CLINIC AND OUTPATIENT CLINIC FOR UROLOGY
Transcrição
CLINIC AND OUTPATIENT CLINIC FOR UROLOGY
CLIN IC AN D O U TPATIE NT CLIN IC FO R U R O LO G Y CLIN IC A ND O U TPA TIE N T CLIN IC FO R U R O LO GY FACTS AND FIGU R E S Clinic and Outpatie nt Clinic for Urology Fleis ch m anns traße 42- 44 17475 Gre ifs w ald Te leph one : 03834- 8659 79 Te lefax: 03834- 8659 78 E- m ail: Sim one .Le m m @ uni- gre ifs w ald.de H om e page : w w w .k linik um .uni- gre ifs w ald.de /patie nte ninfo/k linik e n/urologie H e ad of de partm e nt: Univ.- Prof. D r. m e d. K.- J. Klebingat Se nior ph ys icians : OA D r. m e d. U. Z im m e rm ann OA D r. m e d. D . Pie h ler OA D r. m e d. D . Rös ing OA D r. m e d. M . Pe ch oe l H e ad of nurs ing s taff: Frau M . H e nk e QM re pre s e ntative : OA D r. m e d. M . Pe ch oe l Th e de partm e nt h as 28 be ds . In 2006 1665 patie nts re ce ive d inpatie nt tre atm e nt and 3545 patie nts re ce ive d outpatie nt tre atm e nt. QU ALITY R E PO R T FO R PATIE NTS 2006 U NIVE R S ITY CLINIC GR E IFS W ALD CLINIC AND O U TPATIE NT CLIN IC FO R U R O LO GY M E D ICAL CAR E S E R VICE S M e dicalcare s e rvice s of th e Clinic and Outpatie nt Clinic of Urology include th e diagnos is and tre atm e nt of m alform ations and dis e as e s of th e m ale and fe m ale urinary tract and of th e m ale ge nitals. Th us , th e de partm e nt is s pe cialis e d in th e e arly de te ction, diagnos is and th e rapy of dis e as e s of th e k idne ys , th e urinary bladde r, th e pros tate , of th e te s ticles and th e s crotum and of th e pe nis . Th e s e are pre dom inantly inflam m ations , dis orde rs of th e urinary trans port and outflow , urolith s , tum ours and s e xualdis orde rs . Urologicaldis e as e s are tre ate d according to nationaland inte rnationalguide line s w h ich corre s pond to th e curre nt leve lof s cie ntific k now ledge . Th e de partm e nt is auth orize d to com pre h e ns ive ly train s taff and cove rs th e w h ole fie ld of urology e xce pt for k idne y trans plantations . U NIVE R S ITY CLINIC GR E IFS W ALD QU ALITY R E PO R T FO R PATIE NTS 2006 CLIN IC A ND O U TPA TIE N T CLIN IC FO R U R O LO GY S PE CIAL AR E AS O F M E D ICAL CAR E T h e de partm e nt is s pe cialis e d in urologic oncology (carcinom as of te s ticles , pros tate , k idne ys and of th e bladde r), in ne urourology and urinary incontine nce , in s e xualm e dicine and in pros th e tics of th e urinary and ge nitaltract. Furth e r th e de partm e nt offe rs outpatie nt s urge ry to th e e xte rnalge nitalia, one - day inpatie nt tre atm e nt (ch e m o- , im m uno- and pain th e rapy) and th e provis ion of donor organs in coope ration w ith th e organ trans plantation ce ntre Ros tock (Ge rm an as s ociation for organ trans plantation). Afte r individualtalks w ith th e patie nts and th e ir e xam ination urologic dis e as e s are diagnos e d w ith th e h e lp of non- and m inim alinvas ive e xam ination te ch niq ue s (s onograph y, vide o urodynam ic, e ndos copy) com bine d w ith laboratory m e dicine and diagnos tic im aging proce dure s (CT, M RT, angiograph y). Th e individualth e rapie s for h e aling or at leas t im proving dis e as e s follow h olis tic m e dicalconce pts w ith th e aim to k e e p th e q uality of life on th e h igh e s t pos s ible leve l. M axim alinvas ive s urge ry is m ainly us e d for th e tre atm e nt of advance d tum ours . Surge ry trie s to re m ove as m uch of