[Intensive care and emergency medicine as part of training in internal medicine]

[The center for intensive care medicine: a model for interdisciplinary and interprofessional collaboration]

BACKGROUND

The Federal Joint Committee has established requirements for centers for intensive care medicine which, in cooperation with other clinics, are to take on special tasks for intensive care medicine in a region. High demands are placed on these centers, which it may not be possible to meet without restructuring the existing intensive care structures.

OBJECTIVE

In this study, an organizational model for a center for intensive care medicine based on broad interdisciplinary and interprofessional cooperation is presented for discussion.

METHODS AND RESULTS

The organizational model contains proposals for integration of the centers for intensive care medicine into the clinic structure, the management team, the staff composition, the areas of clinical activity, and the further tasks of research, teaching, and education and training.

CONCLUSION

Establishment of the centers for intensive care medicine provides new and forward-looking impetus for the further development of intensive care medicine in Germany. However, for the new organizational model to be implemented effectively, the necessary restructuring measures must be adequately refinanced and supported by hospital management and medical faculties. In addition, a sustained willingness for interdisciplinary and interprofessional cooperation is required on the part of all those involved, and employees in this model must be offered attractive long-term positions in intensive care medicine.

Positive Effekte eines Einarbeitungs- und Weiterbildungscurriculums am Beispiel der interdisziplinären Intensivstation

Die Einarbeitung von neuen ärztlichen Kollegen in Krankenhäusern ist aufgrund mannigfaltiger Aspekte wie z. B. Personalmangel und Zeitdruck für alle Beteiligten oft sehr herausfordernd. Am Beispiel der interdisziplinären Intensivstation wurden positive Effekte eines strukturierten Einarbeitungs- und Ausbildungscurriculums im Rahmen regelmäßiger Mitarbeiterbefragungen wissenschaftlich belegt. Es konnte ein statistisch signifikanter Anstieg der Zufriedenheit zu den Themen der Qualität der Einarbeitung (p < 0,0001), der Qualität der Ausbildung (p < 0,0001), der Vorbereitung auf Nachtdienste auf der Intensivstation (p < 0,0001) und ebenso eine Verbesserung der allgemeinen Zufriedenheit in der Klinik (p < 0,003) dargestellt werden. Ein solches Curriculum trägt aus diesen Gründen sowohl zur Erhöhung der Versorgungsqualität und Patientensicherheit bei als auch erhöht es die Sicherheit im medizinischen Handeln der ärztlichen Mitarbeiter.

[Fellowship Training Program in Emergency Medicine]

German emergency departments have experienced significant development in recent years due to changes in health care policy as well as continued professionalism in emergency department medical care. The German Medical Association has taken this development into account and included an additional post residency fellowship training program in emergency medicine into their 2018 model training regulation guidelines. The specialized training in emergency medicine covers the initial diagnosis and treatment of patients in the emergency department as well as medical decision making and coordination of further specialist medical care in interdisciplinary cooperation. The following article provides information about requirements, content, and duration of the fellowship training program in emergency medicine, which has now been introduced in emergency departments throughout Germany.