title: [Structural and organisational changes in the hospital from a senior consultant's perspective].
abstract: Organisational negligence from the point of view of hospital-based physicians essentially results in a failure to adhere to the medical standards expected of specialists, loss of information with handover at shift change, more hectic pace due to reduced length of hospital stay, high patient "throughput" along with staff shortages (shortage of time) as well as cost containment or reduced financial resources in the technical area; special problems include sanitation deficiencies and trouble with equipment. The corresponding catchwords include: strict treatment protocols, DRG funding system, Working Time Act, cross-discipline duties and modular hospital. As the physicians "on site" at best have minimal influence only on the externally established limitations the respective hospital owners should also be subjected to organisational liability.
authors.affiliation: Chirurgische Klinik Holweide, Städt. Kliniken Köln GmbH, Köln. KienzleHF@Kliniken-Koeln.de
authors.forename: Hans-Friedrich
authors.initials: HF
authors.lastname: Kienzle
mesh_terms: D003253:Consultants; D003953:Diagnosis-Related Groups; D005858:Germany; D006739:Hospital Administration / Q000592:standards*; D006801:Humans; D008318:Malpractice; D008507:Medically Underserved Area; D009936:Organizational Innovation; D010564:Personnel, Hospital / Q000592:standards*