Space as a cost producing unit in Space as a cost producing unit in
hospitals hospitals
- - Results of Results of the the OPIK research project OPIK research project - -
Partners 2003 Partners 2003
Hospital partners
• Städtisches Klinikum Karlsruhe
• Klinikum Mittelbaden (Baden-Baden)
• St.Marien- + St. Anna- stiftskrankenhaus
Ludwigshafen
• Bethesda
Krankenhaus Stuttgart – Ulm
• Klinikum der JWG- Universität Frankfurt
• Klinikum Saarbrücken
Industry partners
• Infraserv Höchst
• LGM
Lufthansa
Gebäudemanagement
• HSG
Technischer Service GmbH
• Dr. Sasse
Gebäudedienste GmbH
• Universitätsklinikum Gießen
• St. Vincentius Kliniken KA
• Universitätsklinikum Heidelberg
• Kreiskrankenhaus Eberbach
• Kreiskrankenhaus Schwetzingen
• Kreiskrankenhaus Sinsheim
• Kreiskrankenhaus Weinheim
Cooperating partners
• MHH Prof. Hartung
• FKT
• GEFMA
• FBMT
Introduction
Posed Problem
Methodology
Results
Conclusions
Health care costs in comparison Health care costs in comparison
8,3
2,7 8,2
2,9 8,4
2,9 6,6
3 7,8
3 8,4
3,2 9,3
3,2 10,5
3,4 8,4
3,5 13
3,5 8,6
3,6 9
3,8 10,1
4 11,1
4,6
0 2 4 6 8 10 12 14
S FIN NL L E UK P D DK USA I A F CH
Health expenditure as a proportion of GDP
total expense inpatient treatment costs
Per cent
Stapf-Finé et al. 2003
Introduction
Posed Problem
Methodology
Results
Average patient stay in comparison Average patient stay in comparison
5 6 7 8 9 10 11 12 13 14 15
1995 1996 1997 1998 1999
average patient stay
germany average in europe USA
Introduction
Posed Problem
Methodology
Results
Conclusions
Posed problem
Posed problem
Real estate as a working stock Real estate as a working stock
Core Processes Necessary envirionment
Diagnosis
Operation
Care Therapy
Ward
Intensive Care Unit Operating rooms
Radiology
Laboratories
Introduction
Posed Problem
Methodology
Results
Conclusions
Example OR Example OR
space –
operating room
system border sterile goods
energy
linen
cleaning
media med. equip.
waste
personnel
personnel
personnel
personnel personnel
personnel
personnel material
material material
material
material material
material
Introduction
Posed Problem
Methodology
Results
Professional managed facilities (I) Professional managed facilities (I)
Professional management of health care facilities means:
To provide the necessary surrounding for the core process according to the high requirements of the medical processes.
Source:
Horst-Stoeckel-Museum for anesthesia:
OR of 1930 Source:
Zentrum für Kinderheilkunde, Uniklinik Bonn
Introduction
Posed Problem
Methodology
Results
Conclusions
Professional managed facilities (II) Professional managed facilities (II)
Professional management of health care facilities also means : The rising costs for providing and maintaining the surroundings and performance of the affiliated services are refinanced
through the core process.
Introduction
Posed Problem
Methodology
Results
Methodology
Methodology
Products as a base for refinancing Products as a base for refinancing
products
quantities products quantities
products
quantities products
quantities
FM-base rate FM-case rate thrid parties
(hospital) (surgical unit) (appendix)
FM-unit rate
100% FM costs
n = 1 5 < n < 30 n = ca. 660 n = X
Introduction
Posed Problem
Methodology
Results
Approach Approach
analysis of the accounting structures
development of a standard accounting structure
linkage between products and cost pools development of the product list
inquiry of cost data and product quantities
linkage between costs and products
price benchmarking
Introduction
Posed Problem
Methodology
Results
Conclusions
Product list – basics Product list – basics
• Services need to be performed to the benefit of the customer
• Comprehensible allocation bases need to be definable
• The effort to acquire the quantities needs to be reasonable
• The product quantity has to be influenceable by the customer
Introduction
Posed Problem
Methodology
Results
Illustration of the links Illustration of the links
Introduction
Posed Problem
Methodology
Results
Conclusions
Linkage between costs and products Linkage between costs and products
product:
02 outside facilities
.
680021 gardening – material 681022 gardening – service
provider
. .
720021 maintenance of outside facilities inspections
720022 maintenance of outside facilities repair
. .
731021 street cleaning allocation basis:
m² HNF
Introduction
Posed Problem
Methodology
Results
Data collection form Data collection form
Introduction
Posed Problem
Methodology
Results
Conclusions
Results
Results
Optimierung und Analyse von Prozessen in Krankenhäusern – Professor Dr.-Ing. Kunibert Lennerts – Universität Karlsruhe (TH) FM Symposium 2004 OPIK Nr.18
Product list – allocation method Product list – allocation method
allocation basis: m² HNF:
outside facilities operation
building maintenance technical maintenance basic rent
cleaning pest control security
allocated on quantity basis:
waste disposal ton of
waste
bed conditioning bed
IT-services PC
fleet management vehicle
hygiene advice analysis
maintenance of med. equip.
value
cooling service kWh
broadcasting services order related allocation:
office supplies caretaker services repro services mail services removal services Introduction
Posed Problem
Methodology
Results
Conclusions
Accounting structure Accounting structure
Introduction
Posed Problem
Methodology
Results
Data collection Data collection
not yet returned data: 17
returned data: 22 56,4%
43,6%
25 14
64,1%
35,9%
34 18
65,4%
34,6%
41 11
78,8%
21,2%
12
personnel data product quantities cost data
13 11
10 9
8 7
6 5
4 3
2 1
hospital
space data
Introduction
Posed Problem
Methodology
Results
Conclusions
Space as a product Space as a product
The costs for provision of a square meter net floor area in a hospital amount to 30,-€
per month without
consideration of initial investment!
HNF
1 m
1 m
Introduction
Posed Problem
Methodology
Results
Product benchmarking – space costs Product benchmarking – space costs
cost benchmarking m²
30,07 €
2 3 4 5 7 8 9 10 11 12 13
Krankenhaus
Euro per m² net floor area and month
base rent cleaning building maintenance
technical maintenance outside facitlities operation
security pest control average
