Diagnosen einer Zentralen Notaufnahme als Qualitätsindikator
Wilk F, Grosse F, Liebel J, Wagner M, Dormann H (2019)
Publication Type: Journal article
Publication year: 2019
Journal
DOI: 10.1007/s10049-019-0611-3
Abstract
Background: Making the right diagnosis plays an important role in emergency departments, but objective indicators to investigate diagnostic quality are rarely available. Methods: By systematically comparing the main admission diagnosis (AD), the main discharge diagnosis (ED) and the main hospital diagnosis (HD), the diagnostic agreement (dÜ), -sensitivity (dSe), -specifity (dSp) and efficiency (dEff) were calculated for 28 time-critical diagnoses. Results: During the study period, 21,512 emergency department inpatients (average 63 years; min 0, max 104, standard deviation [SD] ± 21.4) were treated with 599 different main admission diagnoses. The diagnostic agreement (dÜ) and sensitivity (dSe) over all time-critical diagnoses reached 66.5 and 70.0%, the diagnostic specificity (dSp) 51.5%. The diagnostic sensitivity (dSe) was highest (100%) among patients with aortic aneurysm and dissection (dSp 72%). Inpatients with Intracranial injury reached the highest diagnostic specificity (dSp) of 94% (dSe 92%), while patients with vascular disorders of intestine had the largest gap between diagnostic sensitivity (dSe) and diagnostic specificity (dSp) (82 and 13%). The diagnostic efficiency over all emergency diagnoses (dEff) was 0.37/minute (min 0.03, max 92, SD ± 1.22), whereas the subgroup of patients with cardiac arrest reached highest diagnostic efficiency (dEff) of 1.04/minute (min 0.42, max 9.17, SD ± 1.41, dSe 55%). Conclusion: Quality indicators for time-critical diagnoses could be determined by routine data of the hospital information systems. By linking outcome- and process indicators diagnostic quality of an emergency department can be objectified.
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Germany (DE)How to cite
APA:
Wilk, F., Grosse, F., Liebel, J., Wagner, M., & Dormann, H. (2019). Diagnosen einer Zentralen Notaufnahme als Qualitätsindikator. Notfall und Rettungsmedizin. https://doi.org/10.1007/s10049-019-0611-3
MLA:
Wilk, Florian, et al. "Diagnosen einer Zentralen Notaufnahme als Qualitätsindikator." Notfall und Rettungsmedizin (2019).
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