Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Development and validation of a short clinical risk management implementation (Short CRiMI) questionnaire","authors":"Nikoloz Gambashidze ,&nbsp;Matthias Marsall ,&nbsp;Martina Schmiedhofer ,&nbsp;Karl Blum ,&nbsp;Hannah Roesner ,&nbsp;Reinhard Strametz ,&nbsp;Matthias Weigl","doi":"10.1016/j.zefq.2024.04.003","DOIUrl":"10.1016/j.zefq.2024.04.003","url":null,"abstract":"<div><p>Clinical Risk Management (CRM) is an important instrument to continuously improve safety of health care delivery. In Germany, hospitals are required by law to implement CRM and incidence reporting systems. Since 2010, nation-wide surveys have been conducted periodically to evaluate implementation of CRM in hospitals. The instrument used in these surveys is constantly being updated to reflect previous experiences, as well as to adapt to ongoing trends and developments in CRM practices. The survey instrument used in 2022 consisted of up to 200 items and took up to an hour to complete. In this study, we aimed to develop a short instrument to measure the level of CRM implementation in hospitals, evaluate its psychometric properties, and to offer benchmarking data for health care facilities of different sizes.</p><p>We used data collected in 2022 as part of KHaSiMiR study, employing a cross-sectional self-reported online survey. The hospital administrations were invited to designate one CRM manager to participate in the study. Out of 1,411 general hospitals invited, 401 responses were collected (response rate of 28%). After removing the cases with excessive missings, we imputed remaining missing values using multiple imputation, and split the resulting sample (n<!--> <!-->=<!--> <!-->362) in two halves (i.e., exploratory and testing subsamples). A principal component analysis was applied on the first subsample. We validated the resulting model using confirmatory factor analysis in the testing subsample. We evaluated internal consistency, and tested external validity of the established instrument using correlation analysis with two single-item measures: subjective evaluation of CRM implementation compared to similar organizations and compared to own ideal level. The principal component analysis included 45 items from the full instrument. The analysis resulted in a three-factor model with 26 items. In the confirmatory factor analysis, the model demonstrated acceptable fit with the data according to the commonly used fit indices: Chi²/df<!--> <!-->=<!--> <!-->1.36, CFI<!--> <!-->=<!--> <!-->0.941, TLI<!--> <!-->=<!--> <!-->0.930, RMSEA<!--> <!-->=<!--> <!-->0.045 (90% CI<!--> <!-->=<!--> <!-->0.032–0.056), SRMR<!--> <!-->=<!--> <!-->0.049. Cronbach’s alpha of all three factors was good (&gt;0.70). All three factors had statistically significant positive correlations with each other (0.359–0.497) and with the two single items (0.282–0.532). None of the correlations were high enough (&gt;0.7) to indicate multicollinearity.</p><p>The proposed short clinical risk management implementation (Short CRiMI) questionnaire is psychometrically valid and can be used to rapidly evaluate CRM implementation in hospitals. Further research can provide evidence of its external validity and association with quality and safety outcomes. Benchmarking data can be used to compare the results with the data from the most recent Germany-wide survey.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Pages 8-14"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000825/pdfft?md5=dfe2f8caeb3022ad8985506e1d7cc388&pid=1-s2.0-S1865921724000825-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960013","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":"Determinanten der Implementierung von Telemedizin in Pflegeeinrichtungen: eine qualitative Analyse aus Schleswig-Holstein","authors":"Lisa Kitschke,&nbsp;Pia Traulsen,&nbsp;Alexander Waschkau,&nbsp;Jost Steinhäuser","doi":"10.1016/j.zefq.2024.05.005","DOIUrl":"10.1016/j.zefq.2024.05.005","url":null,"abstract":"<div><h3>Background</h3><p>During the restrictions on human contact in the COVID-19 pandemic, nursing homes made a great effort to allow relatives, doctors and other persons involved in the care to communicate with residents. For this purpose, the HLTeleheim project offered a practical telemedical support option. This offer was accepted and implemented in a heterogeneous way. The aim of this study was to detect factors that have an influence on the implementation of telemedical applications in long-term care facilities.</p></div><div><h3>Methods</h3><p>As part of a qualitative evaluation approach, guideline-centered interviews (n<!--> <!-->=<!--> <!-->17) were conducted with nurses, doctors and administrative staff from the facilities invited to participate in the project. These interviews were then transcribed and anonymized. The evaluation was carried out according to Mayring's qualitative analysis. The code system was created deductively and inductively. Two independently working persons analyzed the interviews.