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Table 4 Orthopedics care and total knee implants

From: Exploring types of focused factories in hospital care: a multiple case study

Unit 7 8 9 10
Organizational context     
Focusing decisions/operations strategy No clear strategy Strategy pursuing efficiency for total knee implants No clear strategy No clear strategy for total knee implants
Standardized procedures No Yes No No
Dedicated lay-out Layout was not dedicated Diagnostics, preoperative screening and surgery took place on different locations Layout adapted to create 'living room' that enabled group wise treatment and rehabilitation of knee implants patients Diagnostics, preoperative screening and surgery took place on different locations Layout was not (really) dedicated Diagnostics, preoperative screening and surgery took place on one location Layout was not (really) dedicated Diagnostics, preoperative screening and surgery took place on one location
Planning routine Different planning routines per MD Different routines per MD. Joint-care patients not always operated sequentially Standardized planning routines, using fixed surgical times Sequence of surgeries was 'random' ignoring negative changeover effects Standardized planning routines, using fixed surgical times Sequence of surgeries was 'random' ignoring negative changeover effects
Team composition Frequent changes in team composition Frequent changes in team composition Frequent changes in team composition Frequent changes in team composition
Degrees of focus     
Product focus 47% 75% 47% 56%
Process focus 56% 75% 56% 56%
Operational performance     
Average duration of surgery (min) 48 110 90 90
Preparation time for knee surgery (min)   30   40
Average Length of stay 5,6 5,0 5,9 6,9
Utilization of ward 78%   88%  
Overhead cost per discharged patient (€) 107   290