title: [From clinical guidelines to clinical pathways: development of a management-oriented algorithm for the treatment of polytraumatized patients in the acute period].
abstract: BACKGROUND
  The treatment of polytraumatized patients in the acute period is an exemplary model of multidisciplinary cooperation in a very critical timeframe. Implementing standards formulated in the clinical guidelines of the German Association of Traumatology requires a detailed description of "how to do it."
  
  
  METHODS
  Based on the guidelines and validated quality indictors, the optimal standard of care as the goal was defined. A clinical algorithm was developed and personal responsibilities and time limits were clearly assigned to each decision step and action. Checklists, documentation charts, and a full text supplement the algorithm. The complete pathway was adopted by representatives of all occupational groups involved in early trauma care in a consensus process.
  
  
  RESULTS
  Improvement potentials were identified in those areas for which the guidelines did not provide explicit recommendations. These represent the key elements of the algorithm. Pathway-specific review criteria (quality indicators) were defined for scheduled reevaluation.
  
  
  CONCLUSIONS
  Implementing clinical guidelines at the local level requires a problem-oriented and management-oriented elaboration towards a clinical pathway as the basis for a quantitative process and cost analysis.
authors.affiliation: Klinik für Unfall-, Wiederherstellungs- und Handchirurgie, Klinikum der Philipps-Universität Marburg. schnabem@mailer.uni-marburg.de
authors.forename: M
authors.initials: M
authors.lastname: Schnabel
authors.forename: C
authors.initials: C
authors.lastname: Kill
authors.forename: M
authors.initials: M
authors.lastname: El-Sheik
authors.forename: A
authors.initials: A
authors.lastname: Sauvageot
authors.forename: K J
authors.initials: KJ
authors.lastname: Klose
authors.forename: I
authors.initials: I
authors.lastname: Kopp
mesh_terms: D000465:Algorithms; D005260:Female; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000628:therapy*; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care