Background: Antibiotic resistance is a global challenge. Every year, 700,000 people die due to drug-resistant infections. In Germany, 54,500 people contract infections with antibiotic-resistant pathogens every year; around 2,400 people die as a result. The development of resistance is mainly facilitated by inadequate antibiotic prescribing practices, e.g. antibiotic administration/use for viral infections, the administration of non-pathogen-specific substances, incorrect dosing and incorrect dosing cycles. Targeted antibiotic therapy requires particular expertise in the methodology of suitable pathogen detection and the interpretation of microbiological findings, which can take several days to prepare bacterial cultures and test for resistance. For clinical and organizational reasons, this time can often not be waited for, so that broad-spectrum antibiotics and antibiotic combinations are often used in order to reliably detect the broadest possible spectrum of pathogens and resistances. This increases the risk of side effects and complications and may induce further resistance.

Procedure and objectives: The aim of the artificial intelligence (AI)-based decision support system (EUS) KINBIOTICS was to use computer-aided processing of information to help doctors treating sepsis infections to make quick prescribing decisions. For sustainable use, the focus here was on the user-oriented integration of this AI system into everyday clinical practice, which was to be achieved by identifying organizational and procedural determinants of promoting and inhibiting conditions. This involved investigating how the AI-based EUS can be optimally implemented in everyday care practice, which organizational and contextual factors that have not yet been investigated in detail influence its effectiveness and how acceptance among service providers can be optimized through targeted changes to personnel and structural conditions. As part of an iterative process and with the help of a mixed-method approach, an implementation guide for the AI system in everyday clinical practice was designed with potential users. In a systematic review, organizational and procedural determinants of supportive and inhibiting conditions of use were identified and processed. Problem-centered individual interviews with service providers in inpatient care and an online-based expert panel were used to record how the AI system can be implemented in care practice under everyday conditions. This promoted a successful transfer of innovation and benefits into care practice and supported the sustainability and practical translation of innovation development.

Duration: October 2020 to February 2024

Sponsor: Federal Ministry of Health

Cooperation partners: Evangelisches Bielefeld, Klinikum Lippe and Klinikum Bielefeld

Employees: Pinar Tokgöz, Jessica Hafner & Stephan Krayter

Background: Due to changes in the organizational framework and protective measures in the course of the COVID-19 pandemic, it was often not possible to make use of on-site therapies, including aftercare services, in the rehabilitation sector. The promotion of online-based rehabilitation services (telerehabilitation) by the German Pension Insurance (DRV) offered an opportunity to close this gap in care and provide therapies in the home environment, e.g. via video therapy. However, rehabilitants who are unable or unwilling to take advantage of rehabilitation services in the facilities for other reasons, such as long journeys, immobility and/or multimorbidity, also benefit from telerehabilitation services. The successful implementation and use of new IT systems and digital applications requires core digital skills among all those involved, which can be promoted through training. These training courses must be adapted for service providers and rehabilitants and tailored to the specific needs and requirements of the different target groups.

Procedure and objectives: The initial plan was to develop a competence profile for service providers and rehabilitants that focuses on the use of online-based rehabilitation services (tele-rehabilitation aftercare). This was developed on the basis of the tele-rehabilitation aftercare services approved (in some cases for a limited period) by the DRV. Furthermore, existing training offers as well as training needs and requirements in the area of tele-rehabilitation aftercare were to be recorded. The results of the surveys were used to derive specific recommendations for the design of future training courses in the field of tele-rehabilitation. Based on a systematic literature review, the first step was to develop a competence profile for therapists and rehabilitants in dealing with and to derive an empirical-theoretical definition of the term "digital competencies" in the context of telerehabilitation. This was followed by a quantitative online survey of service providers of outpatient and inpatient rehabilitation facilities that provide tele-rehabilitation aftercare services, as well as of rehabilitants who have already taken advantage of a tele-rehabilitation aftercare service. In this survey, existing training courses as well as training needs and requirements for competent use of tele-rehabilitation aftercare services were recorded. The findings were reflected on in the context of World Cafés and translated into recommendations for the practical design of training courses for the acquisition of digital skills, especially in the field of tele-rehabilitation aftercare.

