Qualitätsmanagement nach DIN EN ISO 9001: 2000 an der HNO-Universitätsklinik Frankfurt/Main

Im Jahr 2003 begann die HNO-Universitätsklinik Frankfurt / Main mit der Einführung eines Qualitätsmanagement-Systems, die im August 2005 zur erfolgreichen Zertifizierung nach der vom Klinikumsvorstand geforderten DIN EN ISO 9001:2000 führte. Ziele unseres Qualitätsmanagements waren die Optimierung der internen Betriebsabläufe und die Standardisierung von Arbeitsvorgängen unter Einbeziehung von logistischen Schnittstellen mit externen Strukturen unter Berücksichtigung der besonderen Anforderungen einer Universitätsklinik. Neben einer grundsätzlichen Prüfung und Optimierung sämtlicher Organisationsabläufe wurden für die Kernprozesse unserer Klinik Zielvorgaben festgelegt. Diese Ziele betrafen die Qualität der Arbeitsabläufe für alle Bereiche der HNO-ärztlichen ambulanten und stationären Versorgung ebenso, wie Aufgaben in Forschung und Lehre, die durch ein Ausbildungscurriculum für Mitarbeiter und Sudenten abgebildet wurde. Es wurden aber auch Serviceaspekte, wie Terminvergabe und Befundübermittlung, sowie ökonomische und wirtschaftliche Aspekte unserer Arbeit optimiert. Durch Umstrukturierung und Neuorganisation konnte die Effizienz der Arbeitsabläufe deutlich gesteigert werden, wovon vor allem Patienten und Mitarbeiter erheblich profitieren. Die Einführung eines Qualitätsmanagementsystems in der Frankfurter HNO-Universitätsklinik war zunächst mit einem entsprechenden Arbeitsaufwand verbunden und erforderte ein Umdenken in den einzelnen Funktionsbereichen. Insgesamt überwiegt der positive Einfluss auf die Struktur und Arbeitsabläufe, sodass die Umsetzung eines Qualitätsmanagementsystems in der Universitätsklinik empfehlenswert ist

Bioadhesion in the oral cavity and approaches for biofilm management by surface modifications

Background: All soft and solid surface structures in the oral cavity are covered by the acquired pellicle followed by bacterial colonization. This applies for natural structures as well as for restorative or prosthetic materials; the adherent bacterial biofilm is associated among others with the development of caries, periodontal diseases, peri-implantitis, or denture-associated stomatitis. Accordingly, there is a considerable demand for novel materials and coatings that limit and modulate bacterial attachment and/or propagation of microorganisms. Objectives and findings: The present paper depicts the current knowledge on the impact of different physicochemical surface characteristics on bioadsorption in the oral cavity. Furthermore, it was carved out which strategies were developed in dental research and general surface science to inhibit bacterial colonization and to delay biofilm formation by low-fouling or “easy-to-clean” surfaces. These include the modulation of physicochemical properties such as periodic topographies, roughness, surface free energy, or hardness. In recent years, a large emphasis was laid on micro- and nanostructured surfaces and on liquid repellent superhydrophic as well as superhydrophilic interfaces. Materials incorporating mobile or bound nanoparticles promoting bacteriostatic or bacteriotoxic properties were also used. Recently, chemically textured interfaces gained increasing interest and could represent promising solutions for innovative antibioadhesion interfaces. Due to the unique conditions in the oral cavity, mainly in vivo or in situ studies were considered in the review. Conclusion: Despite many promising approaches for modulation of biofilm formation in the oral cavity, the ubiquitous phenomenon of bioadsorption and adhesion pellicle formation in the challenging oral milieu masks surface properties and therewith hampers low-fouling strategies. Clinical relevance: Improved dental materials and surface coatings with easy-to-clean properties have the potential to improve oral health, but extensive and systematic research is required in this field to develop biocompatible and effective substances. © 2020, The Author(s)

On stochastic imitation dynamics in large-scale networks

We consider a broad class of stochastic imitation dynamics over networks, encompassing several well known learning models such as the replicator dynamics. In the considered models, players have no global information about the game structure: they only know their own current utility and the one of neighbor players contacted through pairwise interactions in a network. In response to this information, players update their state according to some stochastic rules. For potential population games and complete interaction networks, we prove convergence and long-lasting permanence close to the evolutionary stable strategies of the game. These results refine and extend the ones known for deterministic imitation dynamics as they account for new emerging behaviors including meta-stability of the equilibria. Finally, we discuss extensions of our results beyond the fully mixed case, studying imitation dynamics where agents interact on complex communication networks.Comment: Extended version of conference paper accepted at ECC 201

