[Workflow management in the operating room. Analysis of potentials for optimizing efficiency at a university hospital].
BACKGROUND
The introduction of the diagnosis-related groups reimbursement system has increased cost pressures. Due to the interaction of many different professional groups, analysis and optimization of internal coordination and scheduling in the operating room (OR) is mandatory. The aim of this study was to analyze the processes at a university hospital in order to optimize strategies by identifying potential weak points.


METHODS
Over a period 6 weeks before and 4 weeks after intervention processes time intervals in the OR of a tertiary care hospital (university hospital) were documented in a structured data collection sheet.


RESULTS
The main reason for lack of efficiency of labor was underused OR utilization. Multifactorial reasons, particularly in the management of perioperative interfaces, led to vacant ORs. A significant deficit was in the use of OR capacity at the end of the daily OR schedule. After harmonization of working hours of different staff groups and implementation of several other changes an increase in efficiency could be verified.


CONCLUSIONS
These results indicate that optimization of perioperative processes considerably contribute to the success of OR organization. Additionally, the implementation of standard operating procedures and a generally accepted OR statute are mandatory. In this way an efficient OR management can contribute to the economic success of a hospital.
Welker
A
A
Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Dr. Horst Schmidt Klinik Wiesbaden.
Wolcke
B
B
Schleppers
A
A
Schmeck
S B
SB
Focke
U
U
Gervais
H W
HW
Schmeck
J
J
D001071:Appointments and Schedules; D003953:Diagnosis-Related Groups; D017598:Efficiency, Organizational; D005858:Germany; D006785:Hospitals, University / Q000191:economics / Q000458:organization & administration*; D009873:Operating Rooms / Q000191:economics / Q000458:organization & administration*; D019990:Perioperative Care; D010561:Personnel Staffing and Scheduling; D057188:Workflow