Quality management: implementation of the "in-hospital" emergency protocol into clinical routine

• Published in: Medizinische Klinik (München. 1983) Vol. 104; no. 7; p. 520
• Main Authors: Siebig, Sylvia, Reng, Michael, Gantner, Martin, Langgartner, Julia
• Format: Journal Article
• Language: German
• Published: Germany 15.07.2009
• Subjects: Aged; Aged, 80 and over; Documentation - standards; Emergency Service, Hospital - organization & administration; Female; Germany; Health Plan Implementation - organization & administration; Heart Arrest - etiology; Heart Arrest - mortality; Heart Arrest - therapy; Hospital Mortality; Humans; Male; Medical Records, Problem-Oriented - standards; Middle Aged; Patient Care Team - organization & administration; Reference Standards; Resuscitation - standards; Survival Rate; Total Quality Management - organization & administration; Germany
• DOI: 10.1007/s00063-009-1111-x

Outcome after in-hospital resuscitation with survival rates between 14-17% still remains poor. Structured documentation of in-hospital cardiac arrest especially in Germany is rare and inhomogeneous. Documentation of in-hospital emergency situations (I-ES) may help to develop organizational structures, to collect information of treatment after resuscitation and therefore, improve patient's outcome. The aim of this study was to evaluate the documentation quality and user's acceptance after the implementation of an in-house emergency (IHE) protocol used by the authors' internal medicine emergency team (ET). Analysis of IHE protocols and discharge letters of 65 patients between August 2004 and December 2007 at a university medical center. The IHE protocol was used in 65% of all emergency calls with a completion rate of 80% of all available documentation categories. Especially documentation of drugs given, their dosage and the general course of action was incomplete. In 25% the discharge letters did not contain information about the I-ES. Implementation of the authors' IHE protocol, designed in close accordance with the DIVI (German Interdisciplinary Association of Intensive Care and Emergency Medicine) out-of-hospital emergency protocol, helps to collect important data in I-ES. Usage of the protocol resulted in better documentation of emergency situations in contrast to the information found in discharge letters alone. Nevertheless, documentation of I-ES still needs to be improved, especially concerning the completeness of records.