1
|
Helbig L, Stier B, Römer C, Kilian M, Slagman A, Behrens A, Stiehr V, Vollert JO, Bachmann U, Möckel M. [The abdominal pain unit as a treatment pathway : Structured care of patients with atraumatic abdominal pain in the emergency department]. Med Klin Intensivmed Notfmed 2023; 118:132-140. [PMID: 34928407 PMCID: PMC9992050 DOI: 10.1007/s00063-021-00887-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/30/2021] [Accepted: 09/14/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Patients with atraumatic abdominal pain are common in the emergency department and have a relatively high hospital mortality, with a very wide spectrum of different causes. Rapid, goal-directed diagnosis is essential in this context. METHODS In a Delphi process with representatives of different disciplines, a diagnostic treatment pathway was designed, which is called the Abdominal Pain Unit (APU). RESULTS The treatment pathway was designed as an extended event process chain. Crucial decision points were specified using standard operating procedures. DISCUSSION The APU treatment pathway establishes a consistent treatment structure for patients with atraumatic abdominal pain. It has the potential to improve the quality of care and reduce intrahospital mortality over the long term.
Collapse
Affiliation(s)
- Lukas Helbig
- Akut- und Notfallmedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - Britta Stier
- Akut- und Notfallmedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Claudia Römer
- Akut- und Notfallmedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Maik Kilian
- Abteilung für Allgemein- und Viszeralchirurgie, Evangelische Elisabeth Klinik Berlin, Lützowstraße 26, 10785, Berlin, Deutschland
| | - Anna Slagman
- Akut- und Notfallmedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Angelika Behrens
- Abteilung für Innere Medizin, Gastroenterologie und Pneumologie, Evangelische Elisabeth Klinik Berlin, Lützowstraße 26, 10785, Berlin, Deutschland
| | - Vera Stiehr
- Abteilung für Innere Medizin, Gastroenterologie und Pneumologie, Evangelische Elisabeth Klinik Berlin, Lützowstraße 26, 10785, Berlin, Deutschland
| | - Jörn Ole Vollert
- Akut- und Notfallmedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Ulrike Bachmann
- Akut- und Notfallmedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Martin Möckel
- Akut- und Notfallmedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| |
Collapse
|
2
|
Otto R, Blaschke S, Schirrmeister W, Drynda S, Walcher F, Greiner F. Length of stay as quality indicator in emergency departments: analysis of determinants in the German Emergency Department Data Registry (AKTIN registry). Intern Emerg Med 2022; 17:1199-1209. [PMID: 34989969 PMCID: PMC9135863 DOI: 10.1007/s11739-021-02919-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 12/18/2021] [Indexed: 11/21/2022]
Abstract
Several indicators reflect the quality of care within emergency departments (ED). The length of stay (LOS) of emergency patients represents one of the most important performance measures. Determinants of LOS have not yet been evaluated in large cohorts in Germany. This study analyzed the fixed and influenceable determinants of LOS by evaluating data from the German Emergency Department Data Registry (AKTIN registry). We performed a retrospective evaluation of all adult (age ≥ 18 years) ED patients enrolled in the AKTIN registry for the year 2019. Primary outcome was LOS for the whole cohort; secondary outcomes included LOS stratified by (1) patient-related, (2) organizational-related and (3) structure-related factors. Overall, 304,606 patients from 12 EDs were included. Average LOS for all patients was 3 h 28 min (95% CI 3 h 27 min-3 h 29 min). Regardless of other variables, patients admitted to hospital stayed 64 min longer than non-admitted patients. LOS increased with patients' age, was shorter for walk-in patients compared to medical referral, and longer for non-trauma presenting complaints. Relevant differences were also found for acuity level, day of the week, and emergency care levels. We identified different factors influencing the duration of LOS in the ED. Total LOS was dependent on patient-related factors (age), disease-related factors (presentation complaint and triage level), and organizational factors (weekday and admitted/non-admitted status). These findings are important for the development of management strategies to optimize patient flow through the ED and thus to prevent overcrowding.
