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Status quo and current trends of operating room management in Germany

Baumgart, Andréa; Schüpfer, Guidob; Welker, Andreasc; Bender, Hans-Joachimd; Schleppers, Alexandere

Current Opinion in Anesthesiology: April 2010 - Volume 23 - Issue 2 - p 193–200
doi: 10.1097/ACO.0b013e328336b8b4
Ethics, economics and outcome: Edited by Alex Macario

Purpose of review Ongoing healthcare reforms in Germany have required strenuous efforts to adapt hospital and operating room organizations to the needs of patients, new technological developments, and social and economic demands. This review addresses the major developments in German operating room management research and current practice.

Recent findings The introduction of the diagnosis-related group system in 2003 has changed the incentive structure of German hospitals to redesign their operating room units. The role of operating room managers has been gradually changing in hospitals in response to the change in the reimbursement system. Operating room managers are today specifically qualified and increasingly externally hired staff. They are more and more empowered with authority to plan and control operating rooms as profit centers. For measuring performance, common perioperative performance indicators are still scarcely implemented in German hospitals. In 2008, a concerted time glossary was established to enable consistent monitoring of operating room performance with generally accepted process indicators. These key performance indicators are a consistent way to make a procedure or case – and also the effectiveness of the operating room management – more transparent.

Summary In the presence of increasing financial pressure, a hospital's executives need to empower an independent operating room management function to achieve the hospital's economic goals. Operating room managers need to adopt evidence-based methods also from other scientific fields, for example management science and information technology, to further sustain operating room performance.

aMannheim Institute of Public Health, Social and Preventive Medicine, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany

bInstitute of Anaesthesiology, Kantonsspital Luzern, Switzerland

cClinic of Anaesthesiology and Intensive Care Medicine, HSK, Dr Horst Schmidt Klinik, Wiesbaden, Germany

dDepartment of Anesthesiology and Intensive Care, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

eClinic of Anaesthesiology and Intensive Care Medicine, HSK, Dr Horst Schmidt Klinik, Wiesbaden and German Professional Association of German Anaesthesiologists, Nürnberg, Germany

Correspondence to André Baumgart, Mannheim Institute of Public Health, Social and Preventive Medicine, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Ludolf-Krehl Street 7–11, D-68167 Mannheim, Germany Tel: +49 177 3312168; e-mail: andre.baumgart@medma.uni-heidelberg.de

© 2010 Lippincott Williams & Wilkins, Inc.