Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Praxis und Herausforderungen der Delegation ärztlicher Tätigkeiten im interprofessionellen Arbeitsalltag der stationären Krankenversorgung in Deutschland: eine explorative Befragung","authors":"Dajana Mehringer ,&nbsp;Patrick Jahn ,&nbsp;Kim Philip Linoh ,&nbsp;Andreas Wienke ,&nbsp;Patrick Michl ,&nbsp;Jens Walldorf","doi":"10.1016/j.zefq.2024.01.007","DOIUrl":"10.1016/j.zefq.2024.01.007","url":null,"abstract":"<div><h3>Background</h3><p>The delegation of medical tasks (DMT) plays a significant role in the everyday practice of inpatient care but also presents a potential challenge in interprofessional collaboration. Assessing the conditions of DMT in everyday work is crucial to identify areas for optimization.</p></div><div><h3>Methods</h3><p>In a nationwide exploratory study, physicians, nursing and allied health professionals working for inpatient care facilities were surveyed regarding various aspects of DMT using a standardized online questionnaire.</p></div><div><h3>Results</h3><p>The majority of the 757 participants (64.9<!--> <!-->% physicians), perceived DMT to be both economically and time-efficient (88.5<!--> <!-->% agreement) and in the best interest of patients (74<!--> <!-->%). For 78.7<!--> <!-->% of the respondents, DMT represents a potential conflict in their daily work, depending on the quality of interprofessional communication. Inadequate staffing was identified as a barrier to a broader implementation of DMT by 83.8<!--> <!-->% of participants. 63.2<!--> <!-->% of the participants considered their knowledge of legal aspects related to DMT to be at least good (participants with less than 5 years of professional experience: 52.6<!--> <!-->%). Physicians primarily acquire relevant knowledge through professional practice (71.3<!--> <!-->% vs. non-physicians 39.5<!--> <!-->%).</p></div><div><h3>Conclusion</h3><p>Across the different professional groups DMT was considered beneficial and serving the interests of patients. Targeted promotion of safe and cost-effective DMT should be incorporated into medical education. Achieving greater benefits from DMT requires explicit legal frameworks, effective communication within the team and, in particular, adequate staffing among the professional groups responsible for delegated tasks.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"186 ","pages":"Pages 10-17"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000126/pdfft?md5=ed83e472e2d7d467991b63f35019effe&pid=1-s2.0-S1865921724000126-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190209","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":"Needs and feasibility of living systematic reviews (LSRs): Experience from LSRs on COVID-19 vaccine effectiveness","authors":"Wiebe Külper-Schiek ,&nbsp;Iris Thielemann ,&nbsp;Antonia Pilic ,&nbsp;Joerg J. Meerpohl ,&nbsp;Waldemar Siemens ,&nbsp;Sabine Vygen-Bonnet ,&nbsp;Judith Koch ,&nbsp;Thomas Harder ,&nbsp;Vanessa Piechotta","doi":"10.1016/j.zefq.2024.01.003","DOIUrl":"10.1016/j.zefq.2024.01.003","url":null,"abstract":"<div><p>During 2021 and 2023, a team of researchers at the Robert Koch Institute (RKI) and partnering institutions conducted two living systematic reviews (LSRs) on the effectiveness of COVID-19 vaccines in different age groups to inform recommendations of the Standing Committee on Vaccination in Germany (Ständige Impfkommission, STIKO). Based on our experience from the realization of these LSRs, we developed certain criteria to assess the needs and feasibility of conducting LSRs. Combining these with previously established criteria, we developed the following set to inform future planning of LSRs for STIKO: Needs criterion (N)1: Relevance of the research question, N2: Certainty of evidence (CoE) at baseline; N3: Expected need for Population-Intervention-Comparator-Outcome (PICO) adaptations; N4: Expected new evidence over time; N5: Expected impact of new evidence on CoE; Feasibility criterion (F)1: Availability of sufficient human resources; F2: Feasibility of timely dissemination of the results to inform decision-making. For each criterion we suggest rating options which may support the decision to conduct an LSR or other forms of evidence synthesis when following the provided flowchart.</p><p>The suggested criteria were developed on the basis of the experiences from exemplary reviews in a specific research field (i.e., COVID-19 vaccination), and did not follow a formal development or validation process. However, these criteria might also be useful to assess whether questions from other research fields can and should be answered using the LSR approach, or assist in determining whether the use of an LSR is sensible and feasible for specific questions in health policy and practice.