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Klinikum Lippe Detmold

Röntgenstraße 18
32756 Detmold

Phone: 05231-720
Fax: 05231-725095
Mail: ed.eppil-mukinilk@ofni

  • Number of beds: 650
  • Number of specialist departments: 18
  • Number of inpatient cases: 28.475
  • Number of partial inpatient cases: 100
  • Number of outpatient cases: 54.911
  • Hospital owners: Klinikum Lippe GmbH (Gesellschafter Kreis Lippe)
  • Type of provider: öffentlich
  • University Hospital
  • Academic teaching hospital
External comparative quality assurance
Further information
  • External quality assurance according to state law
    No participation
Koronare Herzkrankheit (KHK)

Beratung und Behandlung

Quantity performed 10
Exception? No exception
Standortverlagerung der Orthopädie von KLL nach KLD im Oktober 2022
Quantity performed 21
Exception? No exception
Quantity performed 25
Exception? No exception
Overall result forecast presentation: yes
Quantity performed reporting year: 25
Quantity forecast year: 21
Examination by state associations? yes
Exemption? yes
Result of the examination by the federal state authorities? yes
Transitional arrangement? no
Overall result forecast presentation: yes
Quantity performed reporting year: 10
Quantity forecast year: 40
Examination by state associations? no
Exemption? yes
Result of the examination by the federal state authorities? no
Transitional arrangement? no
Overall result forecast presentation: yes
Quantity performed reporting year: 21
Quantity forecast year: 15
Examination by state associations? yes
Exemption? yes
Result of the examination by the federal state authorities? yes
Transitional arrangement? no
Overall result forecast presentation: yes
Quantity performed reporting year: 25
Quantity forecast year: 21
Examination by state associations? yes
Exemption? yes
Result of the examination by the federal state authorities? yes
Transitional arrangement? no
No. Explanation
CQ05 Measures for quality assurance in the care of pre-term and full-term neonates – Perinatal Centre LEVEL 1
CQ25 Measures for quality assurance in the performance of minimally invasive heart valve interventions pursuant to Article 136, para. 1, sentence 1, number 2 for hospitals licensed in accordance with Article 108 of the SGB V
  • Clarifying chat completed: no
  • Clarifying chat not completed: no
  • No participation in clarifying chat: no
  • Notification of non-fulfilment of nursing care not made: yes
Number Group
147 Medical specialists (m/f) , psychological psychotherapists (m/f) and child and adolescent psychotherapists (m/f) who are subject to the obligation to undergo further training*
112 Number of medical specialists (m/f) from no. 1 who have completed a five-year period of further training and are therefore subject to the obligation to provide evidence
101 Number of those persons from no. 2 who have provided proof of further training according to Article 3 of the G-BA regulations
* according to the “Provisions of the Joint Federal Committee for the Further Training of Medical Specialists (m/f), Psychological Psychotherapists (m/f) and Child and Adolescent Psychotherapists (m/f) in Hospitals”

According to Section 4 (2) of the Quality Management Guideline, facilities must provide for the prevention of and intervention in cases of violence and abuse as part of their internal quality management. The aim is to prevent, recognise and respond appropriately to abuse and violence, particularly against vulnerable patient groups such as children and adolescents or people in need of help, and also to prevent it within the facility. The respective procedure is aligned with the size of the facility, the range of services and the patients in order to define customised solutions for sensitising the teams as well as other suitable preventative and interventional measures. These may include information materials, contact addresses, training/education, codes of conduct, recommendations for action/intervention plans or comprehensive protection concepts.

