Interdisciplinary ambulatory out of hours service – Identification of the relevant reasons for encounter

DOI: 10.3238/zfa.2009.0196

german translation / full article

Markus Gulich, Hans-Peter Zeitler, Uta-Maria Waldmann

Keywords: interdisciplinary ambulatory out of hours service undergraduate training postgraduate training continuing medical education (CME) urological reasons for encounter

Background: Any doctor working in ambulatory care (outside hospital setting) is – irrespective of his or her postgraduate training – obliged to participate in the primary care out of hours service. So, specialists see patients and problems similar to a General Practice setting and have to deal with reasons for encounter, diagnoses and skills (RDS) they never met or needed since leaving university.

Aim of this study is to

1. evaluate if the Delphi method is suitable to identify relevant reasons for encounter, diagnoses and skills (RDS)

2. exemplarily identify the RDS in the field of urology relevant for the interdisciplinary ambulatory out of hours service.

Methods: A two-step delphi method to identify the relevant RDS: experts being 20 General Practitioners involved in out of hours service throughout Germany.

Step 1: independent listing of relevant RDS by experts; structured summary of all answers by the author

Step 2: rating of the summarized RDS according to impor-tance, frequency of occurrence and “good feeling” by experts

Results: In step 1 of the delphi survey, 23 reasons for encounter/symptoms, 34 urological diagnoses, 9 non-urological diagnoses and 60 diagnostic and therapeutic skills were identified. In step 2, 71 out of these 125 RDS were accepted and 15 were rejected by more than 75 % of the experts; 39 are in the grey zone between acceptance and rejection.

Conclusions: The delphi method proofs to be suitable to identify relevant RDS for the interdisciplinary ambulatory out of hours service. Both specific urological and general relevant RDS were categorized. By naming these relevant RDS they could explicitly be included in undergraduate as well as in postgraduate training. This is an important step to increase safety in out of hours services for doctors and

patients alike.

(State: 27.07.2011)

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