title: [Perioperative thermal management in Germany varies depending on the hospital size].
abstract: BACKGROUND
  Improvement of quality of care and patient safety while decreasing costs are major challenges in healthcare systems. This challenge includes the avoidance of perioperative hypothermia to reduce the associated adverse effects, length of stay and treatment costs. Due to the medical and economic relevance the national S3 guidelines for the prevention of perioperative hypothermia were recently published.
  
  
  OBJECTIVE
  This study presents and analyses the reality of utilization of thermal management in German hospitals depending on the size of the hospital, which is based on the number of beds.
  
  
  METHODS
  Based on the data of an online survey among all members of the German Society of Anesthesiology and Intensive Care Medicine about perioperative thermal management, a subgroup analysis differentiating between the size of hospitals was performed. The survey included questions about the structural and organizational conditions, the practical implementation of temperature measurement and warming therapy and the developmental status of clinical standard operating procedures (SOP) and educational training.
  
  
  RESULTS
  Comparing the structural quality, major differences were found with respect to the availability of core body temperature measurement and the provision of warming devices especially at different peripheral anesthesia workplaces as well as the existence of SOPs and educational training. The availability increased with hospital size. With respect to process quality, the frequency of prewarming increased with hospital size as well as the frequency of intraoperative temperature measurements during different anesthesia procedures.
  
  
  CONCLUSIONS
  Major differences were found in several aspects of perioperative thermal management depending on the hospital size. The main potential for improvement was found in smaller hospitals. Developmental needs primarily exist in the configuration of peripheral anesthesia workplaces, educational training, implementation of SOPs and prewarming of patients.
authors.affiliation: Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Deutschland, rwaeschle@med.uni-goettingen.de.
authors.forename: R M
authors.initials: RM
authors.lastname: Waeschle
authors.forename: S G
authors.initials: SG
authors.lastname: Russo
authors.forename: B
authors.initials: B
authors.lastname: Sliwa
authors.forename: F
authors.initials: F
authors.lastname: Bleeker
authors.forename: M
authors.initials: M
authors.lastname: Russo
authors.forename: M
authors.initials: M
authors.lastname: Bauer
authors.forename: A
authors.initials: A
authors.lastname: Bräuer
mesh_terms: D000328:Adult; D000758:Anesthesia; D000776:Anesthesiology / Q000193:education; D001831:Body Temperature; D019090:Case Management; D002648:Child; D005858:Germany; D019538:Health Care Surveys; D006276:Health Facility Size / Q000706:statistics & numerical data*; D006801:Humans; D007035:Hypothermia / Q000628:therapy*; D009873:Operating Rooms; D061214:Patient Safety; D019990:Perioperative Care / Q000706:statistics & numerical data / Q000639:trends*; D017694:Rewarming