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Unlabelled: The abbreviation IDAK stands for the documentation paper developed and tested during the project: Inter-professional Documentation of information (German: Aufklärung) in the hospital (German: Krankenhaus)., Objective: The aim of the IDAK project was to evaluate one documentation system for both medical and nursing staff about what the patients know regarding their diagnosis and prognosis. Accurate documentation of the patients' status of being well-informed should help to realize congruent communication by the nurses., Methods: The case control study was undertaken with patients suffering from lung cancer; it aimed to show that nurses knowing about what the patients know, will be more confident in talks and stay longer at the bedside. After the descriptive examination the data were subjected to an explorative analysis., Results: We collected data for 76 daily profiles in the intervention group and 69 in the control group (N=145). In the intervention group we could detect a significantly higher contact time per conversation (intervention group 2:46 min; SD 1:05; SE 0:07, control group 2:19 min; SD 0:40; SE 0:04; Mann-Whitney: p(0.05)=0.016). The result of this study shows how often and for how long it is possible for patients with lung cancer to exchange information with nursing staff, but the result is too poor for showing an effect of the IDAK documentation.

In 1997 the new law about Public Health Service (OGDG) in Northrhine-Westfalia was put into operation. It included two new sets of compulsory tasks: local health reporting (GBE) and local health conferences (KGK). These new tasks are installed as planning and steering instruments aiming for a better health-care on the local level. The central object is the knowledge-based formation of local health policies. Thereby, local representatives concerned with health and social services should participate as well as administrators and politicians. Since the middle of the 1990 s both new tasks have been established by the public health department of the county of Heinsberg in Northrhine-Westfalia. The experience of this department over almost ten years is the background for the empirical research project that is described in this paper. The study investigates the vocational practices, the decision-making and the health-related attitudes of the relevant local administrative and political representatives. The impulse for the start of the study was given by the constant reluctance of political and administrative top managers to make use of these new planning instruments in agenda setting and decision making. 44 high-ranking staff members and politicians (mayors, party chairmen, heads of departments far beyond the health office) were personally interviewed. Although they are not part of the health administration they claim to be occupied with quite a few health-related tasks. The overlapping of their set of tasks with the local health policies is evident for the interviewed managers. How-ever, this does not cause them to use the two new planning instruments. In particular, they do not participate in the local health conferences. They rather prefer the traditional path of policy making (parties, committees, fractions) even if these paths are less efficient than the new ones. The health conference is much more used by health-service providers as a platform for setting priorities and organising their implementation effectively. So far, the inclusion of the other local representatives (administrative managers, etc.) although they are concerned with health issues has not been achieved. This is also true for local politicians who are responsible for health-care policies. The authors of the paper see it to be the task of the local public health department to convince all these players that the health conference is a productive tool and a useful platform for the discussion of the health problems in the county and the coordination of necessary actions to be taken. The most important focus point is seen in the intersection of health policies with other local policies.

Rehabilitation centers in Germany with a care supply contract according to section 111 Social Code Book Five - statutory health insurance (SGB V) are legally obligated to implement an internal quality management and to participate in comprehensive measures of external quality assurance which particularly aim at improving outcome quality ( section 135a SGB V). The legislator has left it to the central associations of health insurance funds and to the relevant umbrella organisations of care providers to develop these measures as well as the basic requirements on internal quality management in order to reach a joint agreement about it (cf. section 137d [1] and [1a] SGB V). The corresponding agreement was concluded on April 1, 2004. Whereas configuration of the internal quality management to a large extend lies in the discretion of the individual rehabilitation center, although it has to be geared to the objectives and principles set out in the agreement under section 137d SGB V, participation in the external quality assurance procedures of the central associations of health insurance funds (QS-Reha procedure) is obligatory for all rehabilitation centers with a care supply contract according to section 111 or 111a. The QS-Reha procedure comprises a survey of the central quality dimensions (structural, process and outcome quality as well as patient satisfaction) and permits related quality comparisons, which are utilized by the health insurance funds for quality oriented patient allocation and remuneration. The QS-Reha procedure had been developed to implement the legal requirements for external quality assurance in the field of medical rehabilitation ( section 135a in conjunction with section 137d SGB V) as well as to create a basis for quality focussed remuneration and patients allocation, whereas the Eva-Reha database had been developed by the Medical Service of Health Insurances in Rheinland-Pfalz for single case documentation with the objective of utilizing these data for internal quality management and, beyond this, also for various aspects of quality development across centers. The results generated in the framework of external quality assurance and internal management have to be integrated in the concept of internal quality management as they account for important sources of information with respect to the analysis of strengths or weaknesses of the facility. Irrespective of their origin quality relevant results should be integrated into a benchmarking system providing information to the operational and medical management of a rehabilitation center on the effectiveness and efficiency of the medical rehabilitation services provided. Up-to-date data, such as those generated by the Eva-Reha database, or sample survey data as those from the QS-Reha procedure can equally be used for such a benchmarking system and complement each another in a meaningful way. In this paper the main features of the QS-Reha procedure and the Eva-Reha database are described, with the objective of pointing out the particular perspectives of their data structure and results for continuous improvement in the framework of internal quality management.