</p></div><div><h3>Results</h3><p>While a high demand for applications of telemedicine in nursing care was seen in the run-up to the project, considerable barriers emerged during the implementation, and acceptance among the interviewees was mixed. The nurses regarded the regular use of telemedicine as being rather unimportant for their work. Technical and organizational problems were seen as barriers by the interviewees, which partly limited the use of telemedicine applications. Compatibility among the applications used was seen as a prerequisite of effective use. Unstable internet connection was an important limiting determinant. It turned out that consultations were used for communication within the team.</p></div><div><h3>Discussion</h3><p>Although the advantages of video consultations are being recognized among nursing staff, they are still little used. In order to promote the use of telemedicine applications, it is important to repeatedly point out their individual advantages in internal and external communication. Another approach to further implementation, in addition to financial and technical aspects, is to directly address the nursing profession in the software products to be used.</p></div><div><h3>Conclusion</h3><p>The implementation of telemedicine applications in long-term care facilities faces structural barriers, such as insufficient internet coverage and a lack of billing options, as well as personal hurdles, such as a low affinity for technology and a lack of knowledge on the subject of telemedicine.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Pages 1-7"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000904/pdfft?md5=125624f1bfa765cbfe7cc00ec80a19a5&pid=1-s2.0-S1865921724000904-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176444","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":"Gründe für die Nichtteilnahme an einer Patientenbefragung im Kontext der prähospitalen Notfallversorgung durch Gemeindenotfallsanitäter - eine retrospektive Beobachtungsstudie","authors":"Insa Seeger ,&nbsp;Andrea Diana Klausen ,&nbsp;Ulf Günther ,&nbsp;Jonas Bienzeisler ,&nbsp;Helge Schnack ,&nbsp;Johanna Sophie Lubasch","doi":"10.1016/j.zefq.2024.03.007","DOIUrl":"10.1016/j.zefq.2024.03.007","url":null,"abstract":"<div><h3>Background</h3><p>In order to evaluate whether the new rescue means “community emergency paramedics” (Gemeindenotfallsanitäter [G-NFS]) relieves the emergency medical service (EMS) in the care of low-priority emergencies, the perspective of general practitioners and patients was also surveyed in a written questionnaire as part of an innovation fund project. Recruitment for participation in the study proved to be difficult. The aim of this study is to evaluate why the G-NFS decided against providing information on study participation and what measures would be necessary to include more emergency patients in surveys in the future.</p></div><div><h3>Methods</h3><p>Retrospective analysis of the assignment protocols from April 1, 2021 to June 30, 2022. In addition to patient characteristics, data on treatments, interventions and recommendations to patients as well as reasons for non-participation in the patient survey were collected.</p></div><div><h3>Results</h3><p>5,395 G-NFS protocols that contained information on non-participation were included in the analysis. The average age of the patients was 62.4 years (SD 22.7), and 50.2<!--> <!-->% were female. 57.4<!--> <!-->% of the cases were categorised as non-urgent, and 35.2<!--> <!-->% of the cases required an additional ambulance to be alerted. 404 (7.5<!--> <!-->%) patients used the EMS more than once, 1,120 (20.8<!--> <!-->%) did not have sufficient language skills, 1,012 (18.8<!--> <!-->%) patients declined study participation, and 2,975 (55.1<!--> <!-->%) patients were not able to participate according to the G-NFS assessment. Dementia/neurocognitive impairment (35<!--> <!-->%), acute/emergency situation (26.5<!--> <!-->%), mental health impairment (10.3<!--> <!-->%), and substance abuse (6.5<!--> <!-->%) were given as reasons for non-participation from the G-NFS perspective.</p></div><div><h3>Discussion</h3><p>The results show that more than half of the patients were unable to take part in a written survey for various reasons, even though there was no need for urgent care. This could be due to a high demand for care and the complex consent procedure. In addition, further resources are required to provide needs-based care for these patients in order to relieve the burden on emergency medical care. Over half of the patients were unable to take part in a written survey for various reasons. Further research is needed to determine what consent procedures are appropriate to facilitate patients’ study participation.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Pages 61-68"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000552/pdfft?md5=fe9dc02f76165ee7ca2d4261034067c9&pid=1-s2.0-S1865921724000552-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866873","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":"Latente Sicherheitsmängel in einer pädiatrischen Notaufnahme: Testung eines neuen Schockraumkonzepts mithilfe von In-situ-Simulation","authors":"Anja Große Lordemann ,&nbsp;Dirk Sommerfeldt ,&nbsp;Lukas Mileder","doi":"10.1016/j.zefq.2024.03.005","DOIUrl":"10.1016/j.zefq.2024.03.