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Hintergrund: Optimale Ergebnisse wie geringere Morbidität, höhere Patienten- und Mitarbeiterzufriedenheit sowie niedrigere Versorgungskosten im heutigen diagnosefokussierten Gesundheitssystem können durch eine effektive interprofessionelle Zusammenarbeit erreicht werden. Ziel: Basierend auf der Literatur und eigenen klinischen Erfahrungen wird erfolgreiche beziehungsweise verbesserungswürdige interprofessionelle Zusammenarbeit reflektiert. Ergebnisse: Einige Faktoren unterstützen den interprofessionellen Ansatz: das Ausräumen von Vorurteilen gegenüber anderen Berufsgruppen schon in der Grundausbildung - kollektives Lernen, um späteres gemeinsames Arbeiten zu fördern; frühzeitige Förderung der Wertschätzung der Kompetenzen der jeweils anderen Berufsgruppe durch Kommunikation; Organisationsstrukturen nach erforderlicher Fachkompetenz, ohne dass eine Berufsgruppe der anderen vorgesetzt ist; konstruktives Hinterfragen der Handlungsweisen oder Therapieentscheide; Schaffen von Anreizen im Gesundheitssystem zur Stimulation von gemeinsamem Lernen und Arbeiten. Schlussfolgerungen: Von Bereichen wie Intensiv- und Notfallmedizin aber auch der palliativen Versorgung, in denen die Interprofessionalität schon heute gelebt wird, kann gelernt werden, wie eine positive Beeinflussung alltäglicher Prozesse im Sinn der Interprofessionalität möglich wird. Dies stellt einen Paradigmenwechsel im beruflichen Selbstverständnis dar, der in einzelnen Bereichen bereits teilweise vollzogen wird. Neben dem Fachpersonal sollte zukünftig auch der Patient - u nd möglicherweise seine Angehörigen - als weiteres Teammitglied gesehen werden, wodurch eine personenzentrierte Versorgung gewährleistet wird. Effekte einer solchen Teamarbeit müssen bezogen auf gemeinsam definierte Ergebnisse evaluiert werden, um zukunftsweisende Modelle der interprofessionellen Zusammenarbeit zu entwickeln und fördern. Background: Optimal outcomes such as lower mortality, greater satisfaction of patients and health care professionals, and lower health care costs within the current diagnosis oriented health care system, can be achieved by effective interprofessional collaboration. Aim: The aim of this review article is to describe the structure as well as the characteristics of the psychometric qualities of the DOS scale. Aim: Based on the literature and our own clinical experiences, we reflect on successful or improvable interprofessional collaboration. Results: Some factors supporting this development are: to dispel preconceptions towards other professions as early as basic education and to support collective learning so as to enhance later collaborative work; early assistanc e to appreciate the competences of other professions by communication; organizing structures according to the necessary professional competenceswithout having the superior authority of one profession over the other; constructive challenging of procedures or therapeutic decisions; promotion of incentives within the health care system for the stimulation of collective learning and working. Conclusion: We can learn how it is possible to have a positive influence on everyday pr ocesses from areas such as intensive care, emergency care, but also palliative care, where interprofessionalism is already a reality. This will mean a change in paradigm of the professional self-concept, which has already been partially implemented in some areas. In the future, patients and possibly family members could also be seen as team members, alongside the professionals, to ensure person-centered care. The effects of such teamwork have to be evaluated with regard to mutually defined outcomes to develop and facilitate forward-looking models of interprofessional collaboration. [ABSTRACT FROM AUTHOR]

Background: Providing the highest quality care for dying patients should be a core clinical proficiency and an integral part of comprehensive management, as fundamental as diagnosis and treatment. The aim of this study was to provide expert consensus on phenomena for identification and prediction of the last hours or days of a patient's life. This study is part of the OPCARE9 project, funded by the European Commission's Seventh Framework Programme. Method: The phenomena associated with approaching death were generated using Delphi technique. The Delphi process was set up in three cycles to collate a set of useful and relevant phenomena that identify and predict the last hours and days of life. Each cycle included: (1) development of the questionnaire, (2) distribution of the Delphi questionnaire and (3) review and synthesis of findings. Results: The first Delphi cycle of 252 participants (health care professionals, volunteers, public) generated 194 different phenomena, perceptions and observations. In the second cycle, these phenomena were checked for their specific ability to diagnose the last hours/days of life. Fifty-eight phenomena achieved more than 80 % expert consensus and were grouped into nine categories. In the third cycle, these 58 phenomena were ranked by a group of palliative care experts (78 professionals, including physicians, nurses, psycho-social-spiritual support; response rate 72 %, see Table 1) in terms of clinical relevance to the prediction that a person will die within the next few hours/days. Twenty-one phenomena were determined to have 'high relevance' by more than 50 % of the experts. Based on these findings, the changes in the following categories (each consisting of up to three phenomena) were considered highly relevant to clinicians in identifying and predicting a patient's last hours/days of life: 'breathing', 'general deterioration', 'consciousness/cognition', 'skin', 'intake of fluid, food, others', 'emotional state' and 'non-observations/expressed opinions/other'. Conclusion: Experts from different professional backgrounds identified a set of categories describing a structure within which clinical phenomena can be clinically assessed, in order to more accurately predict whether someone will die within the next days or hours. However, these phenomena need further specification for clinical use. [ABSTRACT FROM AUTHOR]