without transport is increasing. To cope with this situation, different alternative care concepts have been developed as complementary resources throughout Germany. This study comprehensively compares these concepts, and it aims to highlight best-practice examples and stimulate a joint learning process.</p><p><strong>Methods: </strong>As part of an online survey project leaders of various concepts were asked to take part in a standardized online survey. The survey comprised a total of 28 questions relating to various areas such as qualifications and training or resource equipment. The information was supplemented by documents, which were additionally submitted by the respondents.</p><p><strong>Results: </strong>A total of seven concepts were examined. They all have in common that they are alerted by the dispatch centers to care mainly for low-code cases. Furthermore, the resources are staffed by trained paramedics, and patient transport is not possible. All resources are able to contact other medical facilities. Differences can be seen in the areas of funding, training, equipment, availability, and further areas of responsibility.</p><p><strong>Discussion: </strong>The development of a large number of different care concepts in Germany has taken place in parallel with the development in other European countries, where different approaches have also been established for low-priority requests for assistance. In order to direct low-priority requests for assistance to a needs-based care unit in Germany as well, rescue dispatch centers should have a broader repertoire of care at their disposal. Implications for research arising from this lie in particular in evaluating the various concepts adequately, especially with regard to the quality of care, and thus ensuring needs-based and targeted care.</p><p><strong>Conclusion: </strong>Widespread introduction of alternative care concepts might help relieve the burden on emergency medical care. This requires more research and evaluation as well as optimized data quality and standardization. In addition, it is desirable to enhance cooperation with the medical on-call service.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":"92-100"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693748","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}