Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Qualitätsindikatoren aus der S3-Leitlinie Palliativmedizin für Patient*innen mit einer nicht-heilbaren Krebserkrankung: Identifikation von Dokumentationsprozessen, Datenquellen und Herausforderungen auf Palliativstationen","authors":"Alexandra Glizner ,&nbsp;Franziska Schade ,&nbsp;Hannah Verena Frerichs,&nbsp;Stephanie Stiel,&nbsp;Katharina van Baal","doi":"10.1016/j.zefq.2025.10.009","DOIUrl":"10.1016/j.zefq.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Routine documentation in inpatient palliative care units takes up a significant amount of caregivers’ workload, but at the same time offers many opportunities for data use, e.g. for quality assurance. The S3 guideline on palliative medicine formulates eleven quality indicators (QIs). It is currently unknown how or to what extent QIs are documented on palliative care units.</div></div><div><h3>Method</h3><div>Semi-structured planning interviews were conducted at seven palliative care units in the catchment area of the Comprehensive Cancer Center of Lower Saxony to determine the extent to which routine documentation contains data sources for measuring ten of the eleven QIs. The documentation systems, data sources and assessments used were recorded and compared with regard to the individual QIs of the S3 guideline on palliative medicine, at the same time identifying challenges in documentation.</div></div><div><h3>Results</h3><div>There is no explicit documentation of all QIs across palliative care units, and the fulfilment of QIs can only be determined secondarily from routine documentation. For all seven palliative care units, the data sources are the baseline palliative care assessment, assessments such as MIDOS, IPOS or individual instruments, the progress documentation in text form and the letter from the attending physician. Challenges regarding documentation include duplicate documentation of content, technical difficulties, and inconsistent documentation procedures of different caregivers.</div></div><div><h3>Discussion</h3><div>Routine documentation in palliative care units is heterogeneous. To determine compliance with the ten QIs, different data sources must be used for each palliative care unit, which makes comparisons between palliative care units difficult. The challenges mentioned above influence the use of data for scientific purposes. In research projects, sufficient time should be allowed for the use of pseudonymised secondary data, in particular to enable data protection coordination.</div></div><div><h3>Conclusion</h3><div>Documentation in palliative care units provides important data sources for measuring QIs, and at the same time, scientific analysis is subject to many limitations. Further research is needed to identify which aspects can motivate the implementation and systematic documentation of QIs.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"200 ","pages":"Pages 10-20"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967404","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":"Dank an die Gutachter*innen des Jahres 2025","authors":"","doi":"10.1016/j.zefq.2026.01.003","DOIUrl":"10.1016/j.zefq.2026.01.003","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"200 ","pages":"Pages 94-95"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147426981","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":"Delegation ärztlicher Aufgaben an nichtärztliche Mitarbeitende: qualitative Analyse von Erfahrungen im Rahmen der DELIVER-CARE Studie","authors":"Kathrin Damm ,&nbsp;Juliana Hoeper ,&nbsp;Maike Kriependorf ,&nbsp;Lukas Noll ,&nbsp;Torsten Witte ,&nbsp;Kirsten Hoeper","doi":"10.1016/j.zefq.2025.10.006","DOIUrl":"10.1016/j.zefq.2025.10.006","url":null,"abstract":"<div><h3>Background</h3><div>The primary objective of the DELIVER-CARE study was to evaluate a generic model for the delegation of clinical tasks to medical practice assistants (MPAs) in the outpatient treatment of chronic inflammatory diseases in the form of an MPA consultation. In addition to proving that the model is not inferior to standard care, permanent implementation also requires a positive evaluation by those involved and knowledge of the barriers and success factors. Therefore, the aim of this study was to investigate the perspectives of those involved from the specialist fields of rheumatology, gastroenterology, and dermatology on the delegation of medical activities to MPAs and to identify both success factors and barriers to transferring the model to standard care. The focus here will be on the experience of setting up and running an MPA consultation.</div></div><div><h3>Material and methods</h3><div>Qualitative, semi-structured guided interviews were conducted with doctors, medical assistants and patients in the fields of rheumatology, gastroenterology, and dermatology (convenience sample). Qualitative content analysis of interview transcripts was used.</div></div><div><h3>Results</h3><div>In 2022, 61 interviews were conducted with physicians (n = 21), medical assistants (n = 18), and patients (n = 22). In addition to the general willingness expressed by the majority of participants to continue using the delegation or MPA consultation model, aspects from the following areas were identified: (1) goals and motives for participating, (2) the participants’ experiences with the intervention as well as current barriers to and challenges of long-term implementation. In summary, the interviewees were mostly pleased with the model and saw advantages, such as easing the workload of doctors, appreciating the work of medical assistants, and improving patient care). However, lack of a funding concept and general staffing conditions (fluctuation, lack of specialist staff) have made it difficult to implement the model.</div></div><div><h3>Discussion</h3><div>Considering the shortage of medical resources, MPA visits can be a key element in the transformation of outpatient care. However, further research and discussion is needed to specify the delegation model before it can be permanently integrated into standard care (i. e., regarding the mandatory face-to-face encounter between doctors and patients, remuneration for services, and the competency framework for medical assistants).