  • Führungszeugnis, Selbstauskunft
Gemäß § 4 Absatz 2 in Verbindung mit Teil B Abschnitt I § 1 der Qualitätsmanagement-Richtlinie haben sich Einrichtungen, die Kinder und Jugendliche versorgen, gezielt mit der Prävention von und Intervention bei (sexueller) Gewalt und Missbrauch bei Kindern und Jugendlichen zu befassen (Risiko- und Gefährdungsanalyse) und – der Größe und Organisationsform der Einrichtung entsprechend – konkrete Schritte und Maßnahmen abzuleiten (Schutzkonzept). In diesem Abschnitt geben Krankenhäuser, die Kinder und Jugendliche versorgen, an, ob sie gemäß § 4 Absatz 2 in Verbindung mit Teil B Abschnitt I § 1 der Qualitätsmanagement-Richtlinie ein Schutzkonzept gegen (sexuelle) Gewalt bei Kindern und Jugendlichen aufweisen.
  • Drug commission
  • Bereitstellung einer geeigneten Infrastruktur zur Sicherstellung einer fehlerfreien Zubereitung
  • Zubereitung durch pharmazeutisches Personal
  • Anwendung von gebrauchsfertigen Arzneimitteln bzw. Zubereitungen
  • Fallbesprechungen
  • Maßnahmen zur Vermeidung von Arzneimittelverwechslung
  • Teilnahme an einem einrichtungsübergreifenden Fehlermeldesystem (siehe Kapitel 12.2.3.2)
  • Aushändigung von arzneimittelbezogenen Informationen für die Weiterbehandlung und Anschlussversorgung der Patientin oder des Patienten im Rahmen eines (ggf. vorläufigen) Entlassbriefs
  • Aushändigung des Medikationsplans
  • bei Bedarf Arzneimittel-Mitgabe oder Ausstellung von Entlassrezepten
The instruments and measures to promote drug therapy safety are presented with a focus on the typical procedures of the medication process in inpatient patient care. A special feature of the medication process in the inpatient environment is the transition management during admission and discharge. The instruments and measures listed below address structural elements, e.g. special IT equipment and work materials, as well as process aspects, such as work descriptions for particularly risky process steps or concepts for securing typical risk situations . In addition, proven measures to avoid or learn from medication errors can be specified. The hospital presents here which aspects it has already dealt with and which measures it has specifically implemented. The following aspects can be presented, if necessary using free text fields:
- Admission to hospital, including anamnesis
; Instruments and measures are presented for determining the old medication (drug history), the subsequent clinical assessment and the switch to the medication available in the hospital (house list), as well as for documenting both the patient's original medication and that for hospital treatment adapted medication.
- Medication process in the hospital
In this context, the following sub-processes are assumed as examples: drug history - prescription - patient information - drug delivery - drug use - documentation - therapy monitoring - result assessment. Instruments and measures for safe medication prescription can be presented, e.g. B. in terms of readability, clarity and completeness of the documentation, but also in terms of area of ​​application, effectiveness, benefit-risk ratio, tolerability (including potential contraindications, interactions, etc.) and resource considerations. Information can also be provided to support reliable medication ordering, delivery and use or administration.
- Discharge
In particular, the measures taken by hospitals can be presented to ensure that information on drug therapy is structured and passed on to doctors and physicians providing further treatment, as well as the appropriate provision of patients with drug information, medication plans and medications. Drug prescriptions are made.
AMTS is the totality of measures to ensure an optimal medication process with the aim of reducing medication errors and thus avoidable risks for patients during drug therapy. A prerequisite for the successful implementation of these measures is that AMTS is practised as an integral part of daily routine in an interdisciplinary and multi-professional approach.
Job
Explanation

z.B. Medizinische Hochschule Hannover, Universität SH Campus Lübeck, Heinrich-Heine-Universität Düsseldorf, O-v-Guericke-Universität Magdeburg, Georg-August-Universität Göttingen, Ruhr-Universität Bochum, Fried.-Schiller-Universität Jena, Westfälische Wilhelms-Universität Münster, Universität Mainz

Explanation

Universitätsklinikum OWL, Campus Lippe

Explanation

TH OWL, Universität Köln, Charité Universitätsmedizin Berlin, Universität Bielefeld, Goethe-Universität Frankfurt, Universität Ulm

Explanation

Rektum/ Kolonkarzinom: ACO/ARO/AIO-18.1, ACO/ARO/AIO-18.2, CIRCULATE, FIRE-9-Studie; AML: AMLSG 28-18, AMLSG 29-18, AMLSG 30-18; CLL: CLL17; Magenkarzinom: RENAISSANCE / FLOT 5

Explanation

Fachhochschule des Mittelstands (FHM) Bielefeld, Studiengang: B.Sc. Physician Assistance

Explanation

Doktoranden werden bei ihrer Forschungstätigkeit für ihre Dissertation von einzelnen Fachkliniken unterstützt.

