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Kennzahlen der OP-Effizienz

Mythos und Evidenz der Steuerungskennzahlen im OP-Management

Key performance indicators of OR efficiency

Myths and evidence of key performance indicators in OR management

  • Trends und Medizinökonomie
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Zusammenfassung

Es steht eine Vielzahl von verschiedenen Kennzahlen zur Beurteilung der OP-Effizienz zur Verfügung, die in Prozessablaufkennzahlen und Finanzkennzahlen unterschieden werden können. Bestimmte Kennzahlen, wie Auslastung und Wechselzeiten, scheinen sich hierbei als allgemeiner Standard durchzusetzen und werden in sehr vielen Krankenhäusern verwendet, um die Prozessabläufe im OP zu beurteilen. Trotz ihrer allgemeinen Verfügbarkeit und Verwendung ist die wissenschaftliche Evidenz hinter den aktuell am häufigsten verwendeten Prozessablaufkennzahlen im OP-Bereich relativ gering. Die Prozessablaufkennzahlen werden stark von Artefakten beeinflusst und sind von Planungsprozessen, Ressourceneinsatz und der Dokumentation abhängig. Direkte Finanzkennzahlen gewinnen durch die zunehmende Eigenständigkeit des OP-Managements an Bedeutung. Hierzu gehört neben der Budgeteinhaltung zunehmend auch das Finanzergebnis der internen Leistungsverrechnung. Diese ermöglicht es, das OP-Management über die Budgetverantwortung von einem reinen Verursacher von Kosten zu einem aktiven Gestalter der perioperativen Prozesse zu wandeln. Hierzu ist aber eine genaue Kenntnis der Mechanismen der Kostenentstehung und der Fallstricke einer internen Leistungsverrechnung notwendig. Die erhöhte Transparenz durch die freie Zugänglichkeit der „Diagnosis-related-groups- (DRG-)Kostendaten“ kann dem OP-Management helfen, entsprechende Werkzeuge zu entwickeln, die ökonomischen Grundlagen des Leistungsprozesses korrekt zu analysieren.

Abstract

A variety of different key performance indicators, both for process and financial performance, are used to evaluate OR efficiency. Certain indicators like OR utilization and turnover times seem to become common standard in many hospitals to evaluate OR process performance. Despite the general use and availability of these indicators in OR management, the scientific evidence behind these data is relatively low. These process indicators are strongly influenced by artefacts and depend on planning process, resource allocation and documentation. Direct financial indicators become more important with increasing autonomy of OR management. Besides budgetary compliance the focus is set on the net results of internal transfer pricing systems. By taking part in an internal transfer pricing system, OR management develops from a mere passive cost center to an active shaper of perioperative processes. However, detailed knowledge of the origin of costs and pitfalls of internal transfer pricing systems is crucial. The increased transparency due to the free accessibility of diagnosis-related-groups (DRG) cost breakdown data can help to develop tools for economic analysis of OR efficiency.

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Schuster, M., Wicha, L. & Fiege, M. Kennzahlen der OP-Effizienz. Anaesthesist 56, 259–271 (2007). https://doi.org/10.1007/s00101-006-1126-0

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  • DOI: https://doi.org/10.1007/s00101-006-1126-0

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