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"186 ","pages":"Pages 86-91"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000072/pdfft?md5=45182810eaa78c5c6abc50da8493c484&pid=1-s2.0-S1865921724000072-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190210","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":"Prähospitale Anlage von Thoraxdrainagen: Welche Faktoren sind mit einem subjektivem Sicherheitsgefühl assoziiert?","authors":"Rebecca Knobloch ,&nbsp;Camilla Metelmann ,&nbsp;Bibiana Metelmann ,&nbsp;Marie-Luise Rübsam ,&nbsp;Bernd Krämer ,&nbsp;Sebastian Krämer ,&nbsp;Isabella B. Metelmann","doi":"10.1016/j.zefq.2024.03.009","DOIUrl":"10.1016/j.zefq.2024.03.009","url":null,"abstract":"<div><h3>Background</h3><p>The prehospital placement of chest tubes is a rare but potentially life-saving procedure. A high level of subjective confidence with the procedure is essential for emergency medical doctors. This study aims to identify if there is a statistically significant difference in the subjective sense of confidence in prehospital chest tube placement regarding medical experience and qualification, clinical routine, and attendance at simulation courses.</p></div><div><h3>Methods</h3><p>Prehospital emergency physicians of three emergency medical services in Southwest Saxony, Greifswald, and Vechta, Germany, were invited to participate in an online survey from January to March 2022 using the online survey service <em>limesurvey</em>. The question “Do you feel confident in chest tube placement?” was used to measure the subjective level of confidence. Answers were compared with data concerning medical qualification, experience in prehospital emergency medicine, clinical routine, and attendance at simulation courses. Statistical analysis was performed using chi-squared test and Fisher’s exact test.</p></div><div><h3>Results</h3><p>Three out of four participants felt confident in chest tube placement (53/71; 74.6<!--> <!-->%). More than half of the participants reported that they did not perform this procedure regularly (35/53, 66<!--> <!-->%). Subjective confidence was highest in physicians who regularly place chest tubes during their non-prehospital work (34/37; 91,9<!--> <!-->%; p<!--> <!-->&lt;<!--> <!-->0.001), and more often when participants had clinical routine and attended simulation courses than when none of this applied (p<!--> <!-->=<!--> <!-->0.012). Attendance at simulation courses alone was not associated with a higher level of confidence (p<!--> <!-->=<!--> <!-->0.002). Specialists showed significantly more often subjective confidence in chest tube placement (p<!--> <!-->=<!--> <!-->0.0401).</p></div><div><h3>Conclusion</h3><p>Prehospital chest tube placement is rare, but potentially lifesaving. An adequately high level of subjective confidence in the placement of chest tubes is a key condition for prehospital emergency doctors. Inhospital clinical routine and attendance at simulation courses are significantly associated with high levels of confidence. Our data indicate that working only in prehospital emergency settings without further clinical routine or medical specialization is not sufficient for achieving and ensuring subjective confidence in chest tube placement.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"186 ","pages":"Pages 27-34"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000576/pdfft?md5=f382aa02701226ce81a307295c8cf7a0&pid=1-s2.0-S1865921724000576-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867751","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":"Das Wahlpflichtfach Planetare Gesundheit: Klima.Umwelt.Gesundheit an der Medizinischen Fakultät Würzburg – Konzeption, didaktische Methoden und Evaluationsergebnisse","authors":"Eva-Maria Schwienhorst-Stich ,&nbsp;Dana Kropff ,&nbsp;Katharina Kersken ,&nbsp;Sarah König ,&nbsp;Tobias Leutritz ,&nbsp;Sandra Parisi ,&nbsp;Clara Schlittenhardt ,&nbsp;Jörg Schmid ,&nbsp;Anne Simmenroth ,&nbsp;Jana Jünger ,&nbsp;Janina Zirkel","doi":"10.1016/j.zefq.2023.12.001","DOIUrl":"10.1016/j.zefq.2023.12.