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Orthopade ; 48(11): 963-968, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31506824


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.

Artroplastia do Joelho/instrumentação , Salas Cirúrgicas/organização & administração , Osteoartrite do Joelho/cirurgia , Instrumentos Cirúrgicos/economia , Artroplastia do Joelho/economia , Artroplastia do Joelho/métodos , Redução de Custos , Custos e Análise de Custo , Eficiência , Alemanha , Custos Hospitalares , Humanos , Salas Cirúrgicas/economia
Adv Health Care Manag ; 17: 195-219, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25985513


PURPOSE: Point-of-care testing (POCT) at the Emergency Department (ED) attains better objectives in patient care while aiming to achieve early diagnosis for faster medical decision-making. This study assesses and compares the benefits of POCT in the ED in Germany and Malta, while considering differences in their health systems. METHODOLOGY/APPROACH: This chapter utilizes multiple case study approach using Six Sigma. The German case study assesses the use of POCT in acute coronary syndrome patients, compared to the central lab setting. The Maltese case study is a pilot study of the use of medical ultrasonography as a POCT to detect abdominal free fluid in post-blunt trauma. FINDINGS: This study provides clear examples of the effectiveness of POCT in life-threatening conditions, as compared to the use of traditional central lab or the medical imaging department. Therapeutic quality in the ED and patient outcomes directly depend upon turnaround time, particularly for life-threatening conditions. Faster turnaround time not only saves lives but reduces morbidity, which in the long-term is a critical cost driver for hospitals. ORIGINALITY/VALUE: The application of Six Sigma and the international comparison of POCT as best practice for life-threatening conditions in the ED.

Traumatismos Abdominais/diagnóstico por imagem , Síndrome Coronariana Aguda/diagnóstico , Serviço Hospitalar de Emergência/normas , Sistemas Automatizados de Assistência Junto ao Leito/normas , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Ferimentos não Penetrantes/diagnóstico por imagem , Biomarcadores/sangue , Técnicas de Laboratório Clínico/normas , Eficiência Organizacional , Alemanha , Humanos , Malta , Ultrassonografia