Rosenklinik, Swiss Medical Network, Switzerland: Optimizing processes in total joint procedures to increase OR throughput from 8 to 10 surgeries per day

Rosenklinik, a small private clinic that is part of the Swiss Medical Network Group, specializes in orthopedics, particularly focusing on total hip and knee replacement. They are continuously striving to optimize and elevate their treatments based on the latest innovations and scientific findings. As their practice needed to expand to meet high patient demand, Rosenklinik engaged with to further optimize and streamline their OR processes, with the goal of treating more patients per day in the available two ORs without compromising the quality of care. 

Partnering with 

Baseline Measurements

In March 2023, for two Rosenklinik ORs measured baseline data of four total joint cases (total knee arthroplasties and total hip arthroplasties) per OR in a single surgery day, as shown in Figure 1 below (2 ORs).

Figure 1. Day overview of baseline measurements.

The data that gathered enabled the Rosenklinik team to obtain a clear and transparent picture of their current processes, as well as allowed them to gain insights on best practices and process inconsistencies. This knowledge laid the foundation to enable sustainable change.

Baseline results showed opportunities for improvement in the preparation and breakdown processes, as well as in the material breakdown process.

Change Management created digital twin simulations, also known as process digital twins, and discussed them with the surgical team, which guided the creation of a change implementation roadmap. The simulations demonstrated the opportunity to add an extra case by the end of the day through optimizing preparation and breakdown processes, as shown in Figure 2 below. The optimizations would enable the Rosenklinik team to perform ten instead of eight joint replacement surgeries per day.

Figure 2. Top: Data from baseline measurements. Bottom: Simulation of the OR day with implementation of best practices. facilitated a workshop to help the team manage change effectively, including helping them align around new processes collaboratively. Simulations for the SOP were based on the best-observed cases in Rosenklinik, which meant that the proposed implementations were feasible and acceptable for the entire surgical team to implement.


One year later, in March 2024, performed post-implementation measurements. The results demonstrated that the Rosenklinik OR team optimized their processes, resulting in consistent preparation and breakdown processes, as shown in Figure 3 below. 

Figure 3. Parallelization flow and consistency for baseline measurements compared to post-implementation measurements.

The data shows that the Rosenklinik OR team is now able to perform five joint replacement surgeries per OR per day, increasing from eight to ten joint replacement surgeries in total per day (2 ORs), as shown in Figure 4 below.  

Figure 4. Day overview of post-implementation measurements.

Next Steps

The OR teams in Rosenklinik remain committed to continuously improving and delivering best-in-class, high quality service to patients of their growing practice. They will soon embark on a journey aiming for twelve cases per day by implementing further process innovations.