[Heidelberg Milestones Communication (HeiMeKOM) - Experiences, Best Practice Examples and Recommendations from the Final Symposium on January 30 and 31 in 2020]. / Heidelberger Meilenstein Kommunikation (HeiMeKOM) ­ Erfahrungen, Best Practice Beispiele und Empfehlungen aus dem Abschluss-Symposium am 30./31. Januar 2020.

The National Cancer Plan emphasises the importance of medical communication and calls for its integration into medical education and training. In this context, the Milestone Communication Approach meets the communicative challenges in dealing with lung cancer patients. Interprofessional tandems, consisting of doctors and nurses, conduct structured conversations at defined moments with patients and their relatives. The concept aims at shared decision making, continuity in the care of lung cancer patients and the early integration of palliative care. During the symposium on the Heidelberg Milestone Communication in January 2020, recommendations on the care situation of lung cancer patients in advanced stages were developed. In addition, the further adaptability of HeiMeKOM to other settings and hospitals and to other diseases was discussed as well as the possibility of implementing such a concept in standard care. This article presents the experiences, best practice examples and recommendations discussed during the symposium in order to enable their extrapolation to other similarly oriented projects. The long-term goal is to transfer the milestone concept to other hospital, primarily certified lung cancer centers, and to ensure permanent funding. For further dissemination of the concept and, above all, to have it established in standard care, health policy awareness and support are required in addition to the integration of the concept in competence catalogues of continuing medical and nursing education.

Effect of a nursing information system on the quality of information processing in nursing: An evaluation study using the HIS-monitor instrument.

OBJECTIVES: To assess the changes in the quality of information processing in nursing after the introduction of a computer-based nursing information system. METHODS: 94 nurses filled out the HIS-monitor survey, comprising 41 questions and focusing on the quality of the information processing, shortly before and again one year after the introduction of a computer-based nursing information system. A McNemar-Bowker-test was used to assess the changes in quality over time. The HIS-monitor instrument was formally validated by calculating Cronbach Alpha. RESULTS: Despite some technical problems, the quality of the information processing in nursing significantly improved after the introduction of a computer-based nursing information system in many areas. The results show improved support during patient anamnesis and care planning, higher availability and completeness of nursing documentation, better overview on the patient, better readability of nursing documentation, reduction of duplicate documentation, better workflow support with task lists and checklists, and better fulfillment of the legal regulations. The results with regard to time efforts for nursing documentation and the related impact on patient care were mixed, however. Most of the expectations of the nurses that were stated before IT introduction seem to have been realized. CONCLUSIONS: The HIS-monitor was found to be a useful instrument, in turn showing that the quality of the information processing in nursing strongly increased after the introduction of a nursing information system.

HIS-Monitor: an approach to assess the quality of information processing in hospitals.

OBJECTIVES: Hospital information systems (HIS) are a substantial quality and cost factor for hospitals. Systematic monitoring of HIS quality is an important task; however, this task is often seen to be insufficiently supported. To support systematic HIS monitoring, we developed HIS-Monitor, comprising about 107 questions, focusing on how a hospital information system does efficiently support clinical and administrative tasks. METHODS: The structure of HIS-Monitor consists of a matrix, crossing HIS quality criteria on one axis with a list of process steps within patient care on the other axis. HIS-Monitor was developed based on several pretests and was now tested in a larger feasibility study with 102 participants. RESULTS: HIS-Monitor intends to describe strengths and weaknesses of information processing in a hospital. Results of the feasibility study show that HIS-Monitor was able to highlight certain HIS problems such as insufficiently supported cross-departmental communication, legibility of drug orders and other paper-based documents, and overall time needed for documentation. We discuss feasibility of HIS-Monitor and the reliability and validity of the results. CONCLUSIONS: Further refinement and more formal validation of HIS-Monitor are planned.

HIS-monitor: quality of information processing in hospitals.

Systematic monitoring of HIS quality is an important task; however, this task is often seen to be insufficiently supported. To support systematic HIS monitoring, we developed the HIS-Monitor questionnaire, focusing on how a hospital information system (HIS) does efficiently support clinical and administrative tasks. HIS-Monitor was applied in a feasibility study with 102 nursing participants. Results point to strengths and weaknesses of information processing in the participating departments. Based on the experiences of the feasibility study, HIS-Monitor is now further being optimized.

Design and development of a monitoring system to assess the quality of hospital information systems: concept and structure.

Hospital information systems (HIS) are a substantial quality and cost factor in health care. Systematic monitoring of HIS quality is an important task for information management; however, this task is often seen to be insufficiently supported by available methods and tools. The aim of this research project is to develop a comprehensive monitoring system to assess the quality of hospital information systems, taking into account both computer-based and paper-based information processing.The structure of the developed monitoring system consists of a matrix, crossing HIS quality criteria on one axis (e.g., accessibility of information, or correctness and completeness of information) with a list of process steps within patient care on the other axis (e.g., patient admission, order entry, or clinical documentation). Relevant fields in this matrix, being defined by one quality criterion and one process step, contain detailed questions, that access the HIS quality with regard to the given criterion in a given process step.Based on the matrix, a questionnaire with around 140 questions has been developed, consisting of specific questions for physicians, nurses and other professional groups. The ongoing international evaluation will verify completeness, reliability, validity, and feasibility of this HIS quality monitoring system. First evaluation steps point to a high acceptance of this approach among IT staff and clinical staff.

[Schizophrenic patients, who still live in psychiatric hospitals despite decades of deinstitutionalization. Part 1 of the Hessian Deinstitutionalisation Study]. / Schizophrene Patienten, die trotz Dekaden der Enthospitalisierung in den psychiatrischen Krankenhäusern verblieben sind - Teil 1 der Hessischen Enthospitalisierungsstudie -

Deinstitutionalization (DI) of most of the chronic long-stay patients has taken place in the last decades in Germany. However, a "residual" group of patients often remains in psychiatric hospitals, with an ongoing controversy on an appropriate type of their care (community based vs. hospital). Clinical, functional and social characteristics of such schizophrenic patients still residing in the long-stay wards in the German state of Hesse after decades of DI are presented. The n = 266 patients investigated displayed a marked degree of negative symptoms and moderate positive symptoms but, however, severe social disabilities. In addition, the patients were very dependent in daily living, had an extremely impoverished social network and leisure activities. The findings contribute to the research on "difficult-to-place" patients described in the literature.