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;The connections between climate, environment, and health as well as the concept of planetary health need to be integrated into the education of health professionals, as is increasingly demanded both internationally and nationally. Planetary health education should also aim to foster transformative action for climate protection and sustainability. In recent years, innovative teaching formats and objective catalogues have emerged internationally. In Germany, these topics have not yet been integrated into medical education everywhere. Since 2021, the Faculty of Medicine in Würzburg has offered an elective course as a first step of a longitudinal curriculum currently in development. The design, content, structure, and results of the evaluation are discussed in this article and will be used for quality assurance as well as the (further) development of this kind of educational interventions elsewhere.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methodology&lt;/h3&gt;&lt;p&gt;We developed an elective course for students in their second to tenth semester with 30 onsite and online face-to-face teaching units and an additional project phase. We used an innovative mix of didactic methods with online simulations, training in climate-sensitive health counselling, and interdisciplinary climate communication as well as local sustainability projects in small groups, with a large amount of peer-teaching. A quantitative and qualitative evaluation was done immediately after the teaching units through feedback rounds and online with the evaluation software Evasys®, using closed and open-ended questions exploring learning progress (summer semester) and achievement of learning objectives (winter semester), motivation to participate, acceptance of teaching methods, attitudes, relevance, and further interest. The evaluation questionnaire was slightly modified for the winter semester.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;In the summer and winter semester of 2021/2022, a total of 34 students (17 per semester) participated in the elective course; of these, 33 participated in the written evaluation. The evaluation in the summer semester (&lt;em&gt;n&lt;/em&gt; = 17) showed a significant increase in self-assessed learning gain, the evaluation in the winter semester (&lt;em&gt;n&lt;/em&gt; = 16) indicated a substantial achievement of learning objectives (mean = 3.96 of a 5-point Likert scale). Participants of both semesters (&lt;em&gt;n&lt;/em&gt; = 33) regarded peer-teaching as a suitable method (mean = 4.2) and well-implemented (mean = 4.3). The topics were considered highly relevant but not adequately integrated into the main curriculum. There was a high level of interest in local impacts of climate and environmental changes and local measures for climate protection and sustainability. The specific projects in small groups may serve as examples of how transformative action can be promoted in education.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;p&gt;In the current dynamic development of the widely demanded integration of planetary hea","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"186 ","pages":"Pages 92-103"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921723002209/pdfft?md5=94c5c256fdf1499eb84755a998425a0e&pid=1-s2.0-S1865921723002209-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871940","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":"Inhaltsverzeichnis / Table of Contents","authors":"","doi":"10.1016/S1865-9217(24)00076-X","DOIUrl":"https://doi.org/10.1016/S1865-9217(24)00076-X","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"186 ","pages":"Pages iv-v"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S186592172400076X/pdfft?md5=48938d6e8fec9313123d7db9ca0197b9&pid=1-s2.0-S186592172400076X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239093","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(24)00075-8","DOIUrl":"https://doi.org/10.1016/S1865-9217(24)00075-8","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"186 ","pages":"Page iii"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000758/pdfft?md5=14834eb74762e7b20fa203e870a1cafa&pid=1-s2.0-S1865921724000758-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239812","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":"Health-related quality of life (HRQoL) in German early benefit assessment: The importance of disease-specific instruments","authors":"Lisa Kramer ,&nbsp;Malte Moos ,&nbsp;Bastian Thaa ,&nbsp;Robert Welte ,&nbsp;Marc Esser","doi":"10.1016/j.zefq.2024.02.003","DOIUrl":"10.1016/j.zefq.2024.02.