title: [Development and implementation of an integrated care pathway at the POLIKUM health centers using the example of anemia].
abstract: BACKGROUND
  Integrated treatment pathways are an appropriate means for increasing the quality of treatment and outcome via process optimization. Taking the POLIKUM Health Centers as an example, we intend to demonstrate how the implementation can be effected for the indication of anemia.
  
  
  METHODS
  The development and implementation were executed by an interdisciplinary workgroup in several workshops. In addition, the diagnoses and hemoglobin values of all patients with requests for hemograms were obtained and analyzed at two locations.
  
  
  RESULTS
  Developing the pathway required significantly greater efforts than initially planned. The biggest challenge was to adequately map the complexity of the different forms of anemia and, concomitantly, to design a pathway that can actually be realized in everyday life. Moreover, evaluation of the patient data demonstrated that there are a large number of cases where existing anemias are not reflected in the respective diagnoses.
  
  
  CONCLUSIONS
  While the ultimate effects of the new pathway cannot yet be assessed conclusively, it was possible to obtain valuable findings for practical use even at this point. Despite the limitations of the sample, the surprisingly high number of undetected anemias should give physicians cause for taking diagnostic measures even in patients with mild anemia.
authors.affiliation: LS für Gesundheitsmanagement, FAU Erlangen-Nürnberg, Lange Gasse 20, 90403, Nürnberg, Deutschland, martin.bierbaum@fau.de.
authors.forename: M
authors.initials: M
authors.lastname: Bierbaum
authors.forename: M O
authors.initials: MO
authors.lastname: Grad
authors.forename: H
authors.initials: H
authors.lastname: Wulff
authors.forename: S
authors.initials: S
authors.lastname: Kewenig
authors.forename: O
authors.initials: O
authors.lastname: Schöffski
mesh_terms: D000465:Algorithms; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000628:therapy*; D003151:Community Health Centers / Q000458:organization & administration*; D003299:Cooperative Behavior; D019091:Critical Pathways / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005858:Germany; D006284:Health Plan Implementation / Q000458:organization & administration*; D006452:Hemoglobinometry; D006801:Humans; D033183:Interdisciplinary Communication; D007388:Internal Medicine / Q000458:organization & administration*; D058996:Quality Improvement / Q000458:organization & administration