Institut für Health Care & Public Management

Permanent URI for this collectionhttps://hohpublica.uni-hohenheim.de/handle/123456789/25

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Mathematische Optimierung der Sterilgutversorgung in medizinischen Einrichtungen unter Berücksichtigung von Einweg- und Mehrweginstrumenten
(2021) Hummel, Rebecca Madeleine; Ernst, Christian
Due to demographic change, healthcare systems in industrialized countries are confronted with increases in service volumes and costs combined with high quality and care demands. Increased efficiency is an important - if not the most important - means of meeting this challenge. Logistics processes, which account for up to 30% of total costs, offer a starting point for efficiency improvements in hospitals. Cost savings of up to 50% can be achieved by optimizing logistics processes. In particular, optimization in the area of hospital logistics offers the opportunity to reduce costs while maintaining quality assurance. This thesis considers the logistical process of sterile supply, which has the task of providing and preparing sterile surgical instruments. As an sub-process of the surgical process, it is of essential importance both from the point of view of economy and quality. The aim of this work is to develop an optimization approach for the sterile supply process which, with the aid of a mathematical model, combines the decision on the grouping of reusable instruments in trays and the decision between the use of a disposable or a reusable instrument. The combination is intended to unlock optimization potential from synergies of the interdependent decisions. The research contribution of the thesis consists, on the one hand, in a systematic literature review on the state of the art of sieve optimization and the disposable-reusable decision, and, on the other hand, in the development of a new problem, which has not been addressed in the literature before, but is highly relevant in practice. The problem is represented in the form of a mathematical model and a mathematical optimization approach is developed to solve the problem. The optimization model is implemented in the optimization software GAMS and applied to a practical case study using the solver CLPEX. For the purpose of an efficient implementation, an algorithm for the linearization of model variables is also designed. Based on the case study, the savings potential of the optimization approach for the gynecological clinic of a maximum care provider can be estimated at almost 80,000 euros per year.

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