In light of future challenges, such as growing numbers of elderly, increase in chronic diseases, insufficient health care budgets and problems with staff recruitment for the health-care sector, information and communication technology (ICT) becomes a possible means to meet these challenges. Organizational changes such as the decentralization of the health-care system lead to a shift from in-hospital to both advanced and basic home health care. Advanced medical technologies provide solutions for distant home care in form of specialist consultations and home monitoring. Furthermore, the shift towards home health care will increase mobile work and the establishment of shared care teams which require ICT-based solutions that support ubiquitous information access and cooperative work. Clinical documentation and decision support systems are the main ICT-based solutions of interest in the context of ubiquitous computing for shared care environments. This paper therefore describes the prerequisites for clinical documentation and decision support at the point of care, the impact of mobility on the documentation process, and how the introduction of ICT-based solutions will influence organizations and people. Furthermore, the role of dentistry in shared-care environments is discussed and illustrated in the form of a future scenario.

Quality assurance has been started in palliative care units since 1999, using a documentation project based on yearly documentation periods. The project was developed by a working party of palliative care specialists in cooperation with the German Cancer Society and the German Association for Palliative Medicine. The aim was a concise but meaningful standard documentation, able to describe the special therapeutic situation of palliative care patients and the interdisciplinary and multi-professional care they receive. In this paper, data of 4693 in-patient treatment periods relating to structural, procedural and outcome quality of palliative care units are presented from the beginning of the core documentation in 1999 through 2001. In 2002, data from palliative care units were compared with those from oncologic and geriatric wards, as well as hospices. Palliative care units show constant traits since the beginning of the core documentation in 1999, in spite of the rising number of participants. At the same time, there are distinct differences among the groups of participants due to the scope of their therapeutic setting. These relate to structure quality in the functional status of the patients (ECOG), which is worst in hospices (> palliative care units > geriatric wards > oncologic wards); to process quality in intensified pain treatment concerning incidence and intensity of pain, which is most frequent and severe in palliative care units (> hospices > geriatric > oncologic wards); and outcome quality in the rate of discharge home, which is highest in oncologic wards (> geriatric > palliative care units > hospices). Quality assurance in palliative care is difficult due to complex indicators, which should be assessed in a standardised documentation. The core documentation was established as a quality assurance programme for palliative care patients. The results of the previous evaluations have enabled the development of a standard documentation. The continuous application of such a standard documentation will prove the quality improvement and development of the participating units.

Differentiation and classification of ink entries with dated samples of a reference collection are important aspects in the examination of questioned documents. Classification of writing inks is presently achieved by analysis of dyes and colorants contained in the ink. This technique has its limitations in newly developed ink formulations with identical dye composition but differing in their solvents and binder resins. This paper introduces a method for the determination of solvents and binder resins of an ink sample directly from paper without sample preparation. This aim is accomplished by thermodesorption of the sample followed by gas chromatography/mass spectroscopy. The method was tested on numerous samples of ballpoint pen inks, which were subsequently grouped into several solvent and resin subgroups. A case study shows the applicability of the newly developed method.

Usually, hospitals and private doctors are well equipped with computers. However, the documentation of ultrasound data is commonly paper-based. The paper presents a computer-based ultrasound data recording and reporting, using the ultrasound documentation software Digisono.