Collapse
Affiliation(s)
- Ronny Otto
- Department of Trauma Surgery, Otto Von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.
| | - Sabine Blaschke
- Emergency Department, University Medicine Göttingen, Göttingen, Germany
| | - Wiebke Schirrmeister
- Department of Trauma Surgery, Otto Von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Susanne Drynda
- Department of Trauma Surgery, Otto Von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Felix Walcher
- Department of Trauma Surgery, Otto Von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Felix Greiner
- Department of Trauma Surgery, Otto Von Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| |
Collapse
|
3
|
Gewahrsamsfähigkeitsuntersuchungen in der Notaufnahme. Notf Rett Med 2022. [DOI: 10.1007/s10049-021-00971-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
4
|
Greiner F, Erdmann B, Thiemann VS, Baacke M, Grashey R, Habbinga K, Kombeiz A, Majeed RW, Otto R, Wedler K, Brammen D, Walcher F. Der AKTIN-Monatsbericht: Plädoyer für ein standardisiertes Reporting in der Notaufnahme. Notf Rett Med 2021. [DOI: 10.1007/s10049-021-00910-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Zusammenfassung
Hintergrund
Vor dem Hintergrund der steigenden Inanspruchnahme und aktuellen Veränderungen in der Notfallversorgung ist eine standardisierte Erfassung relevanter Kennzahlen in Notaufnahmen zwingend erforderlich.
Ziel der Arbeit
Es werden die Konsentierung von Inhalten und technische Umsetzung eines automatisierten Reportings für Notaufnahmen des AKTIN-Notaufnahmeregisters beschrieben. Ziel war ein aussagefähiger Monatsbericht zur Prozesssteuerung und Qualitätssicherung.
Material und Methoden
Datengrundlage ist der Datensatz Notaufnahme V2015.1 der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin e. V. (DIVI). Die Konsentierung der Inhalte erfolgte auf Basis von externen Referenzen und fachlicher Expertise; die technische Entwicklung erfolgte anhand eines Testdatensatzes. Mit der Software R und Apache Formatting Objects Processor (FOP) wird der finale Bericht im PDF-Format automatisiert erstellt.
Ergebnisse
Der Bericht enthält unter anderem Angaben zu Fallzahlen, Demografie der Patienten, Vorstellungsgründen, Ersteinschätzung, Verbleib und ausgewählten Prozesszeiten in Form von Tabellen und Grafiken. Er wird monatsweise automatisch oder auf Anforderung aus den Routinedaten generiert. Fehlende Werte und Ausreißer werden zur Abschätzung der Datenqualität separat ausgewiesen.
Diskussion
Beim AKTIN-Monatsbericht handelt es sich um ein Instrument, welches das Versorgungsgeschehen aufbereitet und visualisiert. Die konsentierten Kennzahlen sind praxistauglich und bilden auch die Vorgaben des Gemeinsamen Bundesausschusses zur Ersteinschätzung ab. Die Nutzung von Interoperabilitätsstandards erlaubt eine automatische Erfassung im Alltag, gewährleistet eine Unabhängigkeit von einzelnen IT-Systemen und kann als Grundlage für ein klinikübergreifendes Benchmarking dienen.
