Nicht pharmakologische Präventionsmaßnahmen sind evidenzbasiert das effektivste Mittel
zur Vorbeugung des Delirs. Ihre Transformation in die Krankenversorgung ist ein wichtiger
Schritt und
mithilfe von Qualitätsverträgen induzierbar. Bedeutung und Inhalte solcher Qualitätsverträge
werden in diesem Beitrag erläutert.
Abstract
Delirium is one of the most common postoperative complications. Delayed initiation
of treatment leads to an increased mortality rate within the first 90 days and to
an increased need for
post-hospital care. Similarly, neurocognitive disorders (NCDs) occur in a quarter
of affected patients over the long-term. The use of evidence-based guideline recommendations
can reduce
incidence rates of delirium, shorten delirium duration, and prevent complications.
Implementing delirium management according to evidence-based guideline recommendations
requires a
transformation process that integrates all stakeholders. In May 2017, the Federal
Joint Committee (G-BA), the highest decision-making body in the German healthcare
system, approved the
quality contract (QC) as a new instrument for improving healthcare in Germany. With
QC, hospitals have the opportunity to set up better conditions for the transformation
process of
delirium management, because with QC funding, initial hurdles can be more easily overcome,
such as establishing and sustaining new structures or mobilizing resources. The cooperation
of
all stakeholders – but above all their shared understanding – of the need for transformation
is crucial for the successful implementation of delirium management. The digitization
of
cross-departmental processes in particular is an elementary component in a modern
transformation process. This creates new opportunities and processes that offer added
value for patients
and caregivers. Patients thus experience delirium management as a coherent interdisciplinary
and multiprofessional concept that is implemented transparently, comprehensibly, and
evidence-based.
Schlüsselwörter
Transformation - evidenzbasierte Medizin - Delirmanagement - postoperatives Delir
- Prävention
Keywords
transformation - evidence-based medicine - delirium management - postoperative delirium
- prevention