th e tum our as pos s ible and to pre s e rve or to re s tore th e norm alorgan function, for e xam ple organ pre s e rving in cas e s of k idne y tum ours , prote ction of urinary contine nce and e re ction in cas e s of pros tate carcinom as and building of an artificialbladde r out of th e inte s tine in cas e s of bladde r carcinom as . QU ALITY R E PO R T FO R PATIE NTS 2006 U NIVE R S ITY CLINIC GR E IFS W ALD CLINIC AND O U TPATIE NT CLIN IC FO R U R O LO GY Th e ne urourology tre ats controldis orde rs of th e urinary and th e ge nitaltract in cas e s of re naland m e tabolic dis e as e s and afte r accide nts (m ultiple s cleros is , apoplexy, Park ins on’s dis e as e , diabe te s m e llitus , paraplegia). Th e clinic and outpatie nt clinic for urology of Gre ifs w ald Unive rs ity is th e only ce ntre in th e ne w ly- form e d Ge rm an s tate s th at offe rs th e w h ole range of ne urourologic diagnos tics and th e rapy. Conce rning re h abilitation w e w ork in clos e coope ration w ith th e ne urologic re h abilitation ce ntre Gre ifs w ald. Th e s e xualm e dicine offe rs diagnos tic and th e rape utic h e lp to patie nts w ith s e xual function dis orde rs , patie nts w ith s e xualdis orde rs due to dis e as e s or th e rapy and patie nts w ith de viant s e xualbe h aviour. Be s ide cons ultations and inte rvie w - bas e d tre atm e nt w e offe r drug- bas e d or te ch nicalproce dure s to tre at patie nts w ith dis e as e re late d dis orde rs to re s tore organ functions . If oth e r th e rapie s failpros th e tic m e as ure s are also a pos s ibility in urology. In cas e s of urinary incontine nce w e im plant artificialcons trictor m us cles in m e n and w om e n. In cas e s of th e rapy re s is tant e re ction dys functions w e im plant e re ctile/ cave rnous body im plants . Ne rvaldys functions of th e urinary bladde r can be tre ate d w ith e lectronic im plants de pe nding on th e caus e of th e dys function. Allth e rape utic m e as ure s m e ntione d above are s ucce s s fully pe rform e d by th e clinic for urology in Gre ifs w ald. U NIVE R S ITY CLINIC GR E IFS W ALD QU ALITY R E PO R T FO R PATIE NTS 2006 CLIN IC A ND O U TPA TIE N T CLIN IC FO R U R O LO GY M E AS U R E S O F INTE R NAL QU ALITY M ANAGE M E NT T h e m os t im portant ins trum e nt for q uality m anage m e nt w ith in our de partm e nt is th e w ork according to clinicalpath w ays . Th is is valid for th e w ork of our nurs ing s taff and our doctors . Urologicaldis e as e s are tre ate d according to nationaland inte rnationalguide line s w h ich corre s pond to th e curre nt leve lof s cie ntific k now ledge . Our nurs ing s taff w ork s according to s tandardis e d w ork ing ins tructions , s tarting w h e n th e patie nt arrive s in our clinic and e nding w h e n th e patie nt leave s th e clinic. Th e s tandardis e d w ork ing ins tructions include various proph ylactic m e as ure s . D uring h is adm is s ion th e patie nt is inform e d h ow to pre ve nt falls. Oth e r inform ation conce rning th e pre ve ntion of th rom bos is , cys titis , be d s ore s and oth e r follow . Las t ye ar w e could im prove th e dis ch arge proce s s , w h ich led to a bigge r s atis faction of our patie nts . For clinic inte rnalq uality m anage m e nt focus s ing on th e fie ld of urology w e k e e p a s tatis ticals urve y conce rning contine nce afte r pros tate and bladde r s urge ry and afte r bladde r trans plantations . For