TY - Generic T1 - Allseits Zufriedenheit Y1 - 2017 A1 - Barbara Degn A1 - Silke Eichner PB - Ärzte Krone IS - 05 ER - TY - Generic T1 - GHZ Enns - Die Hausärzte Y1 - 2017 A1 - Silke Eichner KW - Primärversorgung PB - Ärzte Krone IS - 02 ER - TY - JOUR T1 - Quality improvement in preoperative assessment by implementation of an electronic decision support tool. JF - J Am Med Inform Assoc Y1 - 2013 A1 - Flamm, Maria A1 - Fritsch, Gerhard A1 - Hysek, Martin A1 - Klausner, Sabine A1 - Entacher, Karl A1 - Panisch, Sigrid A1 - Soennichsen, Andreas C KW - Adult KW - Aged KW - Austria KW - Decision Support Systems, Clinical KW - Diagnostic Tests, Routine KW - Elective Surgical Procedures KW - Female KW - Guideline Adherence KW - Humans KW - Male KW - Middle Aged KW - Practice Guidelines as Topic KW - Preoperative Care KW - Quality Improvement AB -

OBJECTIVES: To evaluate the impact of the electronic decision support (eDS) tool 'PReOPerative evaluation' (PROP) on guideline adherence in preoperative assessment in statutory health care in Salzburg, Austria.

MATERIALS AND METHODS: The evaluation was designed as a non-randomized controlled trial with a historical control group (CG). In 2007, we consecutively recruited 1363 patients admitted for elective surgery, and evaluated the preoperative assessment. In 2008, PROP was implemented and available online. In 2009 we recruited 1148 patients preoperatively assessed using PROP (294 outpatients, 854 hospital sector). Our analysis includes full blood count, liver function tests, coagulation parameters, electrolytes, ECG, and chest x-ray.

RESULTS: The number of tests/patient without indication was 3.39 in the CG vs 0.60 in the intervention group (IG) (p<0.001). 97.8% (CG) vs 31.5% (IG) received at least one unnecessary test. However, we also observed an increase in recommended tests not performed/patient (0.05±0.27 (CG) vs 0.55±1.00 (IG), p<0.001). 4.2% (CG) vs 30.1% (IG) missed at least one necessary test. The guideline adherence (correctly tested/not tested) improved distinctively for all tests (1.6% (CG) vs 49.3% (IG), p<0.001).

DISCUSSION: PROP reduced the number of unnecessary tests/patient by 2.79 which implied a reduction of patients' burden, and a relevant cut in unnecessary costs. However, the advantage in specificity caused an increase in the number of patients incorrectly not tested. Further research is required regarding the impact of PROP on perioperative outcomes.

VL - 20 IS - e1 U1 - https://www.ncbi.nlm.nih.gov/pubmed/23599223?dopt=Abstract ER - TY - JOUR T1 - The treatment experience questionnaire: development and validation of a questionnaire assessing the individual's emotional, perceptual, and cognitive reactions to alternative, physical, and dental treatments. JF - Forsch Komplementmed Y1 - 2013 A1 - Blasche, Gerhard A1 - Marktl, Wolfgang A1 - Eisenwort, Brigitte A1 - Skolka, Astrid A1 - Pichlhöfer, Otto KW - Adolescent KW - Adult KW - Aged KW - Aged, 80 and over KW - Austria KW - Cognition KW - Complementary Therapies KW - Dental Care KW - Emotions KW - Female KW - Humans KW - Male KW - Middle Aged KW - Musculoskeletal Pain KW - Patient Satisfaction KW - Perception KW - Physical and Rehabilitation Medicine KW - Psychometrics KW - Rehabilitation KW - Reproducibility of Results KW - Surveys and Questionnaires KW - Young Adult AB -

BACKGROUND: The aim of this study was to develop and validate a questionnaire designed to assess the patient's affective, cognitive, and perceptual state during treatment administration.

METHODS: 362 individuals (214 females, 148 males, mean age 54.6 years) with predominantly musculoskeletal or dental problems participated in the study. Patients responded to the questionnaire immediately following a treatment. The questionnaire included items of 9 proposed scales devised to assess mood, psychological tension, sleepiness, mental absorption, treatment appraisal, perceived cooperation during treatment administration, perceived somatosensory intensity of treatment as well as negative and positive bodily sensations during treatment. Treatments were administered in 2 spa centers, a clinic for physical medicine and rehabilitation and a clinic for dentistry. Treatments investigated were among others dental treatment, massage, packs, baths, relaxation training, exercise, and acupuncture.

RESULTS: The proposed scales were confirmed. Scales had adequate to good reliability and validity. All scales significantly distinguished between treatments.

CONCLUSION: The devised questionnaire has adequate properties to assess patients' experiences during treatment administration.

VL - 20 UR - http://www.karger.com?doi=10.1159/000351456 IS - 3 U1 - https://www.ncbi.nlm.nih.gov/pubmed/23860022?dopt=Abstract ER - TY - JOUR T1 - Preventive health risk appraisal for older people and impact on GPs' patient management: a prospective study. JF - Fam Pract Y1 - 2007 A1 - Eichler, Klaus A1 - Scrabal, Clemens A1 - Steurer, Johann A1 - Mann, Eva KW - Aged KW - Aged, 80 and over KW - Austria KW - Female KW - Health Status Indicators KW - Humans KW - Male KW - Observation KW - Patient Care Management KW - Physicians, Family KW - Prospective Studies KW - Risk Factors AB -

BACKGROUND: Health risk appraisals (HRAs) are recommended for detection of potentially modifiable risk factors for health status decline of older people. Little is known how family physicians manage detected risk factors.

OBJECTIVE: We evaluated (i) if risk factors in one or more of five predefined domains were detected in a primary care-based HRA and (ii) how often these findings had an impact on the further management of patients.

METHODS: We performed a prospective observational study in a rural community in Austria and included persons (age >or= 70 years) living at home. We applied the standardized assessment for elderly people in primary care (STEP) instrument and evaluated risk factors for status decline assessing five domains (cognitive function, depression, urinary incontinence, hearing impairment and mobility/falls).

RESULTS: Two hundred and sixty-four persons participated and the HRA revealed a wide range of risk factors for health status decline [from 4.5% (12/264) in the depression domain up to 31% (81/264) for mobility/falls and 41% (107/264) in the cognitive domain]. The findings had an impact on the further management in four domains: hearing impairment (100% of findings with impact), mobility/falls (93%), depression (83%) and urinary incontinence (65%). In contrast, abnormal cognitive findings lead to action only in every fifth participant (18%; 19/107).

CONCLUSION: In contrast to other domains, family physicians are hesitant to act upon abnormal findings of cognitive testing. Additional knowledge is needed to clarify the value of abnormal cognitive findings for management of patients and support of their carers.

VL - 24 IS - 6 U1 - https://www.ncbi.nlm.nih.gov/pubmed/17986626?dopt=Abstract ER -