The follow-up documentation of oncological patients in Germany is inadequate in many cases: it is usually limited to a minimal dataset mandated by the epidemiological tumor registers; it is carried out in a paper-based fashion and rarely in a multi-disciplinary context. Parallel documentation efforts can result in redundant or erroneous data and excess work. The introduction of hospital information systems (HIS) allows the implementation of digital oncological documentation systems integrated in surrounding clinical workflows that can provide access to existing data sources as well as data entry and presentation across departmental boundaries. This concept enables the integration of tumor documentation, quality assurance and process optimization within HIS. Feasibility requirements include a high flexibility and adaptability of the underlying HIS to reach a seamless integration of oncological documentation forms within routine clinical workflows. This paper presents the conceptual design and implementation of a modular oncological documentation system at the Muenster University Hospital that is capable of integrating the documentation requirements of multiple departments within the hospital.

Data input in web-htm-forms with a browser is much more efficient in comparison with write in paper mask documents. The specification-compliant forms for data entry as htm-forms are downloaded from the homepage of the project manager by the participants of the study. The transformation of content of different formatted htm-forms is made by the program "security-based form converter (SFC)", which is located on a web server respectively a proxy server. From there the transformed data are returned the project manager via e-mail. Those incoming data are imported into databases by means of ODBC-data source. The data are pivoted from sequential format to table format. The data entry principle presented here is a client-server-structured, web based intranet program. For this purpose only standard software and relational databases with ODBC-interfaces are used; no further registered commercial programs are needed. General data protection is ensured by encrypted data transmission.

The local health conference in a North Rhine-Westphalian county of Germany has made proposals to improve immunisation rates against measles, mumps and rubella. Another target was to prevent decubitus by elderly patients in hospitals, nursing homes and in the outpatient nursing. Local public health reports were the basis for the development of (local) health targets in the health conference. The data of 12,830 immunisation papers from 11-19-year old students showed immunisation rates against measles, mumps and rubella from 44% to 14% depending on the type of school. Virus hepatitis B immunisation rates are 32% in the county. There were also great differences between local towns of the county. The decubitus data showed rates from 2.3% in nursing homes to 5.1% in the outpatient sector. It is also shown that health reports and health conferences help to improve local conditions in public and individual health.

The paper attempts to reconstruct the writing of published case histories. Due to the establishment of a scientific classification system in psychiatry there were at the Charité several changes from the late 1870s onwards: (1) Not only was the documentation in the clinical records altered significantly, but also (2) the archive was reorganized into a double filing system and (3) the casuistic made a development from describing seldom or sensational cases into a mode which aimed to unfold psychiatric theory through 'typical cases'. Original medical records, the internal documentation of psychiatric observation, will be compared to their published version. Both, the narrative of a case study and the documentation in the clinical records reveal performative processes of observation and documentation. [ABSTRACT FROM AUTHOR]

In the opera materials of the Esterházy Court in the Széchényi National Library in Budapest, that have survived from the time when Haydn directed the opera at Eszterháza, there are several inserted papers that had been used before the sheet of paper was re-used for the adaptation of the given opera. The fragmentary notations vary in content and extent. Two groups are of special interest for Haydn scholars: fragments that can be related to Haydn's operas and fragments written by Haydn. The latter are listed in the appendix in a catalogue that might be expanded in the future. [ABSTRACT FROM AUTHOR]

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Quality assurance by documentation in the clinical routine may no longer be regarded as a tedious additional duty providing only little practical value in medical care. This leads to users' resistance and to statistics of doubtful validity. Therefore, the great significance of the primary medical documentation for the quality assurance has to be emphasized and should be the focus of an efficient documentation-management. Requirements for such a documentation-management are described and their implementation in the Albertinen-Haus is shown. This institution uses conventional paper-documents as well as their electronic counterparts. An efficient documentation-management shows the advantage of a quality assurance for the daily routine in hospitals. Data required for the statistical quality assurance should merely be a by-product of the usual documentation. This can only be achieved by an increased computer-support in the clinical routine, but it also requires programmes which fill the needs of all the team members.

In this paper we summarize requirements for archiving in hospitals. Furthermore, we present solutions how digital archives can be built up. Archiving in hospitals requires medical documentation, which should take place preferably in a computer-based way. Requirements for electronic archiving include functionality, integration into the hospital information system, robustness, performance, usability and the ability to meet legal obligations. The latter issue is essential if the conventional archiving of paper records and non-digital images shall be abandoned.