Collapse
|
5
|
Drynda S, Schindler W, Slagman A, Pollmanns J, Horenkamp-Sonntag D, Schirrmeister W, Otto R, Bienzeisler J, Greiner F, Drösler S, Lefering R, Hitzek J, Möckel M, Röhrig R, Swart E, Walcher F. Evaluation of outcome relevance of quality indicators in the emergency department (ENQuIRE): study protocol for a prospective multicentre cohort study. BMJ Open 2020; 10:e038776. [PMID: 32948571 PMCID: PMC7500312 DOI: 10.1136/bmjopen-2020-038776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Quality of emergency department (ED) care affects patient outcomes substantially. Quality indicators (QIs) for ED care are a major challenge due to the heterogeneity of patient populations, health care structures and processes in Germany. Although a number of quality measures are already in use, there is a paucity of data on the importance of these QIs on medium-term and long-term outcomes. The evaluation of outcome relevance of quality indicators in the emergency department study (ENQuIRE) aims to identify and investigate the relevance of QIs in the ED on patient outcomes in a 12-month follow-up. METHODS AND ANALYSIS The study is a prospective non-interventional multicentre cohort study conducted in 15 EDs throughout Germany. Included are all patients in 2019, who were ≥18 years of age, insured at the Techniker Krankenkasse (statutory health insurance (SHI)) and gave their written informed consent to the study.The primary objective of the study is to assess the effect of selected quality measures on patient outcome. The data collected for this purpose comprise medical records from the ED treatment, discharge (claims) data from hospitalised patients, a patient questionnaire to be answered 6-8 weeks after emergency admission, and outcome measures in a 12-month follow-up obtained as claims data from the SHI.Descriptive and analytical statistics will be applied to provide summaries about the characteristics of QIs and associations between quality measures and patient outcomes. ETHICS AND DISSEMINATION Approval of the leading ethics committee at the Medical Faculty of the University of Magdeburg (reference number 163/18 from 19 November 2018) has been obtained and adapted by responsible local ethics committees.The findings of this work will be disseminated by publication of peer-reviewed manuscripts and presentations as conference contributions (abstracts, poster or oral presentations).Moreover, results will be discussed with clinical experts and medical associations before being proposed for implementation into the quality management of EDs. TRIAL REGISTRATION NUMBER German Clinical Trials Registry (DRKS00015203); Pre-results.
Collapse
Affiliation(s)
- Susanne Drynda
- Department of Trauma Surgery, Otto von Guericke University, Magdeburg, Germany
| | - Wencke Schindler
- Institute of Social Medicine and Health Systems Research, Otto von Guericke University, Magdeburg, Germany
| | - Anna Slagman
- Emergency and Acute Medicine, Charité, Berlin, Germany
| | - Johannes Pollmanns
- Faculty of Health Care, Niederrhein University of Applied Sciences, Krefeld, Germany
| | | | | | - Ronny Otto
- Department of Trauma Surgery, Otto von Guericke University, Magdeburg, Germany
| | - Jonas Bienzeisler
- Institute of Medical Informatics, RWTH Aachen University, Aachen, Germany
| | - Felix Greiner
- Department of Trauma Surgery, Otto von Guericke University, Magdeburg, Germany
| | - Saskia Drösler
- Faculty of Health Care, Niederrhein University of Applied Sciences, Krefeld, Germany
| | - Rolf Lefering
- Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Köln, Germany
| | | | - Martin Möckel
- Emergency and Acute Medicine, Charité, Berlin, Germany
| | - Rainer Röhrig
- Institute of Medical Informatics, RWTH Aachen University, Aachen, Germany
| | - Enno Swart
- Institute of Social Medicine and Health Systems Research, Otto von Guericke University, Magdeburg, Germany
| | - Felix Walcher
- Department of Trauma Surgery, Otto von Guericke University, Magdeburg, Germany
| |
Collapse
|
6
|
Dormann H, Eder PA, Gimpel H, Meindl O, Rashid A, Regal C. Assessing healthcare service quality using routinely collected data: Linking information systems in emergency care. J Med Syst 2020; 44:113. [PMID: 32385607 PMCID: PMC7210224 DOI: 10.1007/s10916-020-01572-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/31/2020] [Indexed: 11/29/2022]
Abstract
Emergency departments need to continuously calculate quality indicators in order to perform structural improvements, improvements in the daily routine, and ad-hoc improvements in everyday life. However, many different actors across multiple disciplines collaborate to provide emergency care. Hence, patient-related data is stored in several information systems, which in turn makes the calculation of quality indicators more difficult. To address this issue, we aim to link and use routinely collected data of the different actors within the emergency care continuum. In order to assess the feasibility of linking and using routinely collected data for quality indicators and whether this approach adds value to the assessment of emergency care quality, we conducted a single case study in a German academic teaching hospital. We analyzed the available data of the existing information systems in the emergency continuum and linked and pre-processed the data. Based on this, we then calculated four quality indicators (Left Without Been Seen, Unplanned Reattendance, Diagnostic Efficiency, and Overload Closure). Lessons learned from the calculation and results of the discussions with staff members that had multiple years of work experience in the emergency department provide a better understanding of the quality of the emergency department, the related challenges during the calculation, and the added value of linking routinely collected data.
