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Copyright of Die Orthopädie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Digitalization trends are having an impact on mental healthcare. Online interventions can promote mental health and complement existing mental healthcare services. Effective online interventions have been developed for a variety of mental health disorders and, overall, patient and practitioner acceptance of such programs is high. The Digital Healthcare Act provides the legal framework for the use of healthcare apps in German routine care. After approval by the Federal Institute for Drugs and Medical Devices, the costs of certain healthcare apps are now covered by statutory health insurers. However, digital technologies have rarely been used in mental healthcare to date. Reasons include a low level of awareness of such programs as well as a large number of untested applications. Specified quality criteria can provide better orientation for patients and healthcare providers. Further implementation efforts are necessary in order to fully use the potential of digital support options in psychiatric and psychotherapeutic care for the benefit of patients. [ABSTRACT FROM AUTHOR]

Abstract Objectives Double reading in diagnostic radiology can find discrepancies in the original report, but a systematic program of double reading is resource consuming. There are conflicting opinions on the value of double reading. The purpose of the current study was to perform a systematic review on the value of double reading. Methods A systematic review was performed to find studies calculating the rate of misses and overcalls with the aim of establishing the added value of double reading by human observers. Results The literature search resulted in 1610 hits. After abstract and full-text reading, 46 articles were selected for analysis. The rate of discrepancy varied from 0.4 to 22% depending on study setting. Double reading by a sub-specialist, in general, led to high rates of changed reports. Conclusions The systematic review found rather low discrepancy rates. The benefit of double reading must be balanced by the considerable number of working hours a systematic double-reading scheme requires. A more profitable scheme might be to use systematic double reading for selected, high-risk examination types. A second conclusion is that there seems to be a value of sub-specialisation for increased report quality. A consequent implementation of this would have far-reaching organisational effects. Key Points • In double reading, two or more radiologists read the same images. • A systematic literature review was performed. • The discrepancy rates varied from 0.4 to 22% in various studies. • Double reading by sub-specialists found high discrepancy rates.

Interprofessional practice has been of great interest to both health systems and educational institutions, but has been slow to develop in actual practice. Important efforts to speed adoption have mostly focused on changes in structure or educational interventions. It turns out that the field of jazz music was grappling with similar issues in the early 1960s. In this essay, we draw lessons from the experiences of jazz musicians during a time of transition. We conclude that significant cultural transformation, focused on two paradoxes, and the barriers and contexts that flow from them, will be necessary to achieve ideal interprofessional healthcare practice. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effectiveness of implementing a quality improvement project in a clinical cancer network directed at the response assessment of oncology patients according to RECIST-criteria.Methods: Requests and reports of computed tomography (CT) studies from before (n = 103) and after (n = 112) implementation of interventions were compared. The interventions consisted of: a multidisciplinary working agreement with a clearly described workflow; subspecialisation of radiologists; adaptation of the Picture Archiving and Communication System (PACS); structured reporting.Results: The essential information included in the requests and the reports improved significantly after implementation of the interventions. In the requests, mentioning start date increased from 2% to 49%; date of baseline CT from 7% to 64%; nadir date from 1% to 41%. In the reports, structured layout increased from 14% to 86%; mentioning target lesions from 18% to 80% and non-target lesions from 11% to 80%; measurements stored in PACS increased from 76% to 97%; labelled key images from 38% to 95%; all p values < 0.001.Conclusion: The combination of implementation of an optimised workflow, subspecialisation and structured reporting led to significantly better quality radiology reporting for oncology patients receiving chemotherapy. The applied multifactorial approach can be used within other radiology subspeciality areas as well.Key Points: • Undeveloped subspecialisation makes adherence to RECIST guidelines difficult in general hospitals. • A clinical cancer network provides opportunities to improve healthcare. • Optimised workflow, subspecialisation and structured reporting substantially improve request and report quality. • Good interdisciplinary communication between oncologists, radiologists and others contributes to quality improvement. [ABSTRACT FROM AUTHOR]

