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 | Â | Â | Â | Â |
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 | Â | Â | Â | Â |
Product focus | 47% | 75% | 47% | 56% |
Process focus | 56% | 75% | 56% | 56% |
Operational performance | Â | Â | Â | Â |
Average duration of surgery (min) | 48 | 110 | 90 | 90 |
Preparation time for knee surgery (min) | Â | 30 | Â | 40 |
Average Length of stay | 5,6 | 5,0 | 5,9 | 6,9 |
Utilization of ward | 78% | Â | 88% | Â |
Overhead cost per discharged patient (€) | 107 |  | 290 |  |