Therapy for strikes in distress in clinics


The result is encouraging: "Nursing and surgeons have always got grades 1 or 2," says Prof. Dr. med. Norbert Senninger. The return is phenomenally high. "He is 100%, all the patients participated, I have never experienced that!"

The acting head of the Department of General and Visceral Surgery of Klinikum Oldenburg, accompanied by his assistant dr. Wolfgang Probst and his students presented a questionnaire for patients. As a thank you, all participants will receive a green emergency box containing all important emergency documents. Positive returns in the first three months have seen the 66-year-old as a confirmation of his team's good performance. "The team can be proud of that.We look like a flagship department of the hospital."

However, the questionnaires also show poor grades. For example, patients described the procedure as "4 or even 5 when admitted to the hospital," says Senninger. Until a patient is in the service and is supported by doctors and nurses, he is "hesitant and sometimes unprofessional". "The problems are recognized and the house strives to find solutions," said the chief physician, who took over the management of the orphan hospital in November.

The bottlenecks of staff and space are in his opinion the main cause. The board is basically ready to hire more nurses. "But there is no one." In order to improve the recording process, we should also think about the expansion of space capabilities.

Complex operations

As pleasant as the patient assessments for surgery and care at the General and Visceral Surgery Department are, in Senninger's words, the growing number of patients and the complexity of operations. He found 25 patients when he took office at the clinic. "We are now at about 50 years old."

The increase in more complex gastric and oesophageal surgeries has demonstrated patient confidence in the clinic. These financially important interventions also had a positive impact on clinic revenues. The CMI (Case Mix Index) index, which measures the average severity of patient cases, has increased significantly. "The value fluctuates: after 1.4 at the end of last year and an intermediate increase at 2.9, we are now close to 2.0." For comparison: surgical clinics in non-university hospitals had a mean MIC between 1.2 and 1.8.

The head of the clinic welcomes this upward trend, despite difficult conditions. His department had to yield one-third of all beds to other departments. Only 60% of the capabilities of the operating room were available. "As the most serious step, a whole hospital surgery department will have to close because of a shortage of nurses."

No growth possible

Nevertheless: Senninger seems optimistic. Nurses stayed more often at the clinic after their training. One of the reasons for this development is the "very good working atmosphere" between doctors and nurses. "I hope that good experiences are moving."

The chief physician does in his own words "the pressure that problems be solved". His team is able to master all the tasks and manage the clinic effectively. "But growth is not possible."

The team has made excellent progress and regained confidence in recent months. "The internal structure of the clinic has improved considerably, even beyond the numbers."

The rapid positive evolution of the first two months after taking office is "unfortunately slowed down", but is going "in the right direction". To achieve more radical success, "six months is too little," says Senninger, whose contract expires at the end of August.

It then depends on finding a new clinic leader. Talks were in progress. The most important for the experienced surgeon is that the principle of "unconditional attention to the patient" is maintained.