changing health performancequality vs. profit?

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introduction MIC Clinic

general surgerygynaecology urology

special medical centers for

obesity coloproctology herniasurgery

endometriosis

specialised for minimally invasive surgery

difficultcases

reconstructivegynaecology

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19971998

19992000

20012002

20032004

20052006

20072008

20092010

20112012

0

1000

2000

3000

4000

5000

6000

26

1413

2313

2882 30523285

39994367

5100

case development

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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

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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

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instrument management

more specific cases

causes

no adequate tray stock

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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

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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 €

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high scope for optimizing

little or noscope for optimizing

1. OP 2. OPturnaroundtime

3. OPturnaraoundtime

time management

surgeon missing

reports missing

information missingpatient missing

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time management

OP

Avoid

non-fluid

workflow

the later

a fault is detected,

the higher the costs

for troubleshootingOP

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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

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quality ?profit& !vs.