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Health-Related Quality of Life (HRQoL) data is frequently requested in early benefit assessment in Germany. To test the hypothesis that the importance of HRQoL in general and the significance of disease-specific instruments in particular has increased since the introduction of AMNOG in Germany, we analysed all early benefit assessments between 2011 and 2022.</p></div><div><h3>Methods</h3><p>All 793 early benefit assessments completed between 01/01/2011 and 03/11/2022 were systematically analysed. The HRQoL instruments featured in the dossier submissions were extracted for all assessments and categorized into generic and specific instruments<strong>.</strong> All G-BA resolutions were likewise assessed for consideration and acceptance of generic and specific HRQoL instruments. In addition, it was examined whether there was an association between HRQoL data and the extent of additional benefit.</p></div><div><h3>Results</h3><p>Since 2014 HRQoL data have continuously been submitted in 70% to 80% of assessments per year with the exception of 2022 (63%). Generally, disease-specific instruments are favoured, regarding submissions by industry but especially with higher acceptance by the G-BA in the resolution. Subgroup analyses revealed oncology as a major contributor to the submission and acceptance rates of disease-specific instruments. Disease-specific instruments were submitted in 81% of all oncology assessments and accepted in 53% of assessments. Overall, assessments with accepted HRQoL data tend to reach a higher overall benefit. Procedures with accepted HRQoL were most likely to receive a considerable benefit (31%), while for procedures in which HRQoL data were not accepted, a benefit was most often (65%) not proven.</p></div><div><h3>Discussion</h3><p>Industry has followed the request for submission of specific HRQoL instruments early on. Higher submission rates of specific instruments over time which at the same time meet the methodological requirements indicate that industry has learned from early assessments. A potential reason for the high submission- and acceptance rates of specific HRQoL instruments in oncology might be the particularly high relevance of HRQoL in this indication. Possible effects of changes in legislature on the future development of submission and acceptance of HRQoL data need to be monitored.</p></div><div><h3>Conclusion</h3><p>In Germany, HRQoL has gained a relevant position in early benefit assessment over time. Overall specific instruments are favoured, regarding submissions by industry but especially through consideration by the G-BA in the resolution. Furthermore, HRQoL data can be supportive for benefit assessments, in particular to show that advantages in morbidity and/or mortality are reflected in HRQoL and not at the expense of HRQoL.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"186 ","pages":"Pages 1-9"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871941","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)00078-3","DOIUrl":"https://doi.org/10.1016/S1865-9217(24)00078-3","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"186 ","pages":"Page OBC"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000783/pdfft?md5=dd0f306ab17997efd4c0fc1c1a96996b&pid=1-s2.0-S1865921724000783-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239811","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":"Contextual factors and mechanisms in the implementation of Value Stream Mapping in breast cancer centres – A multiple case study","authors":"Kerstin Dittmer,&nbsp;Marina Beckmann,&nbsp;Holger Pfaff,&nbsp;Ute Karbach","doi":"10.1016/j.zefq.2024.03.006","DOIUrl":"10.1016/j.zefq.2024.03.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Lean, especially Value Stream Mapping is increasingly used in hospitals to optimize processes. This method, which originated in the automotive industry, enables all staff involved in the process to make it more customer-friendly. Despite the widely reported success of Lean projects, they have failed in some cases. This study investigated the contextual factors and mechanisms that contribute to a successful implementation of Value Stream Mapping.</p></div><div><h3>Methods</h3><p>Value Stream Mapping was applied to the discharge process in four breast cancer centers. A mixed-method approach was used in two steps. First, to verify the successful implementation, defined as time optimization, time measurement was conducted at three points in time and analyzed using an ANOVA. Second, an analysis of contextual factors was combined with a qualitative content analysis of mechanisms based on normalization process theory, using routine data, meeting protocols, field notes, and interview transcripts as data source.