</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"200 ","pages":"Pages 38-48"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565831","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":"Mehr Patientensicherheit durch mehr-patientensicherheit.de – Wie ein neues Portal die Patientenperspektive stärkt","authors":"Clara Monaca ,&nbsp;Saskia Huckels-Baumgart ,&nbsp;Marcus Rall","doi":"10.1016/j.zefq.2025.11.002","DOIUrl":"10.1016/j.zefq.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>The active involvement of patients is considered a key factor in improving patient safety. With the model project <em>Mehr Patientensicherheit</em>, Germany has, for the first time, implemented a Critical Incident Reporting System (CIRS) specifically for patients and their relatives, enabling the anonymous reporting of patient safety events. This study aimed to analyze the demographic characteristics of reporters, assess their evaluations of information status, severity, and recurrence risk of incidents, test hypotheses regarding potential influencing factors, and derive implications for the further development of the platform.</div></div><div><h3>Methods</h3><div>A cross-sectional observational study analyzed 1,390 reports submitted via the online platform <span><span>www.mehr-patientensicherheit.de</span><svg><path></path></svg></span> between January and October 2024. Data were collected anonymously using a structured questionnaire containing open-ended and closed-ended items. Descriptive analyses, chi-square tests, and Mann–Whitney U tests were applied.</div></div><div><h3>Results</h3><div>Of all reports, 73 % originated directly from patients, while 24.4 % were submitted by relatives reporting on behalf of patients. The majority of reports concerned female patients (62.2 %). Age distribution was as follows: &gt;80 years (9.9 %), 70–79 years (12.4 %), 50–69 years (32.1 %), 30–49 years (29.1 %), 15–29 years (10.8 %), and &lt;15 years (4.2 %). The majority of the incidents were reported from ambulatory and in-patient care settings. Overall, 71 % of reports indicated insufficient information regarding patient safety measures.</div></div><div><h3>Discussion</h3><div>The findings demonstrate that patients can actively contribute to patient safety. The reports submitted provide novel insights into subjectively perceived risks, thereby complementing existing reporting systems with a previously underrepresented perspective. At the same time, the results highlight structural deficiencies, particularly in communication and feedback processes following serious incidents.</div></div><div><h3>Conclusion</h3><div>The patient-centered CIRS has the potential to foster cross-sector learning and advance the development of patient safety culture. The systematic inclusion of the patient perspective and the institutionalization of the system should be actively encouraged.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"200 ","pages":"Pages 21-30"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776088","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":"Healthcare professionals as promoters and barriers of innovative complex outpatient interventions: A case study of an intervention to increase participation of people living with MS","authors":"Susan Raths,&nbsp;Steffen Flessa","doi":"10.1016/j.zefq.2025.11.001","DOIUrl":"10.1016/j.zefq.2025.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>The German Innovation Funds project MSnetWork introduced a complex outpatient intervention to improve treatment of patients with MS. This study analyses the perception of healthcare professionals working in neurological practices to determine their ability and willingness to implement these interventions during the MSnetWork period and beyond the end of the project. The study assumes that the motivation of these professionals to implement the intervention is crucial for its success.</div></div><div><h3>Methods</h3><div>For this qualitative study, semi-structured interviews assessed the perception of neurological practice personnel (neurologists, assistants) of all MSnetWork practices (full sample) to determine their motivation to implement the interventions. Furthermore, challenges and opportunities of the implementation were retrieved to find out the reasons for promoting or hindering the new intervention. The interviews were transcribed and analysed using qualitative content analysis.</div></div><div><h3>Results</h3><div>The interviews with 26 participants from 19 neurology practices (52.8 % participation, 12 interviews with physicians and 14 interviews with assistants) were conducted from October to December 2023 and lasted about 60 minutes.. From the professionals’ perspective, key motivations included improving patient care, exploring innovative approaches, and fostering collaboration. Challenges included resource limitations, unclear intervention processes, and patient engagement. The healthcare professionals also indicated that making the MSnetWork interventions an essential element of routine treatment of MS patients would require more flexibility, fair reimbursement, and specialized training.</div></div><div><h3>Discussion</h3><div>MSnetWork seems to have implementation potential, i.e., healthcare professionals perceive that the new services fill gaps in care that are usually not appropriately addressed due to a lack of adequate funding. However, the main barrier to implement the new scheme is its integration into routine care, given the tense situation in specialist care and the simultaneous shortage of staff.</div></div><div><h3>Conclusion</h3><div>The ultimate goal of innovative care projects is the transition of the pilot into routine care. The results of this interview study indicate that healthcare professionals have to be involved right from the start in both design and implementation of innovative care projects. Innovative routine care is not only a medical or technological challenge, but above all a social process that requires the joint efforts of all stakeholders. The findings indicate that the project should be transferred into routine care.