Interaction with Interconnected Data in Participatory Processes

This paper proposes a conceptual graphical user interface for the interaction with interconnected data in participatory processes that play an important role for future smart cities. The presented idea is based on identifying important tasks for data exploration and data editing. The data to consider is structured, semi-structured or unstructured and of different facets. For example, participatory processes like planning and decision processes involve text, time and spatial data. In other words, the handling of the data is a complex endeavor in terms of representation and interaction. In this respect, we utilize and describe a graph-based data model that properly reflects the connected data

Bioadhesion on Textured Interfaces in the Human Oral Cavity—An In Situ Study

Extensive biofilm formation on materials used in restorative dentistry is a common reason for their failure and the development of oral diseases like peri-implantitis or secondary caries. Therefore, novel materials and strategies that result in reduced biofouling capacities are urgently sought. Previous research suggests that surface structures in the range of bacterial cell sizes seem to be a promising approach to modulate bacterial adhesion and biofilm formation. Here we investigated bioadhesion within the oral cavity on a low surface energy material (perfluorpolyether) with different texture types (line-, hole-, pillar-like), feature sizes in a range from 0.7–4.5 µm and graded distances (0.7–130.5 µm). As a model system, the materials were fixed on splints and exposed to the oral cavity. We analyzed the enzymatic activity of amylase and lysozyme, pellicle formation, and bacterial colonization after 8 h intraoral exposure. In opposite to in vitro experiments, these in situ experiments revealed no clear signs of altered bacterial surface colonization regarding structure dimensions and texture types compared to unstructured substrates or natural enamel. In part, there seemed to be a decreasing trend of adherent cells with increasing periodicities and structure sizes, but this pattern was weak and irregular. Pellicle formation took place on all substrates in an unaltered manner. However, pellicle formation was most pronounced within recessed areas thereby partially masking the three-dimensional character of the surfaces. As the natural pellicle layer is obviously the most dominant prerequisite for bacterial adhesion, colonization in the oral environment cannot be easily controlled by structural means

Quality management: reduction of waiting time and efficiency enhancement in an ENT-university outpatients' department

Background Public health systems are confronted with constantly rising costs. Furthermore, diagnostic as well as treatment services become more and more specialized. These are the reasons for an interdisciplinary project on the one hand aiming at simplification of planning and scheduling patient appointments, on the other hand at fulfilling all requirements of efficiency and treatment quality. Methods As to understanding procedure and problem solving activities, the responsible project group strictly proceeded with four methodical steps: actual state analysis, analysis of causes, correcting measures, and examination of effectiveness. Various methods of quality management, as for instance opinion polls, data collections, and several procedures of problem identification as well as of solution proposals were applied. All activities were realized according to the requirements of the clinic's ISO 9001:2000 certified quality management system. The development of this project is described step by step from planning phase to inauguration into the daily routine of the clinic and subsequent control of effectiveness. Results Five significant problem fields could be identified. After an analysis of causes the major remedial measures were: installation of a patient telephone hotline, standardization of appointment arrangements for all patients, modification of the appointments book considering the reason for coming in planning defined working periods for certain symptoms and treatments, improvement of telephonic counselling, and transition to flexible time planning by daily updates of the appointments book. After implementation of these changes into the clinic's routine success could be demonstrated by significantly reduced waiting times and resulting increased patient satisfaction. Conclusion Systematic scrutiny of the existing organizational structures of the outpatients' department of our clinic by means of actual state analysis and analysis of causes revealed the necessity of improvement. According to rules of quality management correcting measures and subsequent examination of effectiveness were performed. These changes resulted in higher satisfaction of patients, referring colleagues and clinic staff the like. Additionally the clinic is able to cope with an increasing demand for appointments in outpatients' departments, and the clinic's human resources are employed more effectively

Features of age-related macular degeneration in the general adults and their dependency on age, sex, and smoking : Results from the German KORA study

Acknowledgments We thank all study participants for contributing to the KORA study.Peer reviewedPublisher PD

Datenmanagementpläne in der Forschung – von Grundlagen zu Grundfragen

Datenmanagementpläne werden zunehmend als wichtiges Element der guten wissenschaftlichen Praxis verstanden und bei der Beantragung von Fördermitteln eingefordert. Die Workshopreihe „Datenmanagementpläne in der Forschung – von Grundlagen zu Grundfragen“ hatte zum Ziel, die unterschiedlichen Perspektiven auf Datenmanagementpläne zu beleuchten und einen Austausch zwischen allen am Thema Beteiligten zu ermöglichen. Hierzu wurde im ersten Workshop zunächst ein gemeinsames Verständnis für Definition und Inhalte eines Datenmanagementplans geschaffen. In den zwei folgenden Veranstaltungen wurden die Perspektiven der Forschungsförderer und der Forschenden diverser Fachbereiche beleuchtet. Die abschließende vierte Veranstaltung stellte verschiedene Tools zur Erstellung von Datenmanagementplänen vor. Der vorliegende Artikel informiert über Inhalte und Ergebnisse der vier Workshops und gibt einen Ausblick auf zukünftige Entwicklungen