title: [Influence of working time regulations on the organisation and quality of clinical workflow].
abstract: The present lecture is a personal report on changing working conditions for physicians in German hospitals over the last 20 years. Documentation, coding and other administrative requirements have constantly risen and will increase once again from 2004 onwards when the complete reimbursement system in German hospitals will be rearranged on the basis of diagnosis-related groups, though without providing an adequate workforce of professional coders. Moreover, the European Court ruled that any doctor's on-call hours spent in a hospital should be regarded as part of his full working time, which in Germany is presently restricted to an average 38.5 hours a week. Consequently, this will lead to a huge demand of personnel on the one hand and an increasing fragmentation of doctor-patient relationships on the other hand, as there will be a continuous change of doctors on duty. Here, it is outlined that this fragmentation will have a negative impact on treatment quality and education and training of future physicians.
authors.affiliation: HNO-Klinik, Klinikum Dortmund, Dortmund. stkd.hno@dokom.net
authors.forename: Thomas
authors.initials: T
authors.lastname: Deitmer
mesh_terms: D004282:Documentation; D005858:Germany; D006801:Humans; D010564:Personnel, Hospital / Q000331:legislation & jurisprudence / Q000592:standards*; D011785:Quality Assurance, Health Care; D014940:Work Schedule Tolerance