Acta Univ. Agric. Silvic. Mendelianae Brun. 2020, 68(4), 755-763 | DOI: 10.11118/actaun202068040755

Impact of Digital Supported Process Workflow Optimization for Hip Joint Endoprosthesis Implantation on Hospital-Specific Process and Quality Ratios

Benjamin Lahmann, David Hampel
Department of Statistics and Operation Analysis, Faculty of Business and Economics, Mendel University in Brno, Zemìdìlská 1, 613 00 Brno, Czech Republic

Considering the continuous change within the German health care system, German hospitals are forced to realize efficiency gains and, at the same time, try to enhance their quality standards. Digital support systems in surgery rooms intend to improve operational efficiency and reduce failure quotas. A dataset with 383 hip joint endoprosthesis surgeries from a German hospital was analysed using statistical methods, among others logit model, odds ratio and ANCOVA. Results show that digitally supported surgery results in a shorter hospital stay time and reduces acute hemorrhagic anemia as a postoperative complication. Finally, it is possible to conclude that the Surgical Procedure Manager reduces surgical risks.

Keywords: digital support, endoprosthesis, hospital health care, process standardization, surgical procedure manager

Received: June 11, 2020; Accepted: August 6, 2020; Published: August 30, 2020  Show citation

ACS AIP APA ASA Harvard Chicago IEEE ISO690 MLA NLM Turabian Vancouver
Lahmann, B., & Hampel, D. (2020). Impact of Digital Supported Process Workflow Optimization for Hip Joint Endoprosthesis Implantation on Hospital-Specific Process and Quality Ratios. Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis68(4), 755-763. doi: 10.11118/actaun202068040755
Download citation

