RESUMO
New work models have been discussed for several years. Especially in the area of knowledge work, mobile and distributed work provides advantages over presence time at companies: It offers more freedom and flexibility to the employees, reduces travel time, and counteracts a major trend: the exodus from rural areas. However, to provide an optimized digital work environment for distributed teams of knowledge workers, many different aspects must be considered, including social, physical, legal, and technological aspects. In this article, we focus on the technological aspects. Nowadays, a multitude of tools and technologies exist to support the communication of distributed teams, to allow working concurrently on documents, or to support data and document exchange. However, many existing solutions only provide solutions for a specific purpose rather than a sophisticated platform that offers all of these services in an integrated manner and additionally takes care of delivering intelligent and data-driven services in a trustful and ethical way. In the research project "Digital Teams", we aim at developing such a platform as open source. In this article, we provide the basic architecture of our platform and share the main concepts and solutions we are currently implementing, such as our dashboard, data exchange concepts, or authentication and authorization mechanisms.
RESUMO
BACKGROUND: On 4 August 2011 a modification of the infection protection act became law, meaning that antibiotic consumption surveillance and evaluation of data on the local resistance situation became obligatory for hospitals. Four years after the modification of the infection protection act became law, the Munich public health department aimed to evaluate the state of implementation of antibiotic consumption surveillance in Munich hospitals and to ascertain which antibiotic stewardship (ABS) structures have already been established. METHODS: A questionnaire was sent to Munich hospitals about their antibiotic management structural data and state of implementation of legal requirements. RESULTS: Only 32 % of the hospitals have qualified ABS-experts available. In 76 % of the hospitals persons responsible for antibiotic consumption surveillance are appointed, while in 12 % persons responsible for antibiotic consumption surveillance are at least partly released from their normal work for this activity. Twenty-one hospitals (21 %) conduct antibiotic consumption surveillance taking into account all antiinfective agents mentioned in the Robert Koch-Institute (RKI) guidelines. Of these, 19 (76 %) did this on basis of World Health Organizations ATC/DDD-system (anatomical therapeutic chemical [ATC] classification system which uses defined daily doses [DDD]). The data on antibiotic consumption is evaluated in 72 % of the hospitals, 68 % take account of the local resistance situation. In 96 %, in-house lists of antiinfectives are available; in 80 %, in-house guidelines for antibiotic treatment are available. Fourty-four percent of the hospitals take part in a national surveillance. CONCLUSIONS: For the first time data were collected on implementation of antibiotic consumption surveillance in hospitals, which has been required by law since 2011. An incomplete implementation of legal requirements was demonstrated. It was found that structural and personnel prerequisites are often missing, that release from normal work for this additional duty is rarely granted and that the evaluation of data is often either missing or does not correspond to the legal requirements by omitting to take account of the local resistance situation. The hygienic control of hospitals by the public health service was extended by an additional subject. To carry out this very specialized task in a competent way, an ABS-qualification for public health staff is essential from the perspective of the authors.
