If you have clearly given ths division director KPI’s on paper he/she is not meeting, I would recommend to rapidly change leadership and with that change create a sense of urgency within the department
Being from the Netherlands I encourage you to keep fighting for concentration. What foreigners might not know is that the Netherlands is such a smal country that you are max 1.5 hrs by car away from one of the two anticipated centers.
I guess you have to be bold and pursue. If two is not allowed go for three. Ask the urologists/medical centers to come up with proposals and select the top 2 (or 3).
Streamline your docter’s payment structure along the KPI’s in the dashboard you develop
Working with front end rules can be performed, @Bergman this is what we do for a living. We only perform surgery on ASA 1 & 2 pt’s, which allows us to do it better planned and at lower costs. For more complicated Pt’s we work with general hospitals that get higher payments for these more compex surgeries.
I would create dedicated OR’s for the planneble care, so that at least a portion of your surgery is very efficiently organised