References

  1. ABOLLADO, J. R., SHEHAB, E. and BAMFORTH, P. 2017. Challenges and Benefits of Digital Workflow Implementation in Aerospace Manufacturing Engineering. Procedia CIRP, 60: 80-85. DOI: 10.1016/j.procir.2017.02.044 Go to original source...
  2. AGRESTI, A. 2019. An introduction to categorical data analysis. 3rd Edition. Wiley series in probability and statistics. Hoboken, NJ: John Wiley & Sons.
  3. ALTMAN, D. G. 1999. Practical statistics for medical research. Boca Raton, Fla: Chapman & Hall/CRC.
  4. BEHAR, B. I., GUTH, C. and SALFELD, R. 2018. Modern hospital management: concepts and solutions [in German: Modernes Krankenhausmanagement: Konzepte und Lösungen]. 4th Edition. Berlin: Springer Gabler.
  5. BRITISH STANDARDS INSTITUTION. 2002. Effective records management - Part 3: Performance management for BS. ISO 15489-1. BIP 0025-3:2003. BSI Business information: Jones, P. A.
  6. BOOS, M. and GOLDSCHMIDT, N. 2000. Knowledge value!? economic perspectives of the knowledge society: 3rd Freiburg Economic Symposium [in German: WissensWert!? ökonomische Perspektiven der Wissensgesellschaft: 3. Freiburger Wirtschaftssymposium]. 1st Edition. Baden-Baden: Nomos.
  7. BRABANDT, N. 2017. The solution to the leadership problem: Development of an effective and sustainable leadership model based on the experiences of management and leadership thinkers [in German: Die Lösung der Leadership-Problematik: Entwicklung eines wirksamen und nachhaltigen Führungsmodells auf Grundlage der Erfahrungen der Management- und Leadership-Vordenker]. 1st Edition. Books on Demand.
  8. BRAITHWAITE, J., WESTBROOK, M. T., HINDLE, D., IEDEMA, R. A. and BLACK, D. A. 2006. Does restructuring hospitals result in greater efficiency - an empirical test using diachronic data. Health Services Management Research, 19(1): 1-12. DOI: 10.1258/095148406775322016 Go to original source...
  9. BUSSE, T. 2010. Operation room management: Basics [in German: OP-Management: Grundlagen]. 4th Edition. Heidelberg: Medhochzwei-Verl.
  10. BUSSE, R. and BERGER, E. 2018. From planning inventory protection to demand-oriented hospital services [in German: Vom planerischen Bestandschutz zum bedarfsorientierten Krankenhausangebot]. In: KLAUBER, J., GERAEDTS, M., FRIEDRICH, J. and WASEM, J. (Eds.). Hospital report 2018. Focus: Need and needs-based justice [in German: Krankenhaus-Report 2018. Schwerpunkt: Bedarf und Bedarfsgerechtigkeit]. Stuttgart: Schattauer.
  11. CARVAJAL, G., MAUCEC, M. and CULLICK, S. 2018. Chapter Five - Workflow Automation and Intelligent Control. In: CARVAJAL, G., MAUCEC, M. and CULLICK, S. (Eds.) Intelligent Digital Oil and Gas Fields. pp. 149-195. Boston: Gulf Professional Publishing. Go to original source...
  12. CHATTERJEE, A., MCCARTHY, J. E., MONTAGNE, S. A., LEONG, K. and KERRIGAN, C. L. 2011. A Cost, Profit, and Efficiency Analysis of Performing Carpal Tunnel Surgery in the Operating Room Versus the Clinic Setting in the United States: Annals of Plastic Surgery, 66(3): 245-248. DOI: 10.1097/SAP.0b013e3181db7784 Go to original source...
  13. CHINUBHAI, A. 2011. Efficiency in Software Development Projects: International Journal of Software Engineering and its Applications, 5(4): 171-179.
  14. COOMBER, R., PORTEOUS, M., HUBBLE, M. J. W. and PARKER, M. J. 2016. Total hip replacement for hip fracture: Surgical techniques and concepts. Injury, 47(10): 2060-2064. DOI: 10.1016/j.injury.2016.06.034 Go to original source...
  15. CROZIER, F. 2006. Terminology of quality assurance: towards shared European values? Helsinki: European Association for Quatity Assurance in Higher Education.
  16. DIVATIA, J. and RANGANATHAN, P. 2015. Can we improve operating room efficiency? Journal of Postgraduate Medicine, 61(1): 1-2. DOI: 10.4103/0022-3859.147000 Go to original source...
  17. ERIVAN, R., LECOINTE, T., VILLATTE, G., MULLIEZ, A., DESCAMPS, S. and BOISGARD, S. 2018. Complications with cement spacers in 2-stage treatment of periprosthetic joint infection on total hip replacement. Orthopaedics & Traumatology: Surgery & Research, 104(3): 333-339. Go to original source...
  18. FAWSITT, C. G., THOM, H. H. Z., HUNT, L. P., NEMES, S., BLOM, A. W., WELTON, N. J., HOLLINGWORTH, W., LÓPEZ-LÓPEZ, J. A., BESWICK, A. D., BURSTON, A., ROLFSON, O., GARELLICK, G. and MARQUES, E. M. R. 2019. Choice of Prosthetic Implant Combinations in Total Hip Replacement: Cost-Effectiveness Analysis Using UK and Swedish Hip Joint Registries Data. Value in Health, 22(3): 303-312. DOI: 10.1016/j.jval.2018.08.013 Go to original source...
  19. FEIGE, K., GOLLNICK, I., SCHMITZ, P. and STRAUSS, G. 2017. The application of surgical procedure manager (SPM): first experience with FESS. European Archives of Oto-Rhino-Laryngology, 274(9): 3407-3416. DOI: 10.1007/s00405-017-4658-9 Go to original source...
