[Health Services research in Germany in Times of COVID-19: How Does the Pandemic Influence Research Processes, Methods and the Personal Situation of Researchers? An Online Survey]. / Versorgungsforschung in Deutschland in Zeiten von COVID-19: Wie beeinflusst die Pandemie Forschungsprozesse, Methoden und die persönliche Situation von Forschenden? Eine Online-Befragung.

The COVID-19 pandemic has a massive impact on social life, the healthcare system, and also on health services research. However, the effects of the pandemic on research processes, methods, and the personal situation of researchers has not been investigated so far. Guided by the question of how research processes and methods are adapted to the challenges posed by COVID-19 and how researchers perceive the impact of the pandemic on their personal situation, an online survey of health services researchers was conducted from June to July 2021. The results showed that a large proportion of research projects have had delays due to recruitment and/or data collection issues. Two-thirds of the respondents who had already collected data since the beginning of the pandemic (March 2020) were unable to collect data in the originally planned form and relied primarily on digital data collection methods. The analysis of the open-ended survey responses showed that the pandemic had a massive impact on all phases of the research process: key challenges included difficult field access, problems in achieving planned sample sizes, and concerns about data quality. Regarding their personal situation, researchers perceived the reduction of personal contacts, and the resulting lack of visibility as negative, while at the same time they benefited from the easy digital contact possibilities. Overall, the study provides an initial assessment of how the COVID-19 pandemic affected health services research and researchers. It shows that after the initial "shock" of the first lockdown in March 2020, pragmatic and often innovative ways were found to carry out projects under the pandemic conditions. However, the increased use of digital communication forms and data collection methods brings numerous challenges, but also methodological impulses.

[Reasons for non-participation in a patient survey in the context of prehospital emergency medical care by community emergency paramedics - A retrospective observational study]. / Gründe für die Nichtteilnahme an einer Patientenbefragung im Kontext der prähospitalen Notfallversorgung durch Gemeindenotfallsanitäter - eine retrospektive Beobachtungsstudie.

BACKGROUND: In order to evaluate whether the new rescue means "community emergency paramedics" (Gemeindenotfallsanitäter [G-NFS]) relieves the emergency medical service (EMS) in the care of low-priority emergencies, the perspective of general practitioners and patients was also surveyed in a written questionnaire as part of an innovation fund project. Recruitment for participation in the study proved to be difficult. The aim of this study is to evaluate why the G-NFS decided against providing information on study participation and what measures would be necessary to include more emergency patients in surveys in the future. METHODS: Retrospective analysis of the assignment protocols from April 1, 2021 to June 30, 2022. In addition to patient characteristics, data on treatments, interventions and recommendations to patients as well as reasons for non-participation in the patient survey were collected. RESULTS: 5,395 G-NFS protocols that contained information on non-participation were included in the analysis. The average age of the patients was 62.4 years (SD 22.7), and 50.2% were female. 57.4% of the cases were categorised as non-urgent, and 35.2% of the cases required an additional ambulance to be alerted. 404 (7.5%) patients used the EMS more than once, 1,120 (20.8%) did not have sufficient language skills, 1,012 (18.8%) patients declined study participation, and 2,975 (55.1%) patients were not able to participate according to the G-NFS assessment. Dementia/neurocognitive impairment (35%), acute/emergency situation (26.5%), mental health impairment (10.3%), and substance abuse (6.5%) were given as reasons for non-participation from the G-NFS perspective. DISCUSSION: The results show that more than half of the patients were unable to take part in a written survey for various reasons, even though there was no need for urgent care. This could be due to a high demand for care and the complex consent procedure. In addition, further resources are required to provide needs-based care for these patients in order to relieve the burden on emergency medical care. Over half of the patients were unable to take part in a written survey for various reasons. Further research is needed to determine what consent procedures are appropriate to facilitate patients' study participation.

Making a voice heard: evaluation of a new service delivery in augmentative and alternative communication through qualitative interviews with people without natural speech.

OBJECTIVE: Due to communication barriers, people without natural speech who use augmentative and alternative communication (AAC) are rarely interviewed about their healthcare needs, expectations, and experiences. This qualitative interview study aims to investigate how AAC users evaluate a new service delivery (nSD) in AAC care in Germany. RESULTS: We conducted 8 semi-structured qualitative interviews with 8 AAC users. The results of the performed qualitative content analysis show a positive evaluation of the nSD among AAC users. Contextual factors were identified that seem to hinder the achievement of the intervention goals. These include caregivers' prejudice and inexperience with AAC and an unfavourable environment in which AAC is used.

The perceived impact of physician shortages on human resource strategies in German hospitals - a resource dependency perspective.

PURPOSE: Like other European countries, Germany is facing regional physician shortages, which have several consequences on patient care. This study analyzes how hospitals perceive physician shortages and which strategies they adopt to address them. As a theoretical framework, the resource dependency theory is chosen. DESIGN/METHODOLOGY/APPROACH: The authors conducted 20 semi-structured expert interviews with human resource officers, human resource directors, and executive directors from hospitals in the northwest of Germany. Hospitals of different ownership types, of varying sizes and from rural and urban locations were included in the sample. The interviews were analyzed by using qualitative content analysis. FINDINGS: The interviewees reported that human resource departments in hospitals expand their recruiting activities and no longer rely on one single recruiting instrument. In addition, they try to adapt their retaining measures to physicians' needs and offer a broad range of employment benefits (e.g. childcare) to increase attractiveness. The study also reveals that interviewees from small and rural hospitals report more difficulties with attracting new staff and therefore focus on recruiting physicians from abroad. PRACTICAL IMPLICATIONS: Since the staffing situation in German hospitals will not change in the short term, the study provides suggestions for hospital managers and health policy decision-makers in dealing with physician shortages. ORIGINALITY/VALUE: This study uses the resource dependency theory to explain hospitals' strategies for dealing with healthcare staff shortages for the first time.