Objective: In 1994 the Department of Anaesthesiology and Intensive Care Medicine of the Justus Liebig University of Giessen decided to implement an Anaesthesia Information Management System (AIMS) to replace the previous hand-written documentation on paper. From 1997 until the end of 1998 the data sets of 41,393 anaesthesia procedures were recorded with the help of computers and imported into a data bank. Individual aspects and results of this data pool are presented under the aspect of how the system in its present form is able to guarantee documentation of quality according to the requirements of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI)., Methods: Since 1997 information on all anaesthesia procedures has been documented "online" with the anaesthesia documentation software NarkoData 4 (ProLogic GmbH, Erkrath). The data sets have been stored in a relational data bank (Oracle Corporation) and statistically processed with the help of the SQL-based program Voyant (Brossco Systems, Espoo, Finland). As an example of two adverse perioperative events (AVB) we compared incidences of "hypotension" and "nausea/vomiting", recorded by staff members into the AIMS, with the incidence of comparable events that were recorded with the help of online data during anaesthesia procedures, such as blood pressure and drug application. Since 1998 data recording has been revised constantly in department meetings; advanced training has been given. The results have been analysed critically., Results: In 1997 the incidence of adverse perioperative events entered manually into the system was 3.6% (grade III and higher 0.9%) and increased during 1998 to 22.2% (grade III and higher 1.9%). The frequency of anaesthesia procedures with manually documented AVBs was significantly below the incidence (determined with the help of online data) of comparable events: "hypotension" (1.8% vs. 8.5%) and "nausea/vomiting" (4.9% vs. 8.3%)., Conclusion: The current documentation of AVBs in almost any hospital is incomplete. In contrast to the hand-written procedure, the AIMS provides recorded data for evaluation and guarantees more detailed and complete quality documentation. In addition, the effort needed for documentation is reduced. Whether these data sets really describe and measure quality or not has to be evaluated. In addition it has to be considered whether different requirements (such as automatic AVB recognition for an AIMS) are advantageous for quality documentation regarding the data raster and the AVB recognition, with respect to different documentation procedures.

An instrument documenting the care process in in-patient psychiatric services within the German mental health care system has been developed (BADO). This paper reports on the development of a documentation system for all non-hospital based mental health services (day centres, community mental health centres, supported accommodation, work rehabilitation services for general adult psychiatric patients and people with substance misuse). The development process and the instrument (PC and paper and pencil version) are described. The documentation system (BADO-K) could be an important prerequisite for quality assurance in non-hospital based mental health care, and its structure ensures compatibility with the corresponding hospital-based documentation system.

The high complex requirements on information and information flow in todays hospitals can only be accomplished by the use of modern Information Systems (IS). In order to achieve this, the Stiftung Orthopädische Universitätsklinik has carried out first the Project "Strategic Informations System Planning" in 1993. Then realizing the necessary infrastructure (network; client-server) from 1993 to 1997, and finally started the introduction of modern IS (SAP R/3 and IXOS-Archive) in the clinical area. One of the approved goal was the replacement of the paper medical record by an up-to-date electronical medical record. In this article the following three topics will be discussed: the difference between the up-to-date electronical medical record and the electronically archived finished cases, steps performed by our clinic to realize the up-to-date electronical medical record and the problems occurred during this process.

Follow-up of fracture treatment one year after surgery based on AO Documentation in a small, rural hospital in a region with many tourists is demanding. How many patients can be contacted and assessed at the one year follow-up? From 1.1.95 to 31.12.96 302 patients with 314 fractures were operated on and the results subsequently documented. 255 patients (84%) were assessed personally (221) or by an AO member or family doctor (34). 15 patients died before the appointment, 32 patients could not be contacted or their data was incomplete. To achieve this rate of follow-up, some internal organization in the hospital was necessary, as will be described in this paper. AO Documentation is an important tool for personal quality assurance, especially in small hospitals. Small hospitals might be interesting for the AO since their follow-up rate can be high due to a simple organization and a personal patient-doctor relationship.

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Records of violent behaviour and its sequels gain increasing interest as a matter of quality assurance. The paper presents scales and instruments applied in psychiatric institutions until now. While problems of reliability are solved sufficiently, there are major problems of validity in the measurement of violence. To be usable for quality management, a documentation has to provide a clear cut-off for the severity of violent incidents that should be reported. Otherwise uncomparable data and underreporting will result.

Quality management requires correct and comprehensive monitoring of all complications. Since January 1995 in the department of trauma and orthopaedic surgery complications have been recorded immediately when the patient is scheduled for reoperation or when complications become evident during the X-ray conference or at follow-up clinics. Two senior surgeons note all available information on a sheet of paper. Data are completed as soon as possible and entered into a PC data base. All cases are followed up by the respective surgeon and discussed at monthly complication conferences. A case is not closed until the end result has been documented. We discuss the theoretical and practical problems of this procedure and present the statistical evaluation for 1995.

