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Introduction: The implementation of medical video consultations in nursing homes can support primary care in rural areas and counteract the shortage of physicians. So far, video consultations have been limited to pilot projects and have not yet been comprehensively implemented. The present study addresses potentials of video consultations and challenges that may arise during the implementation of medical video consultations., Methods: Twenty-one guided interviews (pre-implementation: n = 13; post-implementation: n = 8) were conducted with a total of 13 participants (physicians, nurses and medical technical assistants). The data was analyzed using qualitative content analysis. The results were contrasted in a pre-post analysis., Results: Almost all of the interviewees' expectations regarding video consultations described prior to implementation have been met: time savings, improved communication, reduction of information breaks and increase in the quality of care. After implementation, other unexpected advantages of telemedical care became apparent, such as the possibility of regular monitoring or the improved ability to plan routine visits without interrupting the daily schedule. At the same time, the implementation of video consultations is associated with the following challenges: defining responsibilities, acquiring experience in handling video consultation tools, providing for sufficient qualification and training, dealing with new billing modalities as well as missing links between nursing documentation and medical information systems., Discussion: Video consultations can improve health care routines in nursing homes, lead to a wider availability of medical services, and contribute to improving patient safety and the quality of care. However, various aspects and contextual factors need to be addressed when implementing video consultations. These include: implementation of technical requirements, initial training with test consultations, continuous interactive development of potential fields of application, and the definition of the respective responsibilities of caregivers, physicians and medical assistants., (Copyright © 2022. Published by Elsevier GmbH.)

Introduction: General survey of emergency care in nursing homes in the City of Braunschweig., Methods: Retrospective analysis of data from death registry, resuscitation registry and further routine data from the local health authorities and the emergency medical services (EMS)., Results: 30 nursing homes with 3,100 beds (mean: 103; range: 35-250) were included; operators of nursing homes were 18 non-profit organizations; 7 private (local); 5 private (nationwide). Among the inhabitants of these 30 nursing homes 880 deaths occurred, 406 (46 %) in hospital; 4,895 EMS deployments for emergency care; 4,493 (92 %) resulting in emergency department visits; 19 CPRs. EMS deployments without a physician order per bed 1.0 (0.4-1.6); emergency department visits per bed 1.4 (0.7-3.1); rate of EMS deployments without physicians order / emergency department visits 70 % (41-96 %); deaths per bed 0,29 (0.12-0.48); rate of deaths in hospital 46 % (0-62 %); CPRs per 1,000 beds 6.1 (0-28); CPR failure rate 22 (0-83) per 1,000 deaths per year. EMS deployment without physician order was significantly more frequent in privately (nationwide) operated nursing homes 1.2 (1.0-1.4). In the entire urban region, the incidence of EMS deployment without a physician order was 0.2 per inhabitant per year and the rate of hospital deaths was 64 %., Conclusion: Compared to the entire population of the City of Braunschweig, EMS deployment was more frequent in nursing homes. The chance of hospital death or failed CPR was slightly lower. There are large variations between the different nursing homes. Indicators from routine data can provide guidance for more specific surveys but do not allow benchmarking., (Copyright © 2019. Published by Elsevier GmbH.)