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Background: Continuity of care is associated with many benefits for patients and health care systems. Therefore measuring care coordination - the deliberate organization of patient care activities between two or more participants - is especially needed to identify entries for improvement. The aim of this study was the translation and cultural adaptation of the Medical Home Care Coordination Survey (MHCCS) into German, and the examination of the psychometric properties of the resulting German versions of the MHCCS-P (patient version) and MHCCS-H (healthcare team version).
Methods: We conducted a paper-based, cross-sectional survey in primary care practices in three German federal states (Schleswig-Holstein, Hamburg, Baden-Württemberg) with patients and health care team members from May 2018 to April 2019. Descriptive item analysis, factor analysis, internal consistency and convergent, discriminant and predictive validity of the German instrument versions were calculated by using SPSS 25.0 (Inc., IBM).
Results: Response rates were 43% (n = 350) for patients and 34% (n = 141) for healthcare team members. In total, 300 patient questionnaires and 140 team member questionnaires could be included into further analysis. Exploratory factor analyses resulted in three domains in the MHCCS-D-P and seven domains in the MHCCS-D-H: “link to community resources”, “communication”, “care transitions”, and additionally “self-management”, “accountability”, “information technology for quality assurance”, and “information technology supporting patient care” for the MHCCS-D-H. The domains showed acceptable and good internal consistency (α = 0.838 to α = 0.936 for the MHCCS-D-P and α = 0.680 to α = 0.819 for the MHCCS-D-H).
As 77% of patients (n = 232) and 63% of health care team members denied to have or make written care plans, items regarding the “plan of care” of the original MHCCS have been removed from the MHCCS-D.
Conclusions: The German versions of the Medical Home Care Coordination Survey for patients and healthcare team members are reliable instruments in measuring the care coordination in German primary care practices. Practicability is high since the total number of items is low (9 for patients and 27 for team members).
Agility is considered the silver bullet for survival in the VUCA world. However, many organisations are afraid of endangering their ISO 9001 certificate when introducing agile processes. A joint research project of the University of Applied Sciences and Arts Hannover and the DGQ has set itself the goal of providing more security in this area. The findings were based on interviews with managers and team members from various organisations of different sizes and industries working in an agile manner as well as on common audit practices and a literature analysis. The outcome presents a clear distinction of agility from flexibility as well as useful guidelines for the integration of agile processes in QM systems - for QM practitioners and auditors alike.
Viele Unternehmen experimentieren mit Agilität. Gleichzeitig ist die Unsicherheit groß, wieviel Agilität ein QM-System nach ISO 9001 tatsächlich verträgt. Ein gemeinsames Forschungsprojekt der Hochschule Hannover und der DGQ hat sich zum Ziel gesetzt, hier mehr Sicherheit zu geben. Aus Interviews mit Vertretern von Unternehmen, welche teilweise agil arbeiten, entstanden Leitlinien für die Integration von agilen Vorgehensweisen in QM-Systeme und erstmals eine klare Definition von Agilität.
Agile Prozesse und zertifizierte Managementsysteme wirken anfänglich wie ein Widerspruch, insbesondere hinsichtlich der Steuerung des Prozessverlaufs sowie der Kontrolle beabsichtigter Ergebnisse. Doch ein wissenschaftlicher Blick auf etablierte Formen der Prozesssteuerung legte im Rahmen einer Masterarbeit offen, dass sich einheitliche Mechanismen dahinter verbergen, die auch auf agile Prozesse angewendet werden können. Fünf erkannte Prozesssteuerungsmechanismen geben dem Leser konkrete Ansatzpunkte zur ISO 9001-konformen Steuerung und Kontrolle agiler Prozesse.