Five systems for computerized documentation (ADAM-Fujinon, ENDOBASE-Olympus, MEDASYS-Pentax, MEPAS-Fritsch & Jirak, OPTAMED-Krötlinger) are compared in their different functions: configuration of system, software, communication, structure of program, user guidance, data-protection, data back-up, patient registration, preparation for examination, terminology setup, report generation, image filing, statistic, system adjustments, costs. This paper should be a help in buying a computer-aided system. All systems fulfil the three basic requirements for a computer-aided documentation in gastrointestinal endoscopy: database, image filing, report generation. Actually none of the programs can be favoured. Peculiarities, weakness and strength of the different programs are discussed. The principle of the scoring-method in choosing a system is explained.

Structured reporting of medical findings is known to have positive effects on data quality, whereas user acceptance tends to be low because of time requirements. This paper presents the results of a survey among 19 physicians who worked for 14 months with a computer system using structured data input for abdominal ultrasonography. During this time, they prepared 8.827 reports. The two most important results are that it is feasible to realize well accepted documentation systems with high data quality by using modern computer technology, and that graphic user interfaces tend to increase user acceptance. For comparable systems, evaluation studies are suggested.

The care of patients with cleft lip, alveolus, and palate demands supervision of the development and progress over a long period of time. It also requires a standardized and systematic basic documentation. In our cleft center the documentation is summarized on one sheet of paper with DIN-A4 formation (297 x 210 mm). The use of electronic data processing improves the documentation. The storage of general and medical data has been supplemented by a personal computer system, PC-System. Five years after developing of this computer aided documentation system several patients are shown as examples for the application of this system for longterm control patients with cleft lip, alveolus, and palate.

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The personal computer program package FANDOS (Facial Nerve Documentation System) has been designed especially for diseases of the facial nerve. It provides a very simple and exact method of documentation; it does not require much time and is easy to handle. In the ENT department of the University of Göttingen, this program has been tested in the clinical routine. In this paper we present the program package and explain its use in prospective studies.

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Background: Patient data management systems (PDMS) enable digital documentation on intensive care units (ICU). A commercial PDMS was implemented in a 25-bed ICU replacing paper-based patient charting. The ICU electronic patient record is completely managed inside the PDMS. It compiles data from vital signs monitors, ventilators and further medical devices and facilitates some drug dose and fluid balance calculations as well as data reuse for administrative purposes. Ventilation time and patient severity scoring as well as coding of diagnoses and procedures is supported. Billing data transferred via interface to the central billing system of the hospital. Such benefits should show in measurable parameters, such as documented ventilator time, number of coded diagnoses and procedures and others. These parameters influence reimbursement in the German DRG system. Therefore, measurable changes in cost and reimbursement data of the ICU were expected.Material and Methods: A retrospective analysis of documentation quality parameters, cost data and mortality rate of a 25-bed surgical ICU within a German university hospital 3 years before (2004-2006) and 5 years after (2007-2011) PDMS implementation. Selected parameters were documented electronically, consistently and reproducibly for the complete time span of 8 years including those years where no electronic patient recording was available. The following parameters were included: number of cleared DRG, cleared ventilator time, case mix (CM), case mix index (CMI), length of stay, number of coded diagnoses and procedures, detailed overview of a specific procedure code based on daily Apache II and TISS Core 10 scores, mortality, total ICU costs and revenues and partial profits for specific ICU procedures, such as renal replacement therapy and blood products.Results: Systematic shifts were detected over the study period, such as increasing case numbers and decreasing length of stay as well as annual fluctuations in severity of disease seen in the CM and CMI. After PDMS introduction, the total number of coded diagnoses increased but the proportion of DRG relevant diagnoses dropped significantly. The number of procedures increased (not significantly) and the number of procedures per case did not rise significantly. The procedure 8-980 showed a significant increase after PDMS introduction whereas the DRG-relevant proportion of those procedures dropped insignificantly. The number of ventilator-associated DRG cases as well as the total ventilator time increased but not significantly. Costs and revenues increased slightly but profit varied considerably from year to year in the 5 years after system implementation. A small increase was observed per case, per nursing day and per case mix point. Additional revenues for specific ICU procedures increased in the years before and dropped after PDMS implementation. There was an insignificant increase in ICU mortality rate from 7.4 % in the year 2006 (before) to 8.5 % in 2007 (after PDMS implementation). In the following years mortality dropped below the base level.Conclusion: The implementation of the PDMS showed only small effects on documentation of reimbursement-relevant parameters which were too small to set off against the total investment. The method itself, a long-term follow-up of different parameters proved successful and can be adapted by other organizations. The quality of results depends on the availability of long-term parameters in good quality. No significant influence of PDMS on mortality was found. [ABSTRACT FROM AUTHOR]