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Structured emergency room concepts have been shown to contribute to patient safety. Until now there has been no uniform emergency room concept for critically ill and seriously injured children and adolescents in the emergency room at the Altona Children's Hospital in Hamburg. This concept has been newly developed in interdisciplinary cooperation and includes the use of new clinical premises as well as new responsibilities and team compositions. The introduction of new processes and rooms for handling emergencies is associated with a risk of overlooking latent safety deficiencies or detecting them only after the process has been implemented. This may have a direct impact on patient safety. Before moving to new clinical premises, in situ simulation can be helpful to identify and to resolve latent safety threats in advance. Therefore, this method was chosen to test the newly created emergency room concept in the future emergency room at the Altona Children's Hospital.</p></div><div><h3>Methods</h3><p>Two in situ simulations were carried out in the future real emergency room. Latent safety threats detected by the observation team and the participants (medical and nursing staff of the Altona Children's Hospital from the departments of pediatric surgery, traumatology, orthopedics, pediatrics, anesthesia, intensive care medicine, radiology, emergency medicine) were collected using free text notes after the simulations and evaluated retrospectively. In order to better deal with these latent safety threats, the observations were classified into different categories: working environment (e.<!--> <!-->g., lack of equipment, unfavorable positioning of material), process (e.<!--> <!-->g., lack of defined responsibilities in the team) and other safety threats that did not fall into one of the two categories defined.</p></div><div><h3>Results</h3><p>A total of 51 latent safety threats were identified during the two in situ simulations. Of these, 22 (43.1<!--> <!-->%) were assigned to the “working environment” category, 20 (39.2<!--> <!-->%) to the “process” category and 9 (17.7<!--> <!-->%) to the “other safety threats” category.</p><p>Of the latent safety threats identified, 46 (90.2 %) could be resolved before the emergency room was put into operation. For the non-recoverable safety threats, safety concepts were developed in order to further minimize the risk of patient hazard.</p></div><div><h3>Discussion</h3><p>With the help of this study, it could be shown that the implementation of in situ simulation before the commissioning of new clinical premises and the introduction of new processes can contribute to the detection of latent safety threats in an interdisciplinary German pediatric emergency department.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Pages 15-21"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863734","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":"Bürgerzentrierte Gesundheitsversorgung in Deutschland – eine Analyse von ExpertInneninterviews","authors":"Eva Steinfeld ,&nbsp;Katharina Schneegans ,&nbsp;Carina Benstoem ,&nbsp;Michaela Hesse ,&nbsp;Sandra Dohmen","doi":"10.1016/j.zefq.2024.03.010","DOIUrl":"10.1016/j.zefq.2024.03.010","url":null,"abstract":"<div><h3>Background</h3><p>Citizens can represent a relevant key resource in health care, for example by actively practicing preventive health care and managing their own health care needs. In Germany, the role of citizens in the health care system has not yet been defined. Therefore, the aim of this study is, as a first step, to determine what is meant by “citizen-centred healthcare”, since there is, as yet, no clear definition.</p></div><div><h3>Methods</h3><p>Between September and November 2022, semi-structured expert interviews were conducted with representatives from the fields of politics and self-administration and service providers and, with their consent, recorded and transcribed. A category system was developed inductively and deductively based on Mayring's content analysis. Using this, two members of the project team coded the interviews independently of each other using the QCAmap software. After a replication check of the deviations, the content could then be analyzed.</p></div><div><h3>Results</h3><p>A total of n = 10 interviews were conducted (n = 3 service providers, n = 2 self-administration, n = 5 politicians). The analysis revealed two different understandings of citizen-centred healthcare. Some of the experts understand citizen-centred healthcare as care that is provided close to home and easily accessible for citizens. The others interpret the term as care where citizens take on an active role. All interviewees saw the lack of health literacy among citizens as a key challenge. The social imbalance, which creates an inequality of opportunity in the involvement of citizens, was also mentioned several times. Opportunities were generally understood as the possibility of conserving resources and maintaining health. The analysis shows that there is still a lack of solutions that specifically address these challenges as well as the implementation of citizen-centred health care.</p></div><div><h3>Discussion</h3><p>The expert interviews demonstrate that there are two fundamentally different understandings of citizen-centred healthcare and how it should be established in Germany. Future research should therefore pursue the goal of developing a definition of “citizen-centred health care” by expert consensus. This can then form the basis for concrete, future goals for action. There was consensus among the experts regarding the problems that need to be considered in this context. Factors such as citizens' lack of health literacy and social imbalance should therefore be given more attention in the future.