Logistical Innovations on the Centralized Surgical Platform of Munich University Hospital

On October 21–22, 2025, a delegation of French hospital executives participated in a study tour in Munich focused on organizational performance and logistical innovation within the centralized surgical platform of Munich University Hospital.

The objective of this mission was to analyze how a German university hospital structures, manages, and optimizes a large-scale centralized operating theatre complex, integrating key challenges related to surgical scheduling, logistics, sterilization, ambulatory surgery, and activity ramp-up management.

Day 1 – Strategic and Organizational Vision of the Centralized Operating Theatre

The first working session was dedicated to understanding the overall organizational model and governance structure of the centralized operating theatre. Discussions with medical and nursing leadership provided insight into the project’s origins, its initial objectives, and the structural choices made regarding centralization, allocation of responsibilities, and operational management. Surgical scheduling and the allocation of human and material resources were central themes throughout the exchanges.
The guided tour of the facilities offered a concrete view of patient pathways for both inpatient and outpatient surgery, as well as the layout of operating rooms and staff areas. Observing the logistical circuits and the integration of the sterilization unit highlighted an organization specifically designed to ensure smooth patient flow and pathway safety. This first day underscored the continuous effort to balance activity volume, quality of care, safety, and efficiency.

Day 2 – Operational Analysis in Real Conditions

The second day provided an immersive experience into the day-to-day functioning of the operating theatre, with real-time observation from the start of daily operations. Participants analyzed the organization of patient admissions, coordination between surgical and anesthesia teams, and the management of activity ramp-up. Real-time performance monitoring and the ability to adapt to unforeseen events emerged as key determinants of overall efficiency.
A dedicated session focused on logistical circuits, sterilization processes, and the management of sterile medical devices. Discussions emphasized that logistics is not viewed as a secondary support function, but as a strategic lever directly contributing to cost control, safety, and time optimization. Close coordination between operating theatre teams, pharmacy, and logistics management is integral to this integrated performance model.
The visit continued with an in-depth analysis of the ambulatory surgery center and the patient pathway from admission to discharge. The organization observed demonstrated a specific structuring of teams and circuits designed to ensure fluidity, predictability, and reduced length of stay. Ambulatory surgery clearly emerged as a major driver of organizational transformation.

Key Takeaways and Perspectives

Several structural lessons emerged from this mission. Large-scale centralization relies on clear and shared governance, as well as process standardization. The performance of the surgical platform is inseparable from the quality of its logistical organization and the ability to manage activity with precision and responsiveness. The German financing framework, based on activity-based payment through the G-DRG system, creates strong incentives for efficiency and length-of-stay optimization.
The mission fostered in-depth exchanges among participants from hospital executive teams, operating theatres, and national institutions. Debriefing sessions enabled the identification of transferable levers within the French context, as well as key success factors for centralization initiatives.

This study tour confirms that international benchmarking is a powerful tool for strategic analysis and a strong source of inspiration for advancing hospital organizational models.