</p></div><div><h3>Results</h3><p>At one of the four breast cancer centers, lead- and waiting time were significantly reduced; at the others, these reductions did not occur. Failure/success cannot be explained by the size of the hospital, the number of cases or staffing levels. The variable project team composition is evident, especially leadership involvement.</p></div><div><h3>Discussion</h3><p>A comparative analysis was conducted to identify the factors that led to success. These factors were: participation of all leaders relevant to the process, in the case of the discharge process including medical and nursing leaders; dissemination of the changes from the project team to colleagues including its sense and possibility to discuss it; joint reflection of the implementation process in regular work team meetings.</p></div><div><h3>Conclusions</h3><p>These results confirm the important role of leadership in implementation projects. Leadership support enabled the mechanisms found. The used combination of theoretical approaches from management research and implementation science determined the interpretation and should be applied more often in implementation science.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"186 ","pages":"Pages 52-61"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000540/pdfft?md5=32bc9dd6c92a49f67eaf7dece16d0613&pid=1-s2.0-S1865921724000540-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860983","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":"Entwicklung eines Indikatorensets zur Evaluation der Versorgungsqualität in der ambulanten Routineversorgung häufiger Erkrankungen des Kindes- und Jugendalters","authors":"Claudia Mehl ,&nbsp;Teresa Müller ,&nbsp;Thorsten Nau ,&nbsp;Christian Bachmann ,&nbsp;Max Geraedts","doi":"10.1016/j.zefq.2024.03.002","DOIUrl":"10.1016/j.zefq.2024.03.002","url":null,"abstract":"<div><h3>Background</h3><p>In Germany, no consented quality indicator set (QI set) exists to date that can be used to assess the quality of pediatric care. Therefore, the aim of the project “Assessment of the quality of routine ambulatory health care for common disorders in children and adolescents” (QualiPäd) funded by the Innovation Committee of the Federal Joint Committee (grant no.: 01VSF19035) was to develop a QI set for the diseases asthma, atopic eczema, otitis media, tonsillitis, attention-deficit hyperactivity disorder (ADHD), depression and conduct disorder.</p></div><div><h3>Methods</h3><p>For the observation period 2018/2019, quality indicators (QIs) were searched in indicator databases, guidelines and literature databases and complemented in part by newly formulated QIs (e.<!--> <!-->g., derived from guideline recommendations). The QIs were then assigned to content categories and dimensions according to Donabedian and OECD and reduced by removing duplicates. Finally, a panel of experts consulted the QIs using the modified RAND-UCLA Appropriateness Method (RAM).</p></div><div><h3>Results</h3><p>The search resulted in a preliminary QI set of 2324 QIs. After the reduction steps and the evaluation of the experts, 282 QIs were included in the QI set (asthma: 72 QIs, atopic eczema: 25 QIs, otitis media: 31 QIs, tonsillitis: 12 QIs, ADHD: 53 QIs, depression: 43 QIs, conduct disorder: 46 QIs). The QIs are distributed among the following different categories: Therapy (138 QIs), Diagnostics (95 QIs), Patient-reported outcome measures/Patient-reported experience measures (PROM/PREM) (45 QIs), Practice management (31 QIs), and Health reporting (4 QIs). In the Donabedian model, 89<!--> <!-->% of the QIs capture process quality, 9<!--> <!-->% outcome quality, and 2<!--> <!-->% structural quality; according to the OECD classification, 61<!--> <!-->% measure effectiveness, 23<!--> <!-->% patient-centeredness, and 16<!--> <!-->% safety of care.</p></div><div><h3>Conclusion</h3><p>The consented QI set is currently being tested and can subsequently be used (possibly modified) to measure the quality of routine outpatient care for children and adolescents in Germany, in order to indicate the status quo and potential areas for improvement in outpatient care.</p></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"186 ","pages":"Pages 69-76"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1865921724000497/pdfft?md5=312f88d4b19ff0af49ec9fdc7ed9fb6b&pid=1-s2.0-S1865921724000497-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872839","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}