New structure speeds treatment at Munich emergency department

A reorganisation at Munich’s Harlaching hospital has significantly shortened treatment times in its emergency department, according to the clinic, but other hospitals say the model cannot simply be copied. BR24 examined what has changed and whether the approach can work elsewhere.

The clinic has been testing the new structure for about a year. It says patients are now treated much faster than before, and the waiting area is often empty. The changes followed questions from BR24 readers, some of whom praised the results while others wondered whether the system could work at every hospital.

Space and coordination are central

Tim Flasbeck, who leads in-hospital emergency medicine at the municipal Munich Clinic, developed the concept after finding that paperwork and searching for beds took time away from patients. He drew on discussions with nursing staff. The emergency department he redesigned in Cottbus is considered a model project.

Flasbeck says emergency departments need sufficient space and capacity, and their role within a hospital must be recognised. Rivalries between departments can undermine their work. At the newly built Harlaching hospital, the emergency department was placed in areas considered more suitable than the rooms originally planned for it.

Care also depends on coordination, from initial assessment and treatment to admission to a hospital ward or referral elsewhere. Flasbeck says effective bed management based on statistical experience is essential.

The new structure includes an intermediate holding area where patients can sit or lie down after receiving initial care. Some readers questioned whether this simply shifts nursing work elsewhere. Flasbeck said patients feel better cared for when nursing staff can keep them in view, rather than leaving them worried they may be overlooked in a waiting room.

Hospitals say there is no universal blueprint

Matthias Klein, head of the emergency department at Munich’s Großhadern University Hospital, welcomed the improvements in Harlaching and said his team was studying the changes for ideas. But he cautioned that hospitals differ both in their buildings and in how they are organised. Some features, including a holding area, are already in place at Großhadern.

Markus Wehler, head of the emergency department at Augsburg University Hospital, also said there was no single blueprint for all emergency departments. He cited notifications to the emergency dispatch centre that a hospital cannot accept patients because it is full: the Munich clinics have sharply reduced these notifications under the new approach.