th e s urve y th e patie nts are as k e d to com e back and to s e e one of our doctors about 3 m onth s afte r th e tre atm e nt in h os pitalh as e nde d. Las t ye ar w e initiate d a s e cond s tudy conce rning th e e xam ination of incontine nce and functionalre s trictions afte r radicalre m ovalof th e pros tate in cas e of pros tatic cance r. QU ALITY R E PO R T FO R PATIE NTS 2006 U NIVE R S ITY CLINIC GR E IFS W ALD CLINIC AND O U TPATIE NT CLIN IC FO R U R O LO GY As a ve ry h igh pe rce ntage of our patie nts s uffe r from cance r, w e k e e p for th e s e patie nts a s tatis ticals urve y conce rning h ow long th e y are fre e of tum ours . From th is w e h ope to draw conclus ions for th e th e rapy of oth e r patie nts . To im prove th e inte rnalcom m unication be tw e e n th e e m ploye e s of our de partm e nt w e conduct re gular te am m e e tings on allde partm e ntalleve ls. Th e re s ults of th e s e m e e tings are docum e nte d and forw arde d to colleague s w h o h ave not be e n pre s e nt at th e m e e ting. Th is im prove s also th e inform ation flow . Furth e r ins trum e nts of q uality m anage m e nt are inte rnaland e xte rnaltraining m e as ure s . To k e e p th e num be r of infe ctions as low as pos s ible, th e e valuation of our de partm e nt inte rnalinfe ction s tatis tics is alw ays part of th e clinic inte rnaltraining m e as ure s . Th e Unive rs ity Clinic organize s patie nt inte rvie w s . Th e re s ults are e valuate d in an as s e m bly of th e w h ole clinic and in various s m allgroups to draw conclus ions for th e furth e r im prove m e nt of th e q uality of our m e dicalcare . On a re gular bas is e m ploye e s of our de partm e nt tak e part in th e m orbidity and m ortality confe re nce of th e Unive rs ity Clinic. U NIVE R S ITY CLINIC GR E IFS W ALD QU ALITY R E PO R T FO R PATIE NTS 2006 CLIN IC A ND O U TPA TIE N T CLIN IC FO R U R O LO GY M ain diagnos e s according to ICD in 2006 RANKING ICD NAM E CASES 1 C61 M alignantne oplas m ofpros tate 19 2 2 C67 M alignantne oplas m ofbladde r 185 3 N40 H ype rplas ia ofpros tate 138 4 N13 Obs tructive and re flux uropath y 128 5 N20 Calculus ofk idne y and ure te r 125 6 C64 M alignantne oplas m ofk idne y, e xce ptre nalpe lvis 99 7 N39 Oth e r dis orde rs ofurinary s ys te m 92 8 C79 Se condary m alignantne oplas m ofoth e r s ite s 88 9 G9 5 D is orde rs ofbladde r in com bination w ith unde rlying ne urologic dis e as e 73 10 N32 Oth e r dis orde rs ofbladde r 45 Com pe te ncy diagnos e s according to ICD in 2006 ICD NAM E C67.2 M alignantne oplas m s ofbladde r: Late ralw allofbladde r N20.1 Calculus ofure te r C67.8 M alignantne oplas m s ofbladde r: Ove rlapping les ion ofbladde r N20.0 Calculus ofk idne y G9 5.80 Paralys is ofbladde r w ith les ion ofuppe r m otor ne uron (UM NL) C65 M alignantne oplas m ofre nalpe lvis N9 9 .1 Pos tproce duralure th rals tricture N31.88 Oth e r ne urom us cular dys function ofbladde r C62.1 M alignantne oplas m s ofte s tis : D e s ce nde d te s tis G9 5.81 Paralys is ofbladde r w ith les ion oflow e r m otor ne uron (LM NL) C67.4 M alignantne oplas m s ofbladde r: Pos te rior w allofbladde r N31.80 Oth e r ne urom us cular dys function ofbladde r C67.5 M alignantne oplas m s ofbladde r: Bladde r ne ck N48.8 Oth e r s pe cifie d dis orde rs ofpe nis C67.0 M alignantne oplas m s ofbladde r C67.3 M alignantne oplas m s ofbladde r: Ante rior w allofbladde r D 41.0 Ne oplas