The current state of hospital-based emergency medicine in Germany

Bey, Tareg; Hahn, Sigrid A.; Moecke, Heinzpeter

doi:10.1007/s12245-008-0076-5

Cited by 17 publications

(8 citation statements)

References 6 publications

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“…Most recently, there has been a trend toward intra-clinic reorganization of emergency services in hospitals across Europe. There also has been a trend toward centralization of emergency services in which previously decentralized out-patient clinics are integrated into a single interdisciplinary Emergency Department [5] . Along with this development, triage systems based on Anglo-American models are being established in German emergency rooms [6] .…”

Section: Introductionmentioning

confidence: 99%

The German Version of the Manchester Triage System and Its Quality Criteria – First Assessment of Validity and Reliability

Gräff¹,

Goldschmidt

Glien

et al. 2014

PLoS ONE

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BackgroundThe German Version of the Manchester Triage System (MTS) has found widespread use in EDs across German-speaking Europe. Studies about the quality criteria validity and reliability of the MTS currently only exist for the English-language version. Most importantly, the content of the German version differs from the English version with respect to presentation diagrams and change indicators, which have a significant impact on the category assigned. This investigation offers a preliminary assessment in terms of validity and inter-rater reliability of the German MTS.MethodsConstruct validity of assigned MTS level was assessed based on comparisons to hospitalization (general / intensive care), mortality, ED and hospital length of stay, level of prehospital care and number of invasive diagnostics. A sample of 45,469 patients was used. Inter-rater agreement between an expert and triage nurses (reliability) was calculated separately for a subset group of 167 emergency patients.ResultsFor general hospital admission the area under the curve (AUC) of the receiver operating characteristic was 0.749; for admission to ICU it was 0.871. An examination of MTS-level and number of deceased patients showed that the higher the priority derived from MTS, the higher the number of deaths (p<0.0001 / χ2 Test). There was a substantial difference in the 30-day survival among the 5 MTS categories (p<0.0001 / log-rank test).The AUC for the predict 30-day mortality was 0.613. Categories orange and red had the highest numbers of heart catheter and endoscopy. Category red and orange were mostly accompanied by an emergency physician, whereas categories blue and green were walk-in patients. Inter-rater agreement between expert triage nurses was almost perfect (κ = 0.954).ConclusionThe German version of the MTS is a reliable and valid instrument for a first assessment of emergency patients in the emergency department.

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Section: Introductionmentioning

confidence: 99%

The German Version of the Manchester Triage System and Its Quality Criteria – First Assessment of Validity and Reliability

Gräff¹,

Goldschmidt

Glien

et al. 2014

PLoS ONE

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“…b) This model is rapidly expanding in many countries around the world (15,16). c) The model of a multidisciplinary approach has been developed in many European countries, and has been applied in B&H. In this model definitive diagnostic and therapeutic procedures are performed in hospital wards of different clinical disciplines (18). The subspecialist model puts emergency medicine in the area of a sub specializa-tion, because prior training in emergency medicine is a basic need specialization from other clinical disciplines (such as surgery, anesthesia or internal medicine).…”

Section: Discussionmentioning

confidence: 99%

“…In order to achieve these objectives Eu-SEM has the following aims: European competency-based core curriculum to include: There are great differences in the manner and degree of development of emergency medicine in the European Union countries, as elsewhere in the world. Although Germany has a well-developed health care and pre-hospital emergency medical system is still not recognized as the formation of district departments of emergency medicine in hospitals and an increased need for emergency procedures in practice requires the integration of both models in the development of emergency medical system as recommended by the European Association and adopted curriculum (18). Sweden officially introduced emergency medicine residency in 2005.…”

Section: Development Of Emergency Medicine In Europementioning

confidence: 99%

Development of Emergency Medicine as Academic and Distinct Clinical Discipline in Bosnia and Herzegovina

Salihefendić¹,

Zildžić²,

Masic³

et al. 2011

Med Arh

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“…Some of the literatures retrieved in this search phase are listed in the reference list. [ 8 – 10 26 – 38 ]…”

Section: Methodsmentioning

confidence: 99%

The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

2011

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Objectives:As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance.Materials and Methods:Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe) health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria.Results:Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries.Conclusion:The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine surveillance and medical intelligence as the backbone of the health sector is necessary, besides adequate management couple with strong leadership principles.

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The current state of hospital-based emergency medicine in Germany

Cited by 17 publications

References 6 publications

The German Version of the Manchester Triage System and Its Quality Criteria – First Assessment of Validity and Reliability

The German Version of the Manchester Triage System and Its Quality Criteria – First Assessment of Validity and Reliability

Development of Emergency Medicine as Academic and Distinct Clinical Discipline in Bosnia and Herzegovina

The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

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