changing health performance quality vs. profit?. 03.09.2013 2 introduction mic clinic general...

changing health performancequality 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 €

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goal

needs

consequence

actual cm ≥ target cm

TRANSPARENCY

change management

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sterilisation process

OR process

ORprocess

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 €

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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

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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.