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The present paper gives a review of German studies concerning the AMP and AMDP system that have been published since 1983. The test manual to the AMDP-system, published 1983, is complemented herewith. The following topics are discussed: Syndromes/scales on the basis of psychological and somatic outcomes, studies on reliability (especially interrater reliability); capability to differentiate diagnoses; comparison with other assessment instruments, especially biological parameters; results of several diagnoses (schizophrenia, affective disorders, depression etc.); range of application (psychopharmacological studies, diagnostic questions, etc.). The review points out that the AMDP system covers a very wide and elaborate range. Some topics are pointed out that would merit additional study.

This paper is going to investigate 108 gero-psychiatric patients with average-age of 69 +/- 10 years with overwhelming of 70- to 79-year-old persons during one annual. Data of biographic, social and disease factors and diagnostic and therapeutic methods are presented. Diagnostic main-groups are dementias and affective syndromes. At the same time existing internal disorders have a particular importance. The therapeutic concept is composed of group-methods by the side of medical and physical measures. Geropsychiatry is not dependent on "pressure of success". Nevertheless late transfer, previous history for a long time, and old age diminish possibility to improve the mental disorders.

Despite increasing medical use of the computer, many clinics have experienced only limited success (or none at all) in computerized registration of patient data. One important reason for this lies in the complicated user interfaces of most programs. The clinician has no time to familiarize himself with the complicated command sequences involved, while necessary acceptance of the new technology by administrative staff is often lacking. This paper shows that computerized registration and interpretation of patient data are well within the bounds of possibility, given the use of newly-developed user-friendly operating systems and suitable personal computers. A concrete example of computerized registration of data in a remedial center is given: a case with squint symptoms for which 176 parameters can be entered.

The experiences of 60 years of pictorial documentation in an Orthopaedic Clinic are presented. Whereas the evaluation of patient's progress by photographs dominated formerly, nowadays the main interest is frequently centered on scientific illustrations and documentation for teaching, lectures and publications. The paper describes, how these two demands can be met economically by effective utilization of the technical possibilities.

This paper presents an information system for the support of clinical research in reproductive medicine (ISRA/R). The system is established on a database approach--all data arising at our center is instantly recorded on-line into the database. Thus a mighty tool has been established to aid us considerably in our daily work as well as in clinical studies.

The introduction of powerful and inexpensive personal computers (PC) enabled us to develop a documentation system for upper gastrointestinal endoscopy. The system was programmed using the database management system dBASE III. It works on-line, and no computer knowledge or additional staff is needed to run the system. It is now routinely used in the endoscopic units of three different hospitals. Features of performance are a menu-driven data input, automatic report generation and record retrieval, listing according to different criteria as well as other dBASE III facilities. This paper deals with the quality, time effort and user acceptance of the PC-aided system in clinical routine. The analysis showed a good data quality with respect to completeness and adequate use of terminology. Reliability and validity of the documentation were satisfactory considering the methodological problems encountered at their determination. The system was generally judged useful, but time effort was increased compared to conventional documentation.

Standardised documentation in accident surgery is to provide detailed information on surgical practice at the ward concerned, data for comparison with other hospitals, statistical documentation from which to find answers to topical questions, and material for counselling and assistance to partners. It is also intended to help in more effective economic planning. An account is given in this paper of the effectiveness of various therapeutic procedures, with reference being made to 13 years of data acquisition, using form sheet documentation of bone fractures. Reference is also made to postoperative infections, image documentation, and on some therapeutic techniques.

An exact documentation is a necessary demand of modern medicine. Different methods of the registration of information, for example the conventional sick-paper, the punch card and the electronic data processing documentation are opposed with their pros and cons. The own experiences of the surgical hospital of the Friedrich-Schiller-University with the documentation of injured patients is shown and explained. The text points to the importance of the electronic data processing registration and evaluation of the many facts of the injured patients concerning the therapeutic, epicritical, but also epidemic and legal questions.