m ofunce rtain or unk now n be h aviour ofk idne y C67.1 M alignantne oplas m s ofbladde r: D om e ofbladde r C77 Se condary and uns pe cifie d m alignantne oplas m oflym ph node s Inform ation s tate d h e re are additionalcom pe te nce s for th e m ain diagnos e s m e ntione d above (inde pe nde ntof th e cas e s tre ate d in th e re portye ar 2006) QU ALITY R E PO R T FO R PATIE NTS 2006 U NIVE R S ITY CLINIC GR E IFS W ALD CLINIC AND O U TPATIE NT CLIN IC FO R U R O LO GY M ain proce dure s according to OPS in 2006* RANKING OPS NAM E CASES 1 5- 560 Th e rape utic de h ydration ofurinary organs 410 2 5- 573 Proce dure s affe cting th e urinary bladde r 19 1 3 5 - 572 Ure te re ctas ia via ure te r and k idne y 176 4- 1 8- 542 Incis ion, re m ovalor de s truction of(affe cte d) tis s ue ofth e bladde r, trans ure th ralacce s s 162 4- 2 1- 661 Circum cis ion or e xcis ion ofre trope ritone altis s ue 162 6 5 - 601 Cre ation ofartificialbladde r ope ning 147 * Th e s urve il l ance ofvitals igns during ope rations and anae s th e s ia/s e dations , anae s th e s ia on its ow n and bl ood trans fus ions during th e proce dure s are nots tate d s e parate l y. Com pe te ncy proce dure s according to OPS in 2006 OPS NAM E 5- 553.00 Partialne ph re ctom y: ope n s urgicalvia lum bar s pine 5- 562.4 Ure te ralorifice , calculus tre atm e ntofk idne ys and ure te r: lith e ctom y 5- 554.40 Ne ph re ctom y: ope n s urgicalvia lum bar s pine 5- 576.20 Cys te ctom y: w ith oute xcis ion ofth e ure te r, in cas e ofm e n: ope n s urgical 5- 59 7.01 Surge ry to bladde r clos ing apparatus : im plantation: conce rning m e dulla oblongata 5- 577.00 Subs titution ofbladde r: re cons truction us ing parts ofs m allinte s tine : ope n s urgical 5- 550.3 Endos copy ofk idne ys and incis ion to k idne ys , ins e rting ofa tube to drain urine com ing from th e k idne ys , lith e ctom y and pye lectas ia: calculus de s truction th rough ch rus h ing 5- 554.41 Ne ph re ctom y: ope n abdom inal 5- 404.d Re s e ction ofalllym ph node s as inde pe nde ntproce dure : re trope ritone al,ope n s urgical 5- 584.71 Re cons truction ofure te r: plas tic re cons truction, one - s ide d: w ith pe nis s k in 5- 059 .02 Oth e r ope ration to ne rve s or ganglion: im plantation or e xch ange ofne urs tim ulator (m ach ine for pain th e rapy) for s tim ulation ofpe riph e ralne rvous s ys te m : m ulti- ch anne ls ys te m , w h olly im plantable, non- re ch argable 5- 566.10 D raining ofurine via th e s k in w ith a cath e te r w ith inte s tinalre s e rvoir: building a re s e rvoir for parts ofth e s m all inte s tine and th e cae cum : ope n s urgical 5- 9 85 Surge ry w ith us e oflas e r ins trum e nts 5- 603 Ope rative de s truction or re m ovalofpros tatic tis s ue w ith laparotom y 5- 604.41 Radicalre s e ction ofpros trate due to pros tatic cance r: laparos copic: w ith outre gionalre s e ction oflym ph node s Inform ation s tate d h e re are additionalcom pe te nce s for th e m ain diagnos e s m e ntione d above (inde pe nde ntof th e cas e s tre ate d in th e re portye ar 2006) U NIVE R S ITY CLINIC GR E IFS W ALD QU ALITY R E PO R T FO R PATIE NTS 2006 CLIN IC A ND O U TPA TIE N T CLIN IC FO R U R O LO GY R E S E AR CH In our re s e arch data bas e you can alw ays find curre nt re s e arch re ports of our clinic: h ttp://fodb.uni- gre ifs w ald.de /inde x.ph p. QU ALITY R E PO R T FO R PATIE NTS 2006 U NIVE R S ITY CLINIC GR E IFS W ALD