Skip to main content
Erschienen in: Die Orthopädie 11/2019

10.09.2019 | Originalie

Process optimization in total knee arthoplasty procedures

Impact of size-specific instrument sets on costs and revenue

verfasst von: Maximilian C. von Eiff, Wilfried von Eiff, Andreas Roth, PD Dr. Mohamed Ghanem, MBA

Erschienen in: Die Orthopädie | Ausgabe 11/2019

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat von Eiff MC, von Eiff W (2018) Qualität im Medizinbetrieb: Ziele, Dimensionen, Bewertungskriterien und Erfolgsfaktoren. In: Busch HP (ed) Qualitätsorientiertes Krankenhausmanagement, pp 55–79 von Eiff MC, von Eiff W (2018) Qualität im Medizinbetrieb: Ziele, Dimensionen, Bewertungskriterien und Erfolgsfaktoren. In: Busch HP (ed) Qualitätsorientiertes Krankenhausmanagement, pp 55–79
2.
Zurück zum Zitat von Eiff W (2018) Monitoring des Beschaffungsmanagements im Krankenhaus. Holzmann, Bad Wörishofen, p 79 von Eiff W (2018) Monitoring des Beschaffungsmanagements im Krankenhaus. Holzmann, Bad Wörishofen, p 79
3.
Zurück zum Zitat Schmid R, Schmidt AJ (eds) (2018) Modernes Beschaffungsmanagement im Gesundheitswesen. medhochzwei, Heidelberg (p. 24, 193–204) Schmid R, Schmidt AJ (eds) (2018) Modernes Beschaffungsmanagement im Gesundheitswesen. medhochzwei, Heidelberg (p. 24, 193–204)
5.
Zurück zum Zitat Lunardini D, Arington R, Canacari EG, Gamboa K, Wagner K, McGuire KJ (2014) Lean principles to optimize instrument utilization for spine surgery in an academic medical center: An opportunity to standardize, cut costs, and build a culture of improvement. Spine (Phila Pa 1976) 39(20):1714–1717CrossRef Lunardini D, Arington R, Canacari EG, Gamboa K, Wagner K, McGuire KJ (2014) Lean principles to optimize instrument utilization for spine surgery in an academic medical center: An opportunity to standardize, cut costs, and build a culture of improvement. Spine (Phila Pa 1976) 39(20):1714–1717CrossRef
7.
Zurück zum Zitat Moraros J, Lemstra M, Nwankwo C (2016) Lean interventions in healthcare: Do they actually work? A systematic literature review. Int J Qual Health Care 28(2):150–165CrossRef Moraros J, Lemstra M, Nwankwo C (2016) Lean interventions in healthcare: Do they actually work? A systematic literature review. Int J Qual Health Care 28(2):150–165CrossRef
8.
Zurück zum Zitat Avansino JR, Goldin AB, Risley R, Waldhausen JHT, Sawin RS (2013) Standardization of operative equipment reduces cost. J Pediatr Surg 48:1843–1849CrossRef Avansino JR, Goldin AB, Risley R, Waldhausen JHT, Sawin RS (2013) Standardization of operative equipment reduces cost. J Pediatr Surg 48:1843–1849CrossRef
9.
Zurück zum Zitat Cichos KH, Linsky PL, Wei B, Minnich DJ, Cerfolio RJ (2017) Cost savings of standardization of thoracic surgical instruments: The process of lean. Ann Thorac Surg 104:1889–1895CrossRef Cichos KH, Linsky PL, Wei B, Minnich DJ, Cerfolio RJ (2017) Cost savings of standardization of thoracic surgical instruments: The process of lean. Ann Thorac Surg 104:1889–1895CrossRef
10.
Zurück zum Zitat Rodriguez AST, Gutierres AP (2017) Patient-specific instrumentation in total knee arthroplasty. Should we adopt it? Rev Bras Ortop 52(3):242–250CrossRef Rodriguez AST, Gutierres AP (2017) Patient-specific instrumentation in total knee arthroplasty. Should we adopt it? Rev Bras Ortop 52(3):242–250CrossRef
11.
Zurück zum Zitat Watters TS, Mather RC 3rd, Browne JA, Berend KR, Lombardi AV Jr, Bolognesi MP (2011) Analysis of procedure-related costs and proposed benefits of using patient-specific approach in total knee arthroplasty. J Surg Orthop Adv 20(2):112–116PubMed Watters TS, Mather RC 3rd, Browne JA, Berend KR, Lombardi AV Jr, Bolognesi MP (2011) Analysis of procedure-related costs and proposed benefits of using patient-specific approach in total knee arthroplasty. J Surg Orthop Adv 20(2):112–116PubMed
14.
Zurück zum Zitat Hauser A (2019) Krankenhausrecht kompakt 2019. Kohlhammer, Stuttgart (Fallpauschalenvereinbarung) Hauser A (2019) Krankenhausrecht kompakt 2019. Kohlhammer, Stuttgart (Fallpauschalenvereinbarung)
16.
Zurück zum Zitat Nunley RM, Ellison BS, Ruh EL, Williams BB, Foreman K, Ford AD, Barrack RL (2011) Are patient-specific cutting blocks cost-effective for total knee arthroplasty? Clin Orthop Relat Res 470:889–894CrossRef Nunley RM, Ellison BS, Ruh EL, Williams BB, Foreman K, Ford AD, Barrack RL (2011) Are patient-specific cutting blocks cost-effective for total knee arthroplasty? Clin Orthop Relat Res 470:889–894CrossRef
17.