Hintergrund: Die Deutsche Gesetzliche Unfallversicherung (DGUV) hat ein neues Qualitätssicherungsverfahren für Erstberichte zur „besonderen Heilbehandlung“ nach einem Arbeitsunfall oder einem Wegunfall entwickelt und bundesweit eingesetzt. Diese Berichte werden bezüglich der Dokumentationsqualität (Schlüssigkeit und Vollständigkeit) durch den Einsatz eines Peer-Review-Verfahrens geprüft. Mit diesem Verfahren wird die - für die Steuerung des Heilverfahrens notwendige - Dokumentation überprüft und nicht die Behandlungsqualität.Material und Methoden: Ausgewählte ärztliche Peers nahmen die Beurteilung von ca. 33.000 Durchgangs(D)-Arzt-Berichten EDV-gestützt vor. Die Beurteilung erfolgte anhand einer Checkliste, die in einem vorgelagerten Forschungsprojekt entwickelt und evaluiert worden war.Ergebnis und Schlussfolgerung: Die webbasierte Plattform zur Übermittlung von anonymisierten D‑Arzt-Berichten und deren Bewertung hat sich für den bundesweiten Einsatz mit umfangreicher Stichprobengröße bewährt. Es wurde ein vollständig papierloses Qualitätssicherungs(QS)-Verfahren realisiert, um den D‑Arzt-Bericht als ein zentrales Dokument für die Heilverfahrenssteuerung zu evaluieren. Jeder einzelne der am Projekt teilnehmenden D‑Ärzte wird im Herbst 2018 eine individuelle Rückmeldung erhalten, die auch Informationen über die Ergebnisse der Vergleichsgruppe beinhält. Diese Angaben dienen dem Qualitätsmanagement des D‑Arztes bzw. der D‑Arzt-Praxis. [ABSTRACT FROM AUTHOR]

Objectives: Double reading in diagnostic radiology can find discrepancies in the original report, but a systematic program of double reading is resource consuming. There are conflicting opinions on the value of double reading. The purpose of the current study was to perform a systematic review on the value of double reading.Methods: A systematic review was performed to find studies calculating the rate of misses and overcalls with the aim of establishing the added value of double reading by human observers.Results: The literature search resulted in 1610 hits. After abstract and full-text reading, 46 articles were selected for analysis. The rate of discrepancy varied from 0.4 to 22% depending on study setting. Double reading by a sub-specialist, in general, led to high rates of changed reports.Conclusions: The systematic review found rather low discrepancy rates. The benefit of double reading must be balanced by the considerable number of working hours a systematic double-reading scheme requires. A more profitable scheme might be to use systematic double reading for selected, high-risk examination types. A second conclusion is that there seems to be a value of sub-specialisation for increased report quality. A consequent implementation of this would have far-reaching organisational effects.Key Points: • In double reading, two or more radiologists read the same images.• A systematic literature review was performed.• The discrepancy rates varied from 0.4 to 22% in various studies.• Double reading by sub-specialists found high discrepancy rates. [ABSTRACT FROM AUTHOR]

Background: The EndoCert initiative does not yet allow a long-term assessment of outcome quality. The assessment cannot be achieved without cooperation with the German arthroplasty registry (EPRD) and other quality assurance infrastructure, such as the quality assurance system of the nationwide healthcare insurance data for inpatient hospital treatment (QSR) by the German local healthcare fund (AOK). Therefore, the quality of care of all certified centres for joint replacement (EPZ) after primary hip and knee arthroplasty was to be examined for the first time. These data were subsequently compared to the data of the EPRD., Materials and Methods: In EPZ that provided care to at least one AOK-insured patient in 2016, the risk-adjusted 3‑year revision rate and the SMR-value (standardised mortality or morbidity ratio), which is the quotient of the observed and expected revision rate, were analysed as markers for the quality of care. Annual hospital volume, type of centre and audit results were examined as possible influencing factors., Results: In the group comparison, significant differences (p = 0.042) for the SMR value of the 3‑year revision rate were demonstrated for hip arthroplasty with regard to the EPZ type. The annual number of primary hip arthroplasties, however, did not influence the 3‑year revision rate. For knee arthroplasties, no effect of the defined categories on the 3‑year revision rate and its SMR value was observed. The comparison of our 3‑year revision rates with those of the EPRD showed similar results for the hip but indicated significant differences for the knee., Conclusion: We did not observe a correlation between quality of care and annual hospital volume in certified EPZ. However, different quality assurance procedures can lead to different results with respect to the outcome quality. Therefore, a considerably improved interaction of the German quality systems must be achieved. Participation in the EPRD is not sufficient for this. Rather, a complete report of all arthroplasties must be required, at least with the achievement of a minimum reporting rate per participating hospital. Uniform inclusion and exclusion criteria should be defined., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In order to increse the effectiveness and efficiency of inpatient treatment a new structure will be implemented in 2013. The committee of the German Statutory Accident Insurance (DGUV) formulated these resolutions in September 2012. Aims: The aims of restructuring inpatient treatment were formulated as follows: a concentration of the care of severely injured patients after occupational accidents in specially qualified and experienced clinics, an increased differentiation of treatment according to the type and severity of injuries, a streamlining and updating of quality requirements and an increase in interdisciplinary treatment in the sense of statutory accident insurance (rehabilitation management). Implementation: The White Book on treatment of the severely injured of the German Society for Traumatology played an important role in the implementation of the aims. Decisive amendments include the new accident insurance consultant and the new severe injury procedures whereby the latter also includes amendments to the injury type procedure. The network idea will also be extended further and new procedures for quality assurance will be established. The first changes will come into force on 01.01.2013. [ABSTRACT FROM AUTHOR]