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Pages 34-41"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000588/pdfft?md5=80676798968a4d6d7d649ae3b5cbfe0a&pid=1-s2.0-S1865921724000588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912977","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":"Inhaltliche Weiterentwicklung von Standards zur Erstellung evidenzbasierter Gesundheitsinformationen: Eine Bedarfserhebung und Priorisierung im EbM-Netzwerk","authors":"Roland Brian Büchter ,&nbsp;Martina Albrecht ,&nbsp;Michael Grimm ,&nbsp;Markus Seelig ,&nbsp;Anke Steckelberg ,&nbsp;Anne Christin Rahn","doi":"10.1016/j.zefq.2024.03.011","DOIUrl":"10.1016/j.zefq.2024.03.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;The Good Practice Guidelines for health information, Good Health Information Austria and Guideline Evidence-based Health Information are established resources for developing evidence-based health information in the German-speaking regions. The aim of this project was to capture challenges in applying these standards in practice, identify gaps and development needs and gain insights for their further development.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In December 2020, members of the working group for patient information and involvement of the Network for Evidence-based Medicine were invited to share their experiences and needs in applying German standards for evidence-based health information through an online survey focussing on open questions (part 1: needs assessment). The feedback was analysed using qualitative content analysis and presented in a workshop at the EbM Congress 2021 with the goal of specifying the feedback from the needs assessment and discussing ideas for the further development of the standards (part 2: specification). In the final step, a second survey was conducted in February 2023 to prioritize the identified topics by the working group members (part 3: prioritization). The results were analysed descriptively.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Among the 41 participants, only 23&lt;!--&gt; &lt;!--&gt;% considered the standards to be sufficient, and only 55&lt;!--&gt; &lt;!--&gt;% found their application in the development of information to be easy or rather easy. The needs assessment and workshop (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;46) helped to identify various areas of action. With regard to the application of the standards, the following challenges were identified: lack of user orientation, content gaps, methods and risk communication. Gaps in the standards were identified regarding formats, content, and the connection to healthcare provision. For the advancement of the standards ideas for additional content, stakeholder involvement, and improvement of the usability of the standards were identified. In the prioritization survey, the topic areas, “presenting benefits and harms” and “content beyond treatments (in particular, diagnostics and prognosis)” were considered to be the most important (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;36).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;p&gt;Among members of the working group for patient information and involvement of the German Network for Evidence-based Medicine, a high demand has been identified for the further development of standards for creating evidence-based health information. In addition to content development, the integration of existing documents and tools should also be considered, including products issued by other institutions. The success of advancing the standards also depends on improving their applicability – for example through an attractive online platform. The results are limited by the sample which only included members of the EbM Network's patient information and participation working group and a li","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Pages 42-52"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922706","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":"Akademisiertes Pflegefachpersonal aus Drittstaaten: Professionelles Selbstverständnis vs. berufliche Realität in Deutschland? Eine qualitative Studie am Beispiel migrierter philippinischer Pflegefachpersonen","authors":"Maike Zwergel ,&nbsp;Phillip Florian Schmidt ,&nbsp;Kerstin Hämel","doi":"10.1016/j.zefq.2024.04.005","DOIUrl":"10.1016/j.zefq.2024.04.005","url":null,"abstract":"<div><h3>Background</h3><p>The recruitment of internationally educated nurses is gaining relevance in Germany in response to the growing shortage of nurses. Differences in nursing qualifications and practices between the country of origin and of destination can irritate the professional self-concept and hinder professional integration.</p></div><div><h3>Purpose</h3><p>The study objective was to examine the development of the professional scope of action to unfold the professional self-concept of academically qualified nurses in Germany.</p></div><div><h3>Methods</h3><p>In accordance with the episodic interview, eight guided interviews were conducted with Filipino nurses who had migrated to Germany. Data was analyzed by thematic coding.