  20. GARRIDO, M. M., KELLEY, A. S., PARIS, J., ROZA, K., MEIER, D. E., MORRISON, R. S. and ALDRIDGE, M. D. (2014). Methods for Constructing and Assessing Propensity Scores. Health Services Research, 49(5): 1701-1720. DOI: 10.1111/1475-6773.12182 Go to original source...
  21. GÜNTHER, S. 2010. Design for Six Sigma: Design and operationalization of alternative problem-solving cycles based on evolutionary algorithms [in German: Design for Six Sigma: Konzeption und Operationalisierung von alternativen Problemlösungszyklen auf Basis evolutionärer Algorithmen]. 1st Edition. Wiesbaden: Gabler. Go to original source...
  22. HAJEN, L., PAETOW, H. and SCHUMACHER, H. 2011. Health economics: structures - methods - practical examples [in German: Gesundheitsökonomie: Strukturen - Methoden - Praxisbeispiele]. 6th Edition. Stuttgart: Kohlhammer.
  23. HEIKKILÄ, J. 2002. From supply to demand chain management: efficiency and customer satisfaction. Journal of Operations Management, 20(6): 747-767. DOI: 10.1016/S0272-6963(02)00038-4 Go to original source...
  24. HULL, L., ARORA, S., KASSAB, E., KNEEBONE, R. and SEVDALIS, N. 2011. Assessment of stress and teamwork in the operating room: an exploratory study. The American Journal of Surgery, 201(1): 24-30. DOI: 10.1016/j.amjsurg.2010.07.039 Go to original source...
  25. KUY, S. and ROMERO, R. A. L. 2017. Improving staff perception of a safety climate with crew resource management training. Journal of Surgical Research, 213: 177-183. DOI: 10.1016/j.jss.2016.04.013 Go to original source...
  26. LAITINEN, I., KINDER, T. and STENVALL, J. 2018. International Journal of Knowledge-Based Development. Local public service productivity and performance measurement, 9(1): 49-75. Go to original source...
  27. LAUTERBACH, K., STOCK, S. and BRUNNER, H. 2013. Health economics: textbook for physicians and other health professionals [in German: Gesundheitsökonomie: Lehrbuch für Mediziner und andere Gesundheitsberufe]. 3rd Edition. Bern: Verlag Hans Huber.
  28. MA, T., YANG, T., GUO, Y., WANG, Y. and DENG, J. 2018. Do Challenge Stress and Hindrance Stress Affect Quality of Health Care? Empirical Evidence from China. International Journal of Environmental Research and Public Health, 15(8): 1628. DOI: 10.3390/ijerph15081628 Go to original source...
  29. MACARIO, A. 2010. What does one minute of operating room time cost? Journal of Clinical Anesthesia, 22(4): 233-236. DOI: 10.1016/j.jclinane.2010.02.003 Go to original source...
  30. MARTINUSSEN, P. E. and MIDTTUN, L. 2004. Day surgery and hospital efficiency: empirical analysis of Norwegian hospitals, 1999-2001. Health Policy, 68(2): 183-196. DOI: 10.1016/j.healthpol.2003.09.003 Go to original source...
  31. MATHAR, H.-J. and SCHEURING, J. 2011. Logistics for technical business people and HWD basics with examples, repetition questions and answers and exercises [in German: Logistik für technische Kaufleute und HWD Grundlagen mit Beispielen, Repetitionsfragen und Antworten sowie Übungen]. Zürich: Compendio Bildungsmedien.
  32. MITRA, D. and GOLDER, P. N. 2006. How Does Objective Quality Affect Perceived Quality? Short-Term Effects, Long-Term Effects, and Asymmetries. Marketing Science, 25(3): 230-247. DOI: 10.1287/mksc.1050.0175 Go to original source...
  33. NEUBERG, L. G. 2003. CAUSALITY: MODELS, REASONING, and INFERENCE, by Judea Pearl, Cambridge University Press, 2000. Econometric Theory, 19(4): 675-685. DOI: 10.1017/S0266466603004109 Go to original source...
  34. NEUMUTH, T., JANNIN, P., SCHLOMBERG, J., MEIXENSBERGER, J., WIEDEMANN, P. and BURGERT, O. 2011. Analysis of surgical intervention populations using generic surgical process models. International Journal of Computer Assisted Radiology and Surgery, 6(1): 59-71. DOI: 10.1007/s11548-010-0475-y Go to original source...
  35. NUTT, J. L., PAPANIKOLAOU, K. and KELLETT, C. F. 2013. Complications of total hip arthroplasty. Orthopaedics and Trauma, 27(5): 272-276. DOI: 10.1016/j.mporth.2013.08.012 Go to original source...
  36. PAEGER, A. 2017. Hospital and DRG system - an introduction to incentive systems [in German: Krankenhaus und DRG-Systematik - eine Einführung in die Anreizsysteme]. In: DEBATIN, J. F., EKKERNKAMP, A., SCHULTE, B. and TECKLENBURG, A. (Eds.). Hospital management: strategies, concepts, methods [in German: Krankenhausmanagement: Strategien, Konzepte, Methoden]. 3rd Edition. Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft.
  37. PERSOSKIE, A. and FERRER, R. A. 2017. A Most Odd Ratio: American Journal of Preventive Medicine, 52(2): 224-228. DOI: 10.1016/j.amepre.2016.07.030 Go to original source...
