[Health Literacy: Germany in the Digital Race to Catch Up Introduction of Technological Innovations is not Sufficient]. / Gesundheitskompetenz: Deutschland in der digitalen Aufholjagd Einführung technologischer Innovationen greift zu kurz.

Recently, several acts have been passed by the German Ministry of Health to drive the digital transformation of the healthcare system. These aim at far-reaching innovations to improve care and increase the efficiency of the healthcare system. At the same time, the demands on users in dealing with digital applications and information are increasing. Digital health literacy is thus becoming particularly relevant. However, available studies show that the digital health literacy of the population in Germany is often limited. This paper explores challenges, gaps, and prospects regarding the implementation of these new digital health policies, particularly in terms of the implications for improving digital health literacy and increasing user involvement and participation by providing six major aspects that should be considered.

Communication and patient safety in gynecology and obstetrics - study protocol of an intervention study.

BACKGROUND: Patient safety is a key target in public health, health services and medicine. Communication between all parties involved in gynecology and obstetrics (clinical staff/professionals, expectant mothers/patients and their partners, close relatives or friends providing social support) should be improved to ensure patient safety, including the avoidance of preventable adverse events (pAEs). Therefore, interventions including an app will be developed in this project through a participatory approach integrating two theoretical models. The interventions will be designed to support participants in their communication with each other and to overcome difficulties in everyday hospital life. The aim is to foster effective communication in order to reduce the frequency of pAEs. If communication is improved, clinical staff should show an increase in work satisfaction and patients should show an increase in patient satisfaction. METHODS: The study will take place in two maternity clinics in Germany. In line with previous studies of complex interventions, it is divided into three interdependent phases. Each phase provides its own methods and data. Phase 1: Needs assessment and a training for staff (n = 140) tested in a pre-experimental study with a pre/post-design. Phase 2: Assessment of communication training for patients and their social support providers (n = 423) in a randomized controlled study. Phase 3: Assessment of an app supporting the communication between staff, patients, and their social support providers (n = 423) in a case-control study. The primary outcome is improvement of communication competencies. A range of other implementation outcomes will also be assessed (i.e. pAEs, patient/treatment satisfaction, work satisfaction, safety culture, training-related outcomes). DISCUSSION: This is the first large intervention study on communication and patient safety in gynecology and obstetrics integrating two theoretical models that have not been applied to this setting. It is expected that the interventions, including the app, will improve communication practice which is linked to a lower probability of pAEs. The app will offer an effective and inexpensive way to promote effective communication independent of users' motivation. Insights gained from this study can inform other patient safety interventions and health policy developments. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03855735; date of registration: February 27, 2019.

Associations between hospital characteristics and patient satisfaction in Germany.

BACKGROUND: The patient perspective is increasingly recognized as a central pillar of quality in hospital care. International evidence suggests that an array of interacting factors may influence patient satisfaction with hospital care, whereas only a few studies have examined the impact of hospital characteristics. OBJECTIVE: To explore which hospital characteristics exert an influence on patient satisfaction with inpatient care. DESIGN: Cross-sectional study using secondary data. SETTING AND PARTICIPANTS: A total of 999 hospitals in Germany with 300 200 patient surveys from 2013 formed the study population. Patient satisfaction was surveyed using the Patients' Experience Questionnaire, and hospital characteristics were extracted from mandatory quality reports. Only hospitals with at least 75 surveys were included in the analysis. MAIN VARIABLES STUDIED AND MAIN OUTCOME MEASURES: Four dimensions of patient satisfaction (medical care, nursing care, organization and overall impression) were studied as the outcome measures. Region, profit orientation, size, staffing per bed and quality scores were considered possible influencing hospital characteristics. We performed risk-adjusted multivariate analyses. RESULTS: All of the characteristics had a significant influence on the patient satisfaction dimensions (P<.05), and patients in East Germany, in small hospitals or in not-for-profit hospitals, were more satisfied. Additionally, more staffing per bed as well as a better process and outcome quality were associated with more satisfied patients. CONCLUSION: Structural and quality characteristics of hospitals have a significant impact on patient satisfaction. This association confirms that patients are sensitive to important hospital quality measures and reinforces the consideration of patient satisfaction as an indicator of the quality of care.

[For discussion: What potential does digitization hold for patient safety?] / Zur Diskussion: Welches Potential hat Digitalisierung für die Patientensicherheit?

Digitization is comparatively underdeveloped in the German healthcare system. Many digital applications are potentially capable of improving patient safety. This potential cannot be exploited in the long term with regional and time-limited projects. The present article identifies care areas where digital solutions are possible and necessary for safe patient care. In order for digital solutions and applications to be available to policyholders in the first healthcare market, producer of eHealth solutions will have to consider the goals of patient safety from the very beginning. In addition, processes and structures for proof of benefit must be implemented. (As supplied by publisher).