</p></div><div><h3>Results</h3><p>The analysis shows two dimensions that impact the professional scope of action: perceived systemic constraints in the transition process and perspectives on professional development. The recruitment and recognition process is associated with high financial and time-related uncertainties and professional devaluation experiences. Migrant nurses experience both a loss of competence and a sense of foreignness in their nursing role in Germany. In order to regain professional scope of action, strategies of continuing education and focusing on more technology-intensive nursing care areas are pursued; only a minority can adapt their self-concept to the circumstances of nursing practice in Germany.</p></div><div><h3>Discussion</h3><p>The study results demonstrate the importance of paying attention to both the competence profile and the professional self-concept of academically educated nurses in order to offer migrant nurses professional career prospects in Germany. Especially in long-term care, this has proved to be a structural problem.</p></div><div><h3>Conclusion</h3><p>To provide an attractive destination for international academically qualified nursing professionals in Germany, the ratification of international standards, the provision of transparent and independent information, utilization of existing nursing expertise as well as the establishment of career opportunities are recommended.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Pages 88-94"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000837/pdfft?md5=98a7bf363b63d72b3a6613cefe42ee9c&pid=1-s2.0-S1865921724000837-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093438","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":"MMpowerment: Empowering patients with multiple myeloma for shared decision-making by developing an intervention to integrate personal preferences into digital care pathways","authors":"Mirjam Garvelink ,&nbsp;Atena Mahboubian ,&nbsp;Okke de Weerdt ,&nbsp;Paul van der Nat","doi":"10.1016/j.zefq.2024.04.002","DOIUrl":"10.1016/j.zefq.2024.04.002","url":null,"abstract":"<div><h3>Objective</h3><p>As part of a quality improvement initiative in the context of value-based health care we aimed to optimize the shared decision-making (SDM) process in the care pathway for Multiple Myeloma as part of a digital care pathway (DCP). For this, more insight was needed in health care professionals’ (HCPs’) perspectives on SDM, and how SDM elements could be addressed in a DCP for MM to facilitate HCPs’ performance of SDM.</p></div><div><h3>Methods</h3><p>HCPs were interviewed as per the theory of planned behaviour and the model of organizational context and SDM (phase 1). Multidisciplinary development sessions were organized to discuss concepts of the solution with HCPs (phase 2). The solution was evaluated with two patients from the quality improvement team.</p></div><div><h3>Results</h3><p>In phase 1, ten interviews were held. HCPs’ attitudes and the subjective norm towards SDM were positive, and the intention to perform SDM was high. The clinical environment (physical context, disease characteristics, assumptions about patient characteristics, and workflows) for MM posed challenges on the actual SDM behavior. Education and use of the DCP to create awareness of SDM were seen as possible facilitators for SDM. A prepared and active patient would facilitate the SDM process. In phase 2, three concept solutions were developed before arriving at the final solution. The final solution consisted of three elements to incorporate SDM steps in the DCP: 1) creating patient awareness and activation with two questions about their preferences prior to a consultation, 2) visualisation of preferences centrally in the DCP to trigger HCP to discuss them, 3) monitoring and improving SDM with patient-questionnaires after decision-making. Patients and HCPs were willing to implement it.</p></div><div><h3>Conclusion</h3><p>HCPs intention to engage in SDM was high, but their actual behaviour was challenged by the clinical environment. A 3-element DCP-based intervention was developed to increase SDM.</p></div><div><h3>Patient or public contribution</h3><p>Input on the solution was obtained from end-users including two patients and ten healthcare professionals.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Pages 53-60"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093444","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":"Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations","authors":"","doi":"10.1016/S1865-9217(24)00109-0","DOIUrl":"https://doi.org/10.1016/S1865-9217(24)00109-0","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Page OBC"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724001090/pdfft?md5=6bde23f1a84c1eaf1ad2b232eaf9da51&pid=1-s2.0-S1865921724001090-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540875","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":"Leserbrief zu „Needs and feasibility of living systematic reviews (LSRs): Experience from LSRs on COVID-19 vaccine effectiveness” (ZEFQ 186 (2024) 86–91) von W. Külper-Schiek et al.","authors":"Hinpetch Daungsupawong ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.zefq.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.05.002","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Page 100"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540876","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}