  38. RAUSCH, K. 2007. Shaping the organization: Reconciling Structure with Culture, Volume for the 13th Conference of the Society for Applied Business Psychology e. V. on 2 and 3 February 2007 at the FH Osnabrück [in German: Organisation gestalten: Struktur mit Kultur versöhnen; Band zur 13. Tagung der Gesellschaft für angewandte Wirtschaftspsychologie e. V. am 2. und 3. Februar 2007 in der FH Osnabrück]. Lengerich, Westf: Pabst Science Publ.
  39. RICHTER-KUHLMANN, E., MAYBAUM, T. and BEERHEIM, R. 2017. Hospital: A question of quality [in German: Krankenhaus: Eine Frage der Qualität]. Aerzteblatt.de [Online]. Available at: https://www.aerzteblatt.de/archiv/192973/Krankenhaus-Eine-Frage-der-Qualitaet [Accessed: 2019, January 15].
  40. ROBBINS, S. P. 2011. Management: the essentials. Frenchs Forest, N.S.W.: Pearson Australia.
  41. ROSENBAUM, P. R. and RUBIN, D. B. 1983. The Central Role of the Propensity Score in Observational Studies for Causal Effects. Biometrika, 70(1): 41-55. DOI: 10.1093/biomet/70.1.41 Go to original source...
  42. ROSS, A. D. and DROGE, C. 2004. An analysis of operations efficiency in large-scale distribution systems. Journal of Operations Management, 21(6): 673-688. DOI: 10.1016/j.jom.2003.11.003 Go to original source...
  43. SCHMID, A. and ULRICH, V. 2013. Consolidation and concentration in the German hospital market: The two sides of the coin. Health Policy, 109(3): 301-310. DOI: 10.1016/j.healthpol.2012.08.012 Go to original source...
  44. SCHROEDER, R. G., GOLDSTEIN, S. M. and RUNGTUSANATHAM, M. J. 2016. Operations management in the supply chain: decisions and cases. 7th Edition. Dubuque: McGraw-Hill Education.
  45. SHESKIN, D. 2011. Handbook of parametric and nonparametric statistical procedures. 5th Edition. Boca Raton: CRC Press.
  46. SIMON, M. 2017. The health care system in Germany: an introduction to its structure and functioning [in German: Das Gesundheitssystem in Deutschland: eine Einführung in Struktur und Funktionsweise]. 6th Edition. Bern: Hogrefe.
  47. SLACK, N. and BRANDON-JONES, A. 2019. Operations management. 9th Edition. Harlow, England; New York, US: Pearson.
  48. SMITH, M. 2005. Performance measurement & management: a strategic approach to management accounting. London, England; Thousand Oaks, Calif: SAGE.
  49. SOUDERS, C. P., CATCHPOLE, K. R., WOOD, L. N., SOLNIK, J. M., AVENIDO, R. M., STRAUSS, P. L., EILBER, K. S. and ANGER, J. T. 2017. Reducing Operating Room Turnover Time for Robotic Surgery Using a Motor Racing Pit Stop Model. World Journal of Surgery, 41(8): 1943-1949. DOI: 10.1007/s00268-017-3936-4 Go to original source...
  50. STRAUSS, G., ARIES, F., ABRI, O., DIETZ, A., MEIXENSBERGER, J. and LÜTH, T. 2010. Konzeption, Realisierung und Analyse einer neuartigen OP-Konzeption für die HNO-Chirurgie. HNO, 58(11): 1074-1084. DOI: 10.1007/s00106-010-2194-7 Go to original source...
  51. STRAUSS, G., GOLLNICK, I., NEUMUTH, T., MEIXENSBERGER, J. and LUETH, T. 2012. The "Surgical Deck": A new surgical generation for ENT surgery [in German: Das "Surgical Deck": Eine neue OP-Generation für die HNO-Chirurgie]. Laryngo-Rhino-Otologie, 92(2): 102-112. Go to original source...
  52. TRIPEPI, G., JAGER, K. J., DEKKER, F. W., WANNER, C. and ZOCCALI, C. 2007. Measures of effect: Relative risks, odds ratios, risk difference, and 'number needed to treat'. Kidney International, 72(7): 789-791. DOI: 10.1038/sj.ki.5002432 Go to original source...
  53. WANG, G., LI, J., HOPP, W. J., FAZZALARI, F. L. and BOLLING, S. 2015. Hospital Quality and Patient Choice: An Empirical Analysis of Mitral Valve Surgery. Ross School of Business Paper No. 1386. University of Michigan. Go to original source...
  54. ZAPP, W. 2010. Key figures in hospitals [in German: Kennzahlen im Krankenhaus]. 1st Edition. Lohmar: Eul. (Reihe: Controlling and Management in Gesundheitseinrichtungen; 2).
  55. ZAPP, W. 2014. Strategic development in hospitals: key figures - portfolio - geocoding - occupancy management [in German: Strategische Entwicklung im Krankenhaus: Kennzahlen - Portfolio - Geokodierung - Belegungsmanagement]. 1st Edition. Stuttgart: Verlag W. Kohlhammer.
  56. ZAPP, W., GRUNDMANN, J., TERBECK, J., HEIER, K. and NIELSEN, S. 2011. Hospital productivity [in German: Produktivität im Krankenhaus]. KU Gesundheitsmanagement, 2011: 41-44.
  57. ZAPP, W. and SCHMIDT-RETTIG, B. 2015. Hospital management: organizational change and leadership [in German: Krankenhausmanagement: organisatorischer Wandel und Leadership]. 1st Edition. Stuttgart: Kohlhammer.

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY NC ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.