Explanation

Keine eigene Herausgeberschaft 2022, >10 Publikationen in Peer-reviewed Journals mit Erst- oder Letztautorschaft

Training in other healing professions
Comment

zusätzlich Bachelor of Science in Physiotherapie

Comment

Lernfeldorientierte Ausbildung nach den Empfehlungen der Deutschen Krankenhausgesellschaft vom 17. September 2013

Comment

Comment

Praktische Ausbildung im Klinikum in Kooperation mit einem überregionalen Weiterbildungsinstitut

Comment

Ausbildung zur Pflegefachassistenz

Comment

In Kooperation mit der Hochschule Bielefeld

Comment

Kooperative Hebammenausbildung mit der Hochschule Fulda

Comment

Vertiefung Akutpflege und Pädiatrie

Comment

Comment

Hans Hermann Weber

Patientenfürsprecher Klinikum Detmold

Röntgenstraße 18
32756 Detmold

Phone: 0151 -59950371-0
Mail: ed.enilno-t@rebew.eh.ah

Petra Rosin

Zentrales Beschwerdemanagement

Röntgenstraße 18
32756 Detmold

Phone: 05231 -725124-
Mail: ed.eppil-mukinilk@nisor.artep

Olaf Stender-Rohrbach

Leiter Referat Qualitäts- & klinisches Risikomanagement

Röntgenstraße 18
32756 Detmold

Phone: 05231 -725042-
Mail: ed.eppil-mukinilk@ofni

Dr. med. Christine Fuchs

Vorsitzende

Röntgenstraße 18
32756 Detmold

Phone: 05231 -725003-
Mail: ed.eppil-mukinilk@ofni

Petra Baecker

Kommissarische Chefapothekerin

Röntgenstraße 18
32756 Detmold

Phone: 05261 -266206-
Mail: ed.eppil-mukinilk@ofni

Petra Baecker

Kommissarische Chefapothekerin

Röntgenstraße 18
32756 Detmold

Phone: 05261 -266206-
Mail: ed.eppil-mukinilk@ofni

Wolfhardt Müther

Inklusionsbeauftragter

Röntgenstraße 18
32756 Detmold

Phone: 05231 -72-5490
Mail: ed.eppil-mukinilk@ofni

Röntgenstraße 18
32756 Detmold

Phone: 05231-720
Fax: 05231-725095
Mail: ed.eppil-mukinilk@ofni

Andreas Zeisberg

Pflegedirektor

Röntgenstraße 18
32756 Detmold

Phone: 05231 -722301-
Mail: ed.eppil-mukinilk@ofni

Dr. Johannes Hütte

Geschäftsführer und Sprecher

Röntgenstraße 18
32756 Detmold

Phone: 05231 -725001-
Mail: ed.eppil-mukinilk@ofni

Dr. med. Christine Fuchs

Medizinische Geschäftsführerin

Röntgenstraße 18
32756 Detmold

Phone: 05231 -725003-
Mail: ed.eppil-mukinilk@ofni

Dr. med. Christine Fuchs

Medizinische Geschäftsführerin

Röntgenstraße 18
32756 Detmold

Phone: 05231 -72-5002
Mail: ed.eppil-mukinilk@ofni

Dr. Christine Fuchs

Medizinische Geschäftsführerin

Röntgenstraße 18
32756 Detmold

Phone: 05231 -725003-
Mail: ed.eppil-mukinilk@ofni

IK: 260570486

Location number: 771184000

Old location number: 771184000