Collapse
Affiliation(s)
- Harald Dormann
- Department of Emergency Medicine, Klinikum Fürth, Fürth, Germany
| | | | - Henner Gimpel
- Project Group Business & Information Systems Engineering of Fraunhofer FIT, Augsburg, Germany.,FIM Research Center, University of Augsburg, Augsburg, Germany
| | - Oliver Meindl
- FIM Research Center, University of Augsburg, Augsburg, Germany.
| | | | - Christian Regal
- Project Group Business & Information Systems Engineering of Fraunhofer FIT, Augsburg, Germany.,FIM Research Center, University of Augsburg, Augsburg, Germany
| |
Collapse
|
7
|
Lucas B, Schladitz P, Schirrmeister W, Pliske G, Walcher F, Kulla M, Brammen D. The way from pen and paper to electronic documentation in a German emergency department. BMC Health Serv Res 2019; 19:558. [PMID: 31399096 PMCID: PMC6688333 DOI: 10.1186/s12913-019-4400-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 08/05/2019] [Indexed: 11/12/2022] Open
Abstract
Background Some of the advantages of implementing electronic emergency department information systems (EDIS) are improvements in data availability and simplification of statistical evaluations of emergency department (ED) treatments. However, for multi-center evaluations, standardized documentation is necessary. The AKTIN project (“National Emergency Department Register: Improvement of Health Services Research in Acute Medicine in Germany”) has used the “German Emergency Department Medical Record” (GEDMR) published by the German Interdisciplinary Association of Intensive and Emergency Care as the documentation standard for its national data registry. Methods Until March 2016 the documentation standard in ED was the pen-and-paper version of the GEDMR. In April 2016 we implemented the GEDMR in a timeline-based EDIS. Related to this, we compared the availability of structured treatment information of traumatological patients between pen-and-paper-based and electronic documentation, with special focus on the treatment time. Results All 796 data fields of the 6 modules (basic data, severe trauma, patient surveillance, anesthesia, council, neurology) were adapted for use with the existing EDIS configuration by a physician working regularly in the ED. Electronic implementation increased availability of structured anamnesis and treatment information. However, treatment time was increased in electronic documentation both immediately (2:12 ± 0:04 h; n = 2907) and 6 months after implementation (2:18 ± 0:03 h; n = 4778) compared to the pen-and-paper group (1:43 ± 0:02 h; n = 2523; p < 0.001). Conclusions We successfully implemented standardized documentation in an EDIS. The availability of structured treatment information was improved, but treatment time was also increased. Thus, further work is necessary to improve input time.
Collapse
Affiliation(s)
- Benjamin Lucas
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, D 39120, Magdeburg, Germany.
| | - Peter Schladitz
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, D 39120, Magdeburg, Germany
| | - Wiebke Schirrmeister
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, D 39120, Magdeburg, Germany
| | - Gerald Pliske
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, D 39120, Magdeburg, Germany
| | - Felix Walcher
- Department of Trauma Surgery, Otto-von-Guericke University Magdeburg, D 39120, Magdeburg, Germany
| | - Martin Kulla
- Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Bundeswehrhospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
| | - Dominik Brammen
- Department of Anaesthesiology and Intensive Care, Otto-von-Guericke University Magdeburg, D-39120, Magdeburg, Germany
| |
Collapse
|
8
|
[Older emergency patients in the emergency department : A key performance indicator analysis based on the DIVI emergency department protocol]. Med Klin Intensivmed Notfmed 2019; 115:228-236. [PMID: 31363798 DOI: 10.1007/s00063-019-0595-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/22/2019] [Accepted: 06/29/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Overall, there is only little data in health care research on the subject of emergency care in older patients in Germany. The aim of the present study is to assess the older emergency patient in regard to the core data set "Emergency Department" of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI). MATERIALS AND METHODS Monocentric, retrospective observational study. RESULTS In the observation period, a total of 29,391 emergency patients were treated at the interdisciplinary emergency center. Of these, 8072 emergency patients were ≥65 years old (27.4%). With increasing age, paramedic ambulances (RTW) or physician-led ambulances (NEF) are increasingly used (p < 0.001). Older emergency patients arriving by a physician-led emergency service show a 38.9-fold increase in mortality compared to ambulatory patients (odds ratio = 38.98 [29.22-51.87]). The initial assessment, using the Manchester Triage System (MTS), shows a steady rise towards higher urgency levels with increasing age (p < 0.001). In the multivariate analysis within the individual age clusters, there is a correlation between the triage level and hospital mortality, unrelated to gender (p < 0.001). Likewise the use of consulting physicians can be linked to advanced age (p < 0.001). Also the length of stay in the interdisciplinary emergency center correlates highly with age (p < 0.001). CONCLUSION The older emergency patient clearly differs from younger emergency patients in all key performance indicators considered and already poses a special challenge to emergency departments.