Duration: February 2022 to January 2024

Sponsor: Society for Rehabilitation Sciences NRW e.V. (GfR)

Cooperation partners: Median Klinik am Burggraben Bad Salzuflen, Dr. Ebel Klinik Moorbad Bad Doberan, Dr. Becker Klinikgruppe Köln and medicos.AufSchalke Gelsenkirchen

Employees: Lea Stark-Blomeier, Stephan Krayter

Background: The SARS-CoV-2 pandemic forced rehabilitation facilities to deviate from their everyday care routine and flexibly adapt organizational, structural and personnel changes to the corresponding circumstances and hygiene requirements. Due to the non-assignment of rehabilitants, e.g. due to elective operations and the recommendations not to initiate new admissions - with the exception of follow-up treatment - the rehabilitation facilities also had to adapt to conditions that were almost impossible to plan. Against this backdrop, existing digitally supported services have been expanded and further developed, demonstrating the potential for a permanent transfer to standard care. For the implementation of these digital services in everyday rehabilitation that is accepted by all users, it is necessary to identify and take into account the requirements for the organizational, structural and personnel framework conditions as well as the necessary change processes.

Procedure and objectives: The aim of the project was initially to systematically take stock of the digitally supported services already used in rehabilitation, including the survey of the necessary organizational, structural and personnel framework conditions, processes and working methods required for implementation. A special focus was also placed on investigating user acceptance with regard to the use of digitally supported rehabilitation services by rehabilitants. The results of the surveys were then used to derive a practical, participatory catalog of criteria for service providers for the implementation of digitally supported services in medical rehabilitation and rehabilitation aftercare. The methodological procedure for achieving the objectives followed a mixed-methods approach, which combines quantitative and qualitative methods of empirical social research. A quantitative online survey was used to assess the status quo, as was a survey of user acceptance among the rehabilitants. In a second step, the latter was examined in greater depth with the help of qualitative individual interviews. In order to consolidate and transfer the results into care practice, they were then discussed in a future workshop to which representatives of all stakeholders involved were invited and recorded in the form of a list of criteria. This serves as a decision-making aid and guideline for the use of digitally supported services in medical rehabilitation and was made available online free of charge to service providers and cost bearers at the end of the project.

Duration: January 2022 to June 2024

Sponsor: German Federal Pension Insurance

Cooperation partner: Bielefeld University

Collaborators: Susanne Stampa

Background: The structure of academic education and training opportunities at German universities and universities of applied sciences is undergoing continuous change. Due to increasing digitalization processes in the health and social sector and the growing relevance of digital public health offerings in public health research, development and practice, the training of young academics in this field is becoming increasingly important.

Procedure and objectives: There is currently no overview of which digital public health-related course content is offered in modules of public health degree programs in Germany. The aim of the project was to survey and systematize the current status of teaching content and skills development related to digital public health in public health degree programmes in Germany. Three central questions guided the research:

• What is the concrete design of digital public health-related teaching content in public health degree programs and what similarities and differences can be seen?
• What curricular framework conditions exist in public health degree programs that teach digital public health content and skills?
• What conclusions can be drawn for education and training in the field of digital public health in Germany?

Procedure and objectives: The data will be obtained as part of a document analysis of module handbooks for public health degree programs at universities and universities of applied sciences in Germany. Teaching content and framework conditions will be clustered thematically in a downstream analysis.

Duration: July 2022 to September 2023

Sponsor: Own funds

Cooperation partner: German Society for Public Health (DGPH)

Collaborators: Dr. Joanna Albrecht, Pinar Tokgöz, Lea Stark-Blomeier