Zurück zum Zitat Slover JD, Rubash HE, Malchau H, Bosco JA (2012) Cost-effectiveness analysis of custom total knee cutting blocks. J Arthroplasty 27:180–185CrossRef Slover JD, Rubash HE, Malchau H, Bosco JA (2012) Cost-effectiveness analysis of custom total knee cutting blocks. J Arthroplasty 27:180–185CrossRef
18.
Zurück zum Zitat Mont MA, McElroy MJ, Johnson AJ, Pivec R (2013) Single-use instruments, cutting blocks, and trials increase efficiency in the operating room during total knee arthroplasty. A prospective comparison of navigated and non-navigates cases. J Arthroplasty 28:1135–1140CrossRef Mont MA, McElroy MJ, Johnson AJ, Pivec R (2013) Single-use instruments, cutting blocks, and trials increase efficiency in the operating room during total knee arthroplasty. A prospective comparison of navigated and non-navigates cases. J Arthroplasty 28:1135–1140CrossRef
19.
Zurück zum Zitat Healy WL, Rana AJ, Iorio R (2011) Hospital economics of primary total knee arthroplasty at a teaching hospital. Clin Orthop Relat Res 469:87–94CrossRef Healy WL, Rana AJ, Iorio R (2011) Hospital economics of primary total knee arthroplasty at a teaching hospital. Clin Orthop Relat Res 469:87–94CrossRef
20.
Zurück zum Zitat Tibesku CO, Hofer P, Portegies W, Ruys CJM, Fennema P (2014) Benefits of using customized instrumentation in total knee arthroplasty: Results from an activity-based costing model. Arch Orthop Trauma Surg 133:405–411CrossRef Tibesku CO, Hofer P, Portegies W, Ruys CJM, Fennema P (2014) Benefits of using customized instrumentation in total knee arthroplasty: Results from an activity-based costing model. Arch Orthop Trauma Surg 133:405–411CrossRef
21.
Zurück zum Zitat Sassoon A, Nam D, Nunley R, Barrack R (2015) Systematic review of patient-specific instrumentation in total knee arthroplasty: New but not improved. Clin Orthop Relat Res 473(1):151–158CrossRef Sassoon A, Nam D, Nunley R, Barrack R (2015) Systematic review of patient-specific instrumentation in total knee arthroplasty: New but not improved. Clin Orthop Relat Res 473(1):151–158CrossRef
22.
Zurück zum Zitat Molicnik A, Naranda J, Dolinar D (2015) Patient-matched instruments versus standard instrumentation in total knee arthroplasty: A prospective randomized study. Wien Klin Wochenschr 127(Suppl 5):S235–S240CrossRef Molicnik A, Naranda J, Dolinar D (2015) Patient-matched instruments versus standard instrumentation in total knee arthroplasty: A prospective randomized study. Wien Klin Wochenschr 127(Suppl 5):S235–S240CrossRef
23.
Zurück zum Zitat Stockert EW, Langermann A (2014) Assessing the magnitude and costs of intraoperative inefficiencies attributable to surgical instrument trays. J Am Coll Surg 219(4):646–655CrossRef Stockert EW, Langermann A (2014) Assessing the magnitude and costs of intraoperative inefficiencies attributable to surgical instrument trays. J Am Coll Surg 219(4):646–655CrossRef
24.
Zurück zum Zitat Macario A (2010) What does one minute of operating room time cost? J Clin Anesth 22:233–236CrossRef Macario A (2010) What does one minute of operating room time cost? J Clin Anesth 22:233–236CrossRef
25.
Zurück zum Zitat Zapp W, Dues C, Kempenich E, Oswald J (2017) Rechnungswesen und Finanzierung in Krankenhäusern und Pflegeeinrichtungen, pp 190–191 Zapp W, Dues C, Kempenich E, Oswald J (2017) Rechnungswesen und Finanzierung in Krankenhäusern und Pflegeeinrichtungen, pp 190–191
27.
Zurück zum Zitat Thienpont E, Paternostre F, Van Wymeersch C (2015) The indirect cost of patient-specific instruments. Acta Orthop Belg 81(3):462–470PubMed Thienpont E, Paternostre F, Van Wymeersch C (2015) The indirect cost of patient-specific instruments. Acta Orthop Belg 81(3):462–470PubMed
29.
Zurück zum Zitat Noble JW Jr., Moore CA, Liu N (2012) The value of patient-matched instrumentation in total knee arthroplasty. J Arthroplasty 27(1):153–155CrossRef Noble JW Jr., Moore CA, Liu N (2012) The value of patient-matched instrumentation in total knee arthroplasty. J Arthroplasty 27(1):153–155CrossRef
31.
Zurück zum Zitat Porter ME, Kaplan RS (2017) Value-based healthcare in 2017. HealthManagement 17(1):1 Porter ME, Kaplan RS (2017) Value-based healthcare in 2017. HealthManagement 17(1):1
Metadaten
Titel
Process optimization in total knee arthoplasty procedures
Impact of size-specific instrument sets on costs and revenue
verfasst von
Maximilian C. von Eiff
Wilfried von Eiff
Andreas Roth
PD Dr. Mohamed Ghanem, MBA
Publikationsdatum
10.09.2019
Verlag
Springer Medizin
Erschienen in
Die Orthopädie / Ausgabe 11/2019
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI
https://doi.org/10.1007/s00132-019-03803-9

Weitere Artikel der Ausgabe 11/2019

Die Orthopädie 11/2019 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.