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"200 ","pages":"Pages 83-93"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678855","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":"Practice test of the German S3 guideline “Thyroid Nodules in Adults in General Practice”: Evaluating feasibility, comprehensibility, and acceptance","authors":"Victoria Kyriacou ,&nbsp;Karola Mergenthal ,&nbsp;Corina Güthlin ,&nbsp;Ferdinand M. Gerlach ,&nbsp;Marjan van den Akker ,&nbsp;Sandra Salm","doi":"10.1016/j.zefq.2025.10.007","DOIUrl":"10.1016/j.zefq.2025.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Thyroid nodules are commonly discovered incidentally during routine examinations in general practice, which often leads to extensive diagnostics and overtreatment. To provide general practitioners (GPs) with evidence-based guidance on the diagnosis and management of thyroid nodules, the S3 guideline “Thyroid Nodules in Adults” by the German Society for General and Family Medicine (DEGAM) was developed in three versions: a short, a long, and a patient leaflet format. An assessment of the effectiveness of the guideline in general practice was undertaken.</div></div><div><h3>Methods</h3><div>We ran a practice test in 17 general practices, yielding data from 17 GPs and 94 patients. Quantitative data were collected using documentation forms and questionnaires for GPs and patients. Two semi-structured online workshops provided qualitative data. Data were analyzed using descriptive statistics and qualitative content analysis.</div></div><div><h3>Results</h3><div>About 50 % of GPs reported modifying their diagnostic methods, while therapy adjustments were reported in 21 % of the consultations. The patient leaflet received positive feedback from patients and GPs, but both groups requested more detailed content. The workshops revealed challenges, including limited consultation time, difficulties in explaining extended follow-up intervals to patients, and differences in approaches between primary care and specialist services.</div></div><div><h3>Discussion</h3><div>The guideline proved applicable in practice. The feedback served ongoing improvements, including plans for supportive tools like conversation guides, case examples, and training materials.</div></div><div><h3>Conclusion</h3><div>The practice test showed the level of guideline comprehensibility and acceptance in general practice, highlighting areas of improvement. These include clearer communication with patients, interprofessional alignment and modification of materials according to patient requirements.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"200 ","pages":"Pages 58-64"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514064","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 problem with PPI is … it keeps needing another ‘P’…","authors":"David Jackson-Perry ,&nbsp;David Haerry","doi":"10.1016/j.zefq.2025.11.006","DOIUrl":"10.1016/j.zefq.2025.11.006","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"200 ","pages":"Pages 1-2"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776078","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":"Inhaltsverzeichnis / Table of Contents","authors":"","doi":"10.1016/S1865-9217(26)00028-0","DOIUrl":"10.1016/S1865-9217(26)00028-0","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"200 ","pages":"Pages iii-iv"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147426983","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":"Wie digital ist meine Praxis? Einstellungen von Hausärztinnen und Hausärzten gegenüber Reifegradmessungen – eine Online-Umfrage","authors":"Timo Neunaber ,&nbsp;Achim Mortsiefer ,&nbsp;Sven Meister","doi":"10.1016/j.zefq.2025.11.003","DOIUrl":"10.1016/j.zefq.2025.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Maturity measurements are becoming increasingly important in order to record the level of digitalization of healthcare institutions. To this point, the digital maturity of GP practices has hardly been measured. This study examines GPs’ interest in maturity measurements and their perceptions of factors influencing the level of digitalization.</div></div><div><h3>Method</h3><div>General practitioners in Germany were surveyed using web-based questionnaires on demographic information, their interest in maturity assessments, and factors influencing the level of digitalization. Multiple regression analysis was used to investigate the influence of demographic characteristics on interest in maturity level measurements. Using a mean value comparison, a ranking of the most important factors influencing the level of digitalization from the GPs’ perspective was established.</div></div><div><h3>Results</h3><div>201 data sets were included in the analysis. The average interest of GPs in maturity measurements was 3.61 out of 5. The levels of digitalization of the practice and digital health literacy of patients were positively associated with interest in maturity measurements. The highest perceived influences on the level of digitalization were related to the technical infrastructure of medical practices.</div></div><div><h3>Conclusion</h3><div>In order to establish maturity level measurements in primary care, the interest of potential users such as GPs should be strengthened at an early stage by including their perspectives. The added value of the surveys in the development of maturity models should be worked out and clearly communicated to GPs.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"200 ","pages":"Pages 31-37"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678897","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":"Herausgeberkollegium / Editorial Board","authors":"","doi":"10.1016/S1865-9217(26)00027-9","DOIUrl":"10.1016/S1865-9217(26)00027-9","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"200 ","pages":"Page ii"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147426984","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}