Background: In order to increse the effectiveness and efficiency of inpatient treatment a new structure will be implemented in 2013. The committee of the German Statutory Accident Insurance (DGUV) formulated these resolutions in September 2012. Aims: The aims of restructuring inpatient treatment were formulated as follows: a concentration of the care of severely injured patients after occupational accidents in specially qualified and experienced clinics, an increased differentiation of treatment according to the type and severity of injuries, a streamlining and updating of quality requirements and an increase in interdisciplinary treatment in the sense of statutory accident insurance (rehabilitation management). Implementation: The White Book on treatment of the severely injured of the German Society for Traumatology played an important role in the implementation of the aims. Decisive amendments include the new accident insurance consultant and the new severe injury procedures whereby the latter also includes amendments to the injury type procedure. The network idea will also be extended further and new procedures for quality assurance will be established. The first changes will come into force on 01.01.2013. [ABSTRACT FROM AUTHOR]

Background: Psychiatric emergency situations (PES) are common in the physician-based emergency medical system (EMS) in Germany. However, many emergency physicians (EP) feel insecure in assessing the necessity for treatment of these patients. The aim of this investigation was to evaluate whether a short, newly developed questionnaire (Indicator for Psychiatric Pharmacotherapy, IPP) is able to help EPs in deciding for or against pharmacological treatment. Patients and methods: The protocols of the EMS at the Saarland University Hospital were prospectively collected over a 1-year period and PESs were identified and analyzed in detail. The 7-item IPP, which focuses on the most relevant psychiatric symptoms, was to be completed for each PES. Results: Among all calls for an EP (2,114) 250 (11.8%) were classified as a PES. The most frequent diagnoses were alcoholic intoxication, state of agitation and suicide attempts. Of the IPP questionnaires 193 could be evaluated and in 31.2% of all PESs a specific psychiatric medication was administered. These patients scored significantly higher in the IPP compared to those who did not receive medication (8.0 ± 3.9 compared to 5.6 ± 3.2, p < 0.001). The IPP items 'anxiety', 'agitation/aggression', 'mood' and 'physical symptoms/disorders' had the highest impact on the administration of psychotherapeutic drugs. Discussion: The IPP can be a valuable tool to assess the necessity of pharmacological treatment for patients in PESs. The assessment of the symptom categories 'anxiety', 'agitation/aggression', 'mood' and 'physical symptoms/disorders' seems to be sufficient to estimate a need for treatment. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapeut is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der MKG-Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Researchers around the world are using Lot Quality Assurance Sampling (LQAS) techniques to assess public health parameters and evaluate program outcomes. In this paper, we report that there are actually two methods being called LQAS in the world today, and that one of them is badly flawed. [ABSTRACT FROM PUBLISHER]

Patient (or person) master index (PMI) data quality activities in public, acute healthcare facilities in the state of Victoria, Australia were evaluated in terms of health information management-information technology best practice including data standards and practice guidelines. The findings indicate that, whilst data quality and linkage activities are undertaken, many are limited in scope or effectiveness. In view of published evidence that: (i) duplicate patient files pose significant risks by reducing information available for clinical decision-making; and (ii) quality and clinical risk management require, as a measurable outcome, continuous monitoring of duplicate files, improvements to PMI data quality practices are recommended. [ABSTRACT FROM AUTHOR]

Background In The Netherlands, health professionals have created a doctor-driven standardised system to report and analyse adverse outcomes (AO). The aim is to improve healthcare by learning from past experiences. The key elements of this system are (1) an unequivocal definition of an adverse outcome, (2) appropriate contextual information and (3) a three-dimensional hierarchical classification system. Objectives First, to assess whether routine doctor-driven AO reporting is feasible. Second, to investigate how doctors can learn from AO reporting and analysis to improve the quality of care. Methods Feasibility was assessed by how well doctors reported AO in the surgical department of a Dutch university hospital over a period of 9 years. AO incidence was analysed per patient subgroup and over time, in a time-trend analysis of three equal 3-year periods. AO were analysed case by case and statistically, to learn lessons from past events. Results In 19 907 surgical admissions, 9189 AOs were reported: one or more AO in 18.2% of admissions. On average, 55 lessons were learnt each year (in 4.3% of AO). More AO were reported in P3 than P1 (OR 1.39 (1.23–1.57)). Although minor AO increased, fatal AO decreased over time (OR 0.59 (0.45–0.77)). Conclusions Doctor-driven AO reporting is shown to be feasible. Lessons can be learnt from case-by-case analyses of individual AO, as well as by statistical analysis of AO groups and subgroups (illustrated by time-trend analysis), thus contributing to the improvement of the quality of care. Moreover, by standardising AO reporting, data can be compared across departments or hospitals, to generate (confidential) mirror information for professionals cooperating in a peer-review setting. [ABSTRACT FROM PUBLISHER]

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)