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Development of surgery improves access to care and productivity


New study at HUS Development of surgery improves access to care and productivity. According to a recent research and development project that focused on effectiveness and functionality of surgical operations at the Hospital District of Helsinki and Uusimaa, there is a potential for increasing day surgery by more than a third of its present volume. Savings of up to 15% could also be achieved in endoprosthetic surgery if the best practices of each unit were introduced across the board.

– The present research and development project* brings new information that will back up efforts to develop the sector. Our aim is to improve the productivity of operations by about 2–3% every year. In order to achieve this, we need uniform management systems and information and costing systems that support work for a high standard of quality. Incentive pay systems and improved management systems will also help us towards more efficient service production, says Kari Nenonen, CEO of HUS.

– This cooperation project between HUS’s operative profit unit, the Nordic Healthcare Group and Sitra has been the first of its kind, but we hope that this kind of cooperation will continue. We will continue to need research results on which to base process development, Nenonen adds.

Day surgery a solution for increasing numbers of patients

According to the study, there is a potential for increasing day surgery (surgery where the patient is able to leave hospital the same day) by more than a third of its present volume at HUCH hospitals. That is the equivalent of about 2700 surgical procedures annually.

– The operating theatres hold true potential. More and more patients can be helped through day surgery. Day surgery procedures also have the advantage of being much more inexpensive than procedures which require patients to be placed in a hospital ward. By developing productivity, their daily productivity could also be boosted considerably from the present level of an average 3–4 procedures per team per day, says analyst Paulus Torkki of Nordic Healthcare Group, who acted as an expert for the study.

– Considerable savings are to be made from comparing operations and learning from the best practices. The productivity of day surgery can also be raised through efficient grouping of procedures, both between hospitals and within them. These measures can also be applied in order to even out the present daily fluctuations in the use of surgery teams, Torkki points out.

Joint replacement improves the patient’s quality of life

Joint replacement is an expensive procedure, but it has an enormous effect in improving the patient’s quality of life.

– Endoprosthetic surgery is done at six hospitals in the HUS district, and the procedures are shared among a number of doctors. The duration of care and how soon people can be discharged also vary a great deal between different units, Torkki says, giving an example of the study’s findings.

– Savings of up to 15% could be achieved in the HUS district just by drawing on the best practices of the different units. Measures to centralise the management of the instrumentation (the replacement joint and related equipment) and the prosthesis stores could also bring savings.

Constant development of operating models

Operations are constantly being developed in the HUS district and the results of the study are already being put to use.

– From the point of view of an operative profit unit, the research and development project provides valuable information on how to develop surgical operations further. They will guide arrangements in the area. Introducing uniform operative management of operating theatres and a uniform day surgery model based on best practices will improve patients’ access to care and boost productivity. The centralisation of endoprosthetic surgery has already begun and will be continued within the Hospital District of Helsinki and Uusimaa, according to Reijo Haapiainen head of the Department of Surgery.

In addition to HUS, the research and development project was funded by Sitra’s Health Care Programme, whose aims the project supports.

– We use these kinds of research and development projects to look for measures and solutions that can make health-care provision more efficient and improve services. Identifying, developing and adopting best practices across the boundaries between hospital districts helps give patients the best possible care and services, says Hannu Hanhijärvi, Executive Director of Sitra’s Health Care Programme.

* Development of surgical operations. The three sectors that the 2007 research and development project for surgical procedures focused on was 1) ways of measuring the effectiveness of surgery, 2) development of day surgery in the HUS district and 3) development of endoprosthetic surgery in the HUS district.

In addition to these, publications also comprise a summary of the principles for incentive pay. All publications are available in Finnish only.

Further information

Research and other reports, Nordic Healthcare Group
Analyst Paulus Torkki, tel: 050 338 5500,

CEO Kari Nenonen, tel. (09) 471 71200
Head of the Department of Surgery: Reijo Haapiainen, tel. 040 731 3339
Endoprosthetic surgery: Head of Department Ville Remes, tel. 050 427 1988
Day surgery: Chief Physician Vesa Perhoniemi, tel. 050 531 9797
Quantifiers for surgical operations: Chief Physician Markku Hynynen, tel. 050 427 9465

SITRA, Sitra’s Health Care Programme
Executive Director Hannu Hanhijärvi, tel. (09) 6189 9261,