[Digital Healthcare: Requirements for a Successful Transformation].

Digital transformation of healthcare is the dominating discussion topic for all healthcare stakeholders. Digital transformation encompasses all areas of healthcare and is far more than digital healthcare applications (DiGA), digital care applications (DiPA), telemedicine applications, telematics infrastructure activities, and applications from the fields of eHealth, mHealth, or Telehealth. All existing care processes and structures in the healthcare system are undergoing an inventory in order to transfer analog components of care into a digital context.

[Digital transformation of German healthcare organizations : Current status and existing challenges from the perspective of quality management].

Introduction: Digital transformation includes, among other things, the project planning and implementation of digital applications, technologies, and measures and currently represents the day-to-day business of all organizations and institutions in the healthcare sector. In this article, the current activities of digital transformation in healthcare facilities from the perspective of quality management are presented.

Methods: A Germany-wide survey among 141 members of the Society for Quality Management in Healthcare (physicians in private practice, hospitals, health insurers, and other healthcare institutions) was conducted on all fields of digital technologies, existing projects, and digital technologies that are currently being implemented.

The influence of cross-sectoral treatment models on patients with mental disorders in Germany: study protocol of a nationwide long-term evaluation study (EVA64).

Background: Close, continuous and efficient collaboration between different professions and sectors of care is necessary to provide patient-centered care for individuals with mental disorders. The lack of structured collaboration between in- and outpatient care constitutes a limitation of the German health care system. Since 2012, a new law in Germany (§64b Social code book (SGB) V) has enabled the establishment of cross-sectoral and patient-centered treatment models in psychiatry.

Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted.

[10-year development of spine surgery in Germany - An analysis of health insurance funds data from 2005 to 2014].

Background: Analysis of the regional development of spine surgery in Germany between 2005 and 2014.

Material And Methods: A secondary data analysis of inpatient data from the Scientific Institute of the AOK (WIdO) was carried out for the period 2005 to 2014. The number of spinal procedures was determined on the basis of 14 defined intervention groups (procedures according to OPS codes).

Implementation and first results of a tablet-based assessment referring to patient-reported outcomes in an inpatient cancer care unit.

Background: Inclusion of patient-reported outcomes (PROs) in routine cancer care is of key importance for individualized treatment, shared decision making and patient satisfaction.

Objective: To describe the implementation under routine conditions of an electronic self-administered PRO assessment and comparison of PROs before and after inpatient treatment in oncologic care.

Methods: In a tablet-based survey PROs on symptom burden, global health status/ quality of life (QoL) and health utility were collected twice (at hospital admission and discharge) in an inpatient oncological setting over a 17-month period using the EORTC QLQ-C30 and EQ-5D questionnaires.

[Epidemiology and prediction of the risk of falling in patients in acute care settings: Analysis of routine data from a university hospital].

Background: Falls are a relevant issue of inpatient treatment. Epidemiological analysis concerning incidence, risk factors for falls and the quality of risk assessments are missing.

Methods: In a routine data-based cross-sectional study all patients hospitalized in the University Hospital Dresden, Germany, during 2012 and 2013 were analyzed according to fall incidence and risk factors (items of Dresden fall risk assessment [Dresden-FRA], age, sex, severity of disease, and length of stay.

Implementation of a mobile inpatient quality of life (QoL) assessment for oncology nursing.

Purpose: Cancer patients suffer from a variety of symptoms, but little is known about changes during hospitalization and symptom burden at discharge. We implemented an electronic quality of life (QoL) assessment used by the nursing team in routine inpatient care. Feasibility, acceptance, and the course of QoL were investigated.

[Indication for total knee arthroplasty: evidence mapping].

Background: Joint replacement surgery is one of the most often performed routine procedures for the treatment of knee osteoarthritis in Germany. Currently, there is no consensus on indication criteria for total knee arthroplasty (TKA).

Objectives: The topic indication for TKA was processed using six guiding questions concerning: 1) Common practice in determining the indication for TKA; 2) Inclusion criteria in clinical trials; 3) Treatment goals/goal criteria; 4) Predictors for goal attainment; 5) Economic aspects of determining a TKA indication; 6) Guidelines of the "Working Group of Scientific Medical Societies" (AWMF) in other areas.

[Practice report: the process-based indicator dashboard. Visualising quality assurance results in standardised processes].

Process management (PM) is a valuable method for the systematic analysis and structural optimisation of the quality and safety of clinical treatment. PM requires a high motivation and willingness to implement changes of both employees and management. Definition of quality indicators is required to systematically measure the quality of the specified processes.

[Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden].

Background: Obligatory external quality assurance is an established method used to ensure the quality of inpatient care in Germany. The comprehensive approach is unique in international comparison. In addition to the statutory requirement, the health insurance funds require this form of external quality control in order to foster quality-based competition between hospitals.

[Requirements for quality indicators. The relevance of current developments in outcomes research for quality management].

The assessment of the health state in patients and changes in their health state for the purpose of diagnosis, prognosis and monitoring of treatment response plays a central role in clinical practice. Quality criteria for measurements in medicine include validity, reliability, responsiveness, interpretability, and feasibility. High-quality measurement instruments are a prerequisite for evidence-based medicine.

The incidence and determinants of decubitus ulcers in hospital care: an analysis of routine quality management data at a university hospital.

Background: The incidence of decubitus ulcers is an established quality indicator for external quality assurance in the inpatient setting. Epidemiologic analyses of the frequency of, and risk factors for, decubitus ulcers in routine care are lacking.

Method: We analyzed routine decubitus-ulcer documentation data relating to all inpatients of the University Hospital of Dresden, Germany, from 2007 to 2011 (n = 246 162 patients).

The study of mitoxantrone as a potential immunosuppressor in transgenic pig renal xenotransplantation in baboons: comparison with cyclophosphamide.

Mounting evidence suggests that delayed xenograft rejection (DXR) of discordant xenografts has a strong humoral component. To explore the possibility of targeting this humoral response more efficiently, we performed a preliminary study in baboons immunized against pig blood cells using the immunosuppressor mitoxantrone (Mx). The results from this study showed that, in comparison with cyclophosphamide (CyP), Mx induced a long-lasting depletion of circulating B cells within 6 days of its administration and delayed secondary anti-Gal antibody (Ab) responses to pig blood cell immunizations.

The effect of mitoxantrone on anti-pig immunization in baboons.

Besides virological and physiological concerns, the success of xenotransplantation (Xt) is still dependent on the prevention of delayed xenograft rejection (DXR). Although multifactorial, DXR is mainly due to xenonatural antibody (Ab) recognizing their xenogenic antigen (Ag) followed by complement activation. Despite the use of intensive treatments capable of inhibiting the humoral response, DXR can still not be avoided and always occurs within weeks following transplantation.

Tolerance induction in rats, using a combination of anti-CD154 and donor splenocytes, given once on the day of transplantation.

Background: Donor-specific tolerance induction remains an attractive objective that generates much research in the field of transplantation. Unfortunately, most of the protocols available involve pregraft conditioning, making these treatments incompatible with clinical applications.

Methods: LEW.