Space as a cost producing unit in hospitals. - Results of the OPIK research project -

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1 Space as a cost producing unit in hospitals - of the OPIK research project -

2 Partners 2003 Hospital partners Städtisches Klinikum Karlsruhe Klinikum Mittelbaden (Baden-Baden) St.Marien- + St. Annastiftskrankenhaus Ludwigshafen Bethesda Krankenhaus Stuttgart Ulm Klinikum der JWG- Universität Frankfurt Klinikum Saarbrücken Universitätsklinikum Gießen St. Vincentius Kliniken KA Universitätsklinikum Heidelberg Kreiskrankenhaus Eberbach Kreiskrankenhaus Schwetzingen Kreiskrankenhaus Sinsheim Kreiskrankenhaus Weinheim Industry partners Infraserv Höchst LGM Lufthansa Gebäudemanagement HSG Technischer Service GmbH Dr. Sasse Gebäudedienste GmbH Cooperating partners MHH Prof. Hartung FKT GEFMA FBMT OPIK Nr.2

3 Health care costs in comparison Health expenditure as a proportion of GDP Per cent ,3 8,2 8,4 6,6 7,8 8,4 9,3 10,5 8,4 13 8,6 9 10,1 11, ,7 2,9 2, ,2 3,2 3,4 3,5 3,5 3,6 3,8 4 4,6 2 0 S FIN NL L E UK P D DK USA I A F CH total expense inpatient treatment costs Stapf-Finé et al OPIK Nr.3

4 Average patient stay in comparison average patient stay germany average in europe USA OPIK Nr.4

5 problem OPIK Nr.5

6 Real estate as a working stock Core Processes Diagnosis Operation Therapy Care Necessary envirionment Radiology Operating rooms Ward Intensive Care Unit Laboratories OPIK Nr.6

7 Example OR waste personnel material sterile goods material personnel personnel personnel media med. equip. personnel material energy space operating room personnel material cleaning material material linen personnel material system border OPIK Nr.7

8 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 OPIK Nr.8

9 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. OPIK Nr.9

10 OPIK Nr.10

11 Products as a base for refinancing products quantities 100% FM costs products quantities products quantities products quantities FM-base rate FM-unit rate FM-case rate thrid parties (hospital) (surgical unit) (appendix) n = 1 5 < n < 30 n = ca. 660 n = X OPIK Nr.11

12 Approach analysis of the accounting structures development of a standard accounting structure development of the product list linkage between products and cost pools inquiry of cost data and product quantities linkage between costs and products price benchmarking OPIK Nr.12

13 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 OPIK Nr.13

14 Illustration of the links OPIK Nr.14

15 Linkage between costs and products product: 02 outside facilities allocation basis: m² HNF gardening material gardening service provider maintenance of outside facilities inspections maintenance of outside facilities repair street cleaning. OPIK Nr.15

16 Data collection form OPIK Nr.16

17 OPIK Nr.17

18 Product list allocation method allocation basis: m² HNF: allocated on quantity basis: outside facilities operation building maintenance technical maintenance basic rent cleaning pest control security order related allocation: office supplies caretaker services repro services mail services removal services waste disposal waste bed conditioning bed IT-services PC fleet management vehicle hygiene advice analysis maintenance of med. equip. value cooling service ton of kwh broadcasting services OPIK Nr.18

19 Accounting structure OPIK Nr.19

20 Data collection hospital cost data product quantities personnel data space data returned data: ,1% 65,4% 78,8% 56,4% not yet returned data: ,9% 34,6% 21,2% 43,6% OPIK Nr.20

21 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 OPIK Nr.21

22 Product benchmarking space costs cost benchmarking m² Euro per m² net floor area and month 30, Krankenhaus base rent cleaning building maintenance technical maintenance outside facitlities operation security pest control average OPIK Nr.22

23 Calculation of utilisation related space price HNF 1 space DIN m² multiplied by points per m² 26,1 points HNF m² 59, HNF 3 HNF 4 HNF m² 500 m² 200 m² 85,3 39,2 59, HNF m² 152, HNF 1 HNF 2 HNF 3 HNF 4 price per m² and month 5,95 13,60 19,44 8,94 26,1 59,6 85,3 39,2 S point value 2,735 Total costs divided by total points HNF 5 HNF 6 13,60 34,70 59,6 152,3 total costs ,- OPIK Nr.23

24 Differentiated space price Differentiated space price cost per m² and month A B C D E F hospital DIN 1 DIN 2 DIN 3 DIN 4 DIN 5 DIN 6 OPIK Nr.24

25 Quantity based products Distribution of costs for quantity based products 4% 3% 3% 3% 4% 5% 21% 8% 8% 10% 13% 18% catering maintenance of med. equipment laundry services IT services bed conditioning phone services cleaning heating supply power supply water supply waste disposal other services OPIK Nr.25

26 OPIK Nr.26

27 Refinancing though the core process OPIK Nr.27

28 (I) Space is the main cost factor regarding non core processes in hospitals Also for products better to be allocated on a quantity basis, space can be used as a simplified first step for allocation Provided space for the core process is a valuable asset to be handled in a professional manner OPIK Nr.28

29 (II) The implementation of the allocation system together with the logging of allocation bases enables the consumer of FM services to influence FM costs by modifying the service quantity. Therewith three effects should be accessible: Reduction of costs through conscious use of resources More comprehension for FM costs through increased transparency Incentive for service optimisation through better price - performance comparison OPIK Nr.29

30 Contact University of Karlsruhe (TH) Facility Management (TMB) Univ.-Prof. Dr.-Ing. Kunibert Lennerts Dipl.-Ing. Jochen Abel Am Fasanengarten Geb D Karlsruhe phone: +49-(0) fax: +49-(0) url: OPIK Nr.30

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