changing health perfomance quality vs. profit?. 03.09.2013 2 introduction mic clinic general surgery...
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changing health perfomancequality vs. profit?
03.09.2013 2
introduction MIC Clinic
general surgerygynaecology urology
special medical centers for
obesity coloproctology herniasurgery
endometriosis
specialised for minimally invasive surgery
difficultcases
reconstructivegynaecology
03.09.2013 3
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20112012
0
1000
2000
3000
4000
5000
6000
26
1413
2313
2882 30523285
39994367
5100
case development
03.09.2013 4
ambulance
ward
OR
ward
ambulance
ambulance ambulanceward OR ward
Logistic Center
ambu
lanc
e
ambu
lanc
e
war
d OR 82 %Logistic Center
war
d
cm target
DRG N21Z revenue 3.321,42 €
costs checkup 120,00 €costs ward 210,76 €costs instruments 440,12 €costs trays 77,25 €costs operation 903,44 €
contribution margin1.569,85 €
03.09.2013 5
goal
needs
consequence
actual cm ≥ target cm
TRANSPARENCY
change management
03.09.2013 6
Prozess Sterilisatio
n
Prozess OPOR
process
consumption process
instrument management
sterilisationprocess
ambulance ambulanceward OR ward
Logistic Center
03.09.2013 7
2007 / 12
KW 6 KW 7 KW 8 KW 9 KW 10 KW 11 KW 12 KW 1360
70
80
90
100
delivered trays
planned trays
GAP
? ?
2007
instrument management
- 180.000 €
03.09.2013 8
2006 2007290030003100320033003400
cases
2006 20070%
10%20%30%40%50%60%70%80%90%
100%
single instruments
trays
optics
instrument management
?software
03.09.2013 9
03.09.2013 10
instrument management
more specific cases
causes
no adequate tray stock
03.09.2013 11
KW 6 KW 7 KW 8 KW 9 KW 10 KW 11 KW 12 KW 13120
125
130
135
140
145
150
instrument management
KW 6 KW 7 KW 8 KW 9 KW 10 KW 11 KW 12 KW 1360
70
80
90
100
deliveredtrays
planned trays
2007
2011
03.09.2013 12
TIME
time management
cm targetDRG N21Z revenue 3.321,42 €
costs checkup 120,00 €costs ward 210,76 €costs instruments 440,12 €costs trays 77,25 €costs operation 903,44 €
contribution margin1.569,85 €
03.09.2013 13
high scope for optimizing
little or noscope for optimizing
1. OP 2. OPturnaroundtime
3. OPturnaraoundtime
time management
surgeon missing
reports missing
information missingpatient missing
03.09.2013 14
time management
OP
Avoid
non-fluid
workflow
the later
a fault is detected,
the higher the costs
for troubleshootingOP
03.09.2013 15
OP 1
time management
OP 2 OP 3
OP 4
03.09.2013 16
15 min. turnaround time in the OR
transparent instrument management
never ending story
5100 cases in 54 beds
success storytransparency change
efficiency compaction
No 1 in Germany according to patient survey 2012
03.09.2013 17
quality ?profit& !vs.
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