Collapse
|
9
|
Bieler D, Hörster A, Lefering R, Franke A, Waydhas C, Huber-Wagner S, Baacke M, Paffrath T, Wnent J, Volland R, Jakisch B, Walcher F, Kulla M. Evaluation of new quality indicators for the TraumaRegister DGU ® using the systematic QUALIFY methodology. Eur J Trauma Emerg Surg 2018; 46:449-460. [PMID: 30552453 DOI: 10.1007/s00068-018-1055-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND The TraumaRegister DGU® (TR-DGU) of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie, DGU) enables the participating hospitals to perform quality management. For that purpose, nine so-called audit filters have existed, since its foundation, which, inter alia, is listed in the Annual Report. The objective of this study effort is a revision of these quality indicators with the aim of developing pertinent new and reliable quality indicators for the management of severely injured patients. MATERIALS AND METHODS Apart from indicators already used at national and international levels, a systematic review of the literature revealed further potential key figures for quality of the management of severely injured patients. The latter were evaluated by an interdisciplinary and interprofessional group of experts using a standardized QUALIFY process to assess their suitability as a quality indicator. RESULTS By means of the review of the literature, 39 potential indicators could be identified. 9 and 14 indicators, respectively, were identified in existing trauma registries (TR-DGU and TARN), 17 in the ATLS® training concept, and 57 in the S3 guideline on the treatment of polytrauma/severe injuries. The exclusion of duplicates and the limitation to indicators that can be collected using the TR-DGU Version 2015 data set resulted in a total of 43 indicators to be reviewed. For each of the 43 indicators, 13 quality criteria were assessed. A consensus was achieved in 305 out of 559 individual assessments. With 13 quality criteria assessed and 43 indicators correspond this to a relative consensus value of 54.6%. None of the indicators achieved a consensus in all 13 quality criteria assessed. The following 13 indicators achieved a consensus in at least 9 quality criteria: time between hospital admission and WBCT, mortality, administration of tranexamic acid to bleeding patients, use of CCT with GCS <14, time until first emergency surgical intervention (7-item list in the TR-DGU), time until surgical intervention for penetrating trauma, application of pelvic sling belt (prehospital), capnometry (etCO2) in intubated patients, time until CCT with GCS < 15, time until surgery for hemorrhagic shock, time until craniotomy for severe TBI, prehospital airway management in unconscious patients (GCS < 9), and complete basic diagnostics available. Two indicators achieved a consensus in 11 criteria and thus represent the maximum consensus achieved within the group of experts. Four indicators only achieved a consensus in three quality criteria. 17 indicators had a mean value for the 3 relevance criteria of ≥ 3.5 and were, therefore, assessed by the group of experts as being highly relevant. CONCLUSION Not all the key figures published for the management of severely injured patients are suitable for use as quality indicators. It remains to be seen whether the quality indicators identified by experts using the QUALIFY process will meet the requirements in practice. Prior to the implementation of the assessed quality indicators in standardized quality assurance programs, a scientific evaluation based on national data will be required.
