Process optimization in total knee arthoplasty procedures
Abstract
Total knee arthroplasty (TKA) is a frequent operation in Germany and in 2017 a total of 191,272 interventions were carried out. These interventions are associated with high costs and involve complex clinical workflow organization and time-consuming instrument logistics. With this in mind, the aim of this study was to identify the economic potential of the instrument configuration in order to optimize the entire process in TKA. Changing the composition of the set of instruments used in the operating theater for TKA resulted in time and cost saving for the complete TKA procedure, including all personnel and off-shoot procedures. In addition, the operating time saved by the introduction of a patient-specific instrumentation set meant that the operating theater could be used for more or other surgical procedures, also generating additional revenue.
Keywords
Surgical instruments Cost analysis Economics Operating rooms EfficiencyAbbreviations
- CMI
Case mix index
- CSSD
Central sterile service department
- DRG
Diagnosis-related groups
- InEK
Institute for Remuneration in Hospitals
- MIS
Minimal invasive surgery
- OR
Operating room
- TKA
Total knee arthroplasty
Prozessoptimierung bei der Implantation von Knietotalendoprothesen
Zusammenfassung
Die Implantation einer Knietotalendoprothese (Knie-TEP) ist eine häufige Operation in Deutschland, und im Jahr 2017 wurden insgesamt 191.272 Eingriffe durchgeführt. Diese Operationen sind mit hohen Kosten und einer komplexen klinischen Ablauforganisation sowie einer zeitaufwändigen Instrumentenlogistik verbunden. In Anbetracht dessen war es das Ziel dieser Studie, das ökonomische Potenzial der Instrumentenkonfiguration zu identifizieren, um den gesamten Prozess der Implantation einer Knie-TEP zu optimieren. Die veränderte Zusammensetzung des im Operationssaal verwendeten Instrumentensets für eine Knie-TEP resultierte in einer Zeit- und Kostenersparnis für den gesamten Eingriff, einschließlich aller personellen und sonstigen damit verbundenen Prozesse. Zudem bedeutete die Zeitersparnis bei der Operation durch ein patientenspezifisches Instrumentarium, dass der Operationssaal für mehr bzw. andere chirurgische Eingriffe genutzt werden konnte und damit auch zusätzliche Einnahmen erwirtschaftet werden konnten.
Schlüsselwörter
Operationsinstrumentarium Kostenanalyse Ökonomie Operationssaal EffizienzNotes
Compliance with ethical guidelines
Conflict of interest
M.C. von Eiff, W. von Eiff, A. Roth and M. Ghanem declare that they have no competing interests.
This study was conducted at a university clinic, department of orthopedics, traumatology and plastic surgery. Authorization was granted by the administration of the department. All data related to this study did not include patient, personnel or department-specific data. Also, the works council consented to the study.
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