TY - JOUR A1 - Raewer, Henrik A1 - Braun von Reinersdorff, Andrea A1 - Ochotta, T. A1 - Rasche, Christoph T1 - Market and competitive positioning of specialized practices JF - UROLOGE N2 - The provision of outpatient services will be confronted by increased market concentration. Under these circumstances, individual medical practices are predicted to have a minimal chance for survival since by nature the specialized physician can only accommodate the considerably heterogeneous needs of the patients up to justifiable limits. Due to patients’ higher rate of mobility in the elective process, specialty physicians in rural areas are obliged to transform their practices into professional service enterprises. While hospitals are attempting to combat a continuing economization of the health care sector, in part by applying aggressive leadership and management methods, an increasing polarization can be noted in the outpatient setting. Also in the field of urology, patients consider themselves medical treatment clients who are unwilling to be relegated to cases of the often criticized"5-minute medicine.". KW - Market positioning KW - Competitive positioning KW - Specialty practices KW - Outpatient care KW - Patient mobility Y1 - 2011 U6 - https://doi.org/10.1007/s00120-011-2745-x SN - 0340-2592 VL - 50 IS - 12 SP - 1550 EP - 1559 PB - SPRINGER HEIDELBERG CY - HEIDELBERG ER - TY - JOUR A1 - Hogan, Barbara A1 - Rasche, Christoph A1 - Braun von Reinersdorff, Andrea T1 - The First View Concept introduction of industrial flow techniques into emergency medicine organization JF - European journal of emergency medicine : official journal of the European Society for Emergency Medicine N2 - The number of patients seeking treatment in emergency departments is rising, although many governments are seeking to reduce expenditure on health. Emergency departments must achieve more with the same resources or perform the same functions with fewer resources. Patients demand higher emergency clinical care quality, with low waiting times viewed as a key quality criterion by many patients. The objective of this study was to create an improved working system in emergency departments that cuts patient waiting times for first specialty physician contact. Techniques from industrial flow management were applied to the working process of an emergency department and the concept was named 'First View.' A total of 3269 patient contacts using the First View Concept during a treatment month showed statistical significance. Before introduction, a total 3230 patients in a comparative treatment month had a median waiting time before the first doctor contact of 47.6 min, a first quartile waiting time of 36.1 min, and a third quartile waiting time of 62.7 min. After introduction, 3269 patients had a median waiting time before first specialty physician contact of 11.2 min, a first quartile waiting time of 9.1 min, and a third quartile waiting time of 15.2 min. Industrial flow concepts can achieve significant improvements in emergency department workflows in countries in which sufficient numbers of specialty physicians are available. More attention to the organization of emergency department working processes is needed, especially involving lean management. KW - emergency department KW - lean management KW - organization KW - waiting times Y1 - 2012 U6 - https://doi.org/10.1097/MEJ.0b013e32834bbd93 SN - 0969-9546 VL - 19 IS - 3 SP - 136 EP - 139 PB - Lippincott Williams & Wilkins CY - Philadelphia ER -