Veränderungen und Entwicklungen in der präklinischen Notfallversorgung: Zentrale Herausforderungen für das Rettungsdienstmanagement

Abstract

ZusammenfassungDer Rettungsdienst in Deutschland und das Management der gesamten präklinischen Notfallversorgung sehen sich aktuell mit zahlreichen Herausforderungen konfrontiert. Im letzten Jahrzehnt stiegen die Einsatzzahlen in nahezu allen Rettungsdienstbereichen kontinuierlich an, so dass die Vorhaltung von Rettungsmitteln vielerorts bereits deutlich verstärkt worden ist. Das Personalmanagement fällt jedoch zunehmend schwer und auch die technischen sowie medizinischen Anforderungen wachsen stetig. Zunehmend werden Stimmen laut, die eine grundlegende Reform der Notfallversorgung fordern.Ziel dieses Beitrags ist es, einen Überblick über die aktuellen Entwicklungen, Trends und zukünftigen Herausforderungen zu geben, um die Anforderungen an das heutige und zukünftige Rettungsdienstmanagement deutlich zu machen. Verschiedene Themen und Handlungsfelder wurden dazu anhand einer nichtsystematischen Literaturrecherche herausgearbeitet. Die Anforderungen an das Rettungsdienstmanagement werden iterativ zusammengeführt.Die Herausforderungen an den Rettungsdienst sind vielfältig und komplex, ebenso die Anforderungen an dessen Management. Die heterogene und kleingliedrige Organisationsstruktur des Rettungsdienstes im Bundesgebiet stellt eine wesentliche Herausforderung für Reformprozesse dar. Fehlende wissenschaftliche Kompetenzen im Rettungsdienst erschweren die Prozessoptimierung ebenfalls. Die zunehmende Akademisierung und Erforschung des Themenfeldes sind ausdrücklich zu begrüßen.

Performance of invasive, non-invasive, and pharmacological measures by emergency physicians in the German emergency medical services. A retrospective cross-sectional study from the rescue association Südwestsachsen

“…In the study presented here, psychiatric emergency also has a high proportion with 8.33%. Deployments with psychosocial problems are considered to be a partial reason for the steadily increasing number of deployments of emergency medical services (6).…”

Improving Emergency Service Quality and Patient Safety Through the Use of Cross-Sectoral Digital Feedback Systems – An Overview

“…Summary results of the PubMed search 1 [10] x congress paper with title and abstract only 2 [11] x highlighted only the importance of using medical data in emergency cases 3 [12] x described requirements on data management tools in emergency departments 4 [13] x neuronal network to identify myocardial ischemia in patients having thoracic pain x feedback system was used to increase physician's confidence in this neuronal network 5 [14] x direct feedback to the emergency medical staff was given after interpretation a transmitted ecg. x feedback was given before transport to the hospital x assignment of patients with STEMI to hospitals with catheterization options 6 [15] x analysed the first medical contact to balloon time in patients with myocardial ischemia x feedback was given by presenting interim results of the study at the f the end of each quarter x no individual feedback 7 [16] x effect of the quality of a cardiac massage using a technical feedback system results of the Scholar search 8 [17] x requirements in digitalisation in health care without reference to feedback o networking of all health care providers o secure exchange of information 9 [18] x requirements of data in emergency care o enabling feedback mechanisms for the individual healthcare provider at the case level o outcome-oriented evaluation of emergency care is only possible by linking the care data of the different structures and sectors at the patient level 10 [19] x cross-sectoral networking without reference on feedback o digitization in the healthcare sector enables networking of the various players o enables a better exchange of knowledge which can be a benefit for patients 11 [20] x challenges for the management of the EMS o medical directors of the EMS are responsible for ensuring the medical supervision of the paramedics and for establishing suitable feedback and training instruments 12 [21] x sectoral separation into emergency and acute care is a problem x the impossibility of rapid transfer of medical information from one sector to the other also poses a problem for patient safety in this context 13 [22] x current status of quality assurance in EMS x EMS do not receive standardized feedback on patient's ongoing disease 14 [23] x Quality management by implementation of a monthly report using the dataset mV2015.1 of the DIVI for emergency departments (AKTIN) x no cross-sectoral feedback system 15 [24] x described an application for cross-sectoral networking x no reference on feedback…”

Relaxation and strain among emergency medical service personnel and emergency control center dispatchers during the first two waves of the SARS-CoV-2 pandemic

“…General challenges during the SARS-CoV-2 pandemic for the health care system, especially EMS Over the past 3 years, the SARS-CoV-2 pandemic has dominated daily life in many places and continues to pose unique challenges to the entire health care system [21]. The World Health Organization (WHO) classified COVID-19 as a "public health emergency of international concern" [22], which affects all aspects of life.…”