Collapse
Affiliation(s)
- Dan Bieler
- Department of Trauma Surgery and Orthopaedics, Reconstructive Surgery, Hand Surgery, Burn Medicine, Armed Forces Central Hospital Koblenz, Ruebenacher Strasse 170, 56072, Coblenz, Germany.
| | - Anna Hörster
- Institute for Research in Operative Medicine (IFOM), University Witten/Herdecke, Ostmerheimer Str. 200 House 38, 51109, Cologne, Germany
| | - Rolf Lefering
- Institute for Research in Operative Medicine (IFOM), University Witten/Herdecke, Ostmerheimer Str. 200 House 38, 51109, Cologne, Germany
| | - Axel Franke
- Department of Trauma Surgery and Orthopaedics, Reconstructive Surgery, Hand Surgery, Burn Medicine, Armed Forces Central Hospital Koblenz, Ruebenacher Strasse 170, 56072, Coblenz, Germany
| | - Christian Waydhas
- Department of Surgery, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, 44789, Bochum, Germany.,Medical Faculty of the University Duisburg-Essen, Bürkle-de-la-Camp Platz 1, Hufelandstr. 55, 45137, Essen, Germany
| | - Stefan Huber-Wagner
- Department of Trauma Surgery, Klinikum rechts, Isar Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Markus Baacke
- Department of Trauma and Reconstructive Surgery/Emergency Department, Krankenhaus der Barmherzigen Brüder Trier, Nordallee 1, 54292, Trier, Germany
| | - Thomas Paffrath
- Department of Trauma and Orthopaedic Surgery, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany
| | - Jan Wnent
- Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Haus 808, 24105, Kiel, Germany
| | - Ruth Volland
- AUC, Academy for Trauma Surgery GmbH, Wilhelm-Hale-Straße 46b, 80639, Munich, Germany
| | - Barbara Jakisch
- Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, Haus 808, 24105, Kiel, Germany
| | - Felix Walcher
- Department of Trauma Surgery, University Magdeburg A.ö.R, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Martin Kulla
- Department for Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Armed Forces Hospital Ulm, HEMS "Christoph 22", Oberer Eselsberg 40, 89081, Ulm, Germany
| |
Collapse
|
10
|
Gries A, Bernhard M, Helm M, Brokmann J, Gräsner JT. [Future of emergency medicine in Germany 2.0]. Anaesthesist 2018; 66:307-317. [PMID: 28424835 DOI: 10.1007/s00101-017-0308-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment. Now after 15 years, the authors have critically assessed the development postulated in 2003 and reevaluated it. Which aspects could be developed further and become firmly established, what is still open and which questions in preclinical and clinical emergency treatment of the population will occupy us in the coming 15 years? With a critical eye to the past, the present contribution aims to capture the essential and new topics and open questions and provide a fresh perspective for the future of emergency medicine. Regulation at the state level or even lower levels of government often stand in contrast to more sweeping and economically effective approaches at the federal level. Prehospital emergency medicine in Germany is on the whole well-positioned with respect to facilities and personnel; however, as far as the economic situation and the utilization of available systems are concerned, there is still substantial room for improvement.
Collapse
Affiliation(s)
- A Gries
- Zentrale Notaufnahme, Universitätsklinikum Leipzig, Leipzig, Deutschland.
| | - M Bernhard
- Zentrale Notaufnahme, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - M Helm
- Abt X, Anästhesie und Intensivmedizin, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland
| | - J Brokmann
- Zentrale Notaufnahme, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - J-T Gräsner
- Institut für Rettungs- und Notfallmedizin, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
| |
Collapse
|
11
|
Wedler K, Mersmann J, Schuster S, Stadelmeyer U, Stork G, Schwarz C, Machner M, Krebs A, Petri B, Fuchs A, Scharf J, Friesdorf M, Swistun H, Glien P, Weiß C, Dietz-Wittstock M, Dormann P, Schilling T, Walcher F. Positionspapier zur Stärkung und Weiterentwicklung der Notfallpflege in deutschen Notaufnahmen. Notf Rett Med 2017. [DOI: 10.1007/s10049-017-0333-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
12
|
|