The hybrid operating room is the standard of the future, on that medical opinion is largely unanimous. While the combination of conventional operating equipment and angiography has long posed enormous challenges for hospitals in terms of design and construction , only now is prefabrication being viewed as a solution: the prefabrication specialist Cadolto, based in Cadolzburg near Nuremberg, showcases a complete hybrid operating room module.

Room design challenge
The hybrid operating room is gaining ground everywhere. It is now no longer only cardiologists and heart surgeons who are enthusiastic at the prospect of performing minimally invasive, catheter-based and conventional operating procedures in one and the same operating room ; this will sooner or later become the norm in the majority of surgical disciplines .

When image-guided diagnostics make their way into the traditional operating theatre environment, it is not simply a case of installing new equipment. Rather, the hybrid operating room revolutionises the whole layout and equipment of the room. For example, the angiography units require a different arrangement of the operating room staff around the patient. This means that the paths taken by staff, for example in the event of complications, must be carefully thought through. The ceiling mounted screens affect the air flows in the room and also hygiene management . More space is required for ancillary rooms and storerooms, and much more besides.

The first prefabricated solution
In other words: hybrid technology is completely redesigning the operating room. The complex issues which arise have hitherto always been dealt with on a case by case basis by interdisciplinary teams in lengthy, complicated processes .

In future, hospitals will no longer necessarily have to shoulder this extremely costly burden for each project . A new room module developed by Cadolto for the first time translates the knowledge of hybrid operating room experts into a rational prefabricated concept. In close collaboration with Siemens Healthcare and the companies Maquet and Trumpf, the global market leader in high-tech modular buildings has developed a room unit, unique in terms of complexity and design features. Conventional operating room technology, high-end imaging and workflow-oriented room and space management are combined in a hybrid solution that meets the highest current standards in cardiology, heart and vascular surgery, neuroradiology and neurosurgery

Specialist in prefabrication in the factory
Cadolto has for many decades been operating on global scale as a leading specialist in the construction of complex, technically sophisticated, modular buildings. The company’s key expertise lies in the high proportion of the building prefabricated in the factory. This enables the rapid completion of a turnkey construction projection. The company’s comprehensive design and consultancy service, factory prefabrication and rapid, cost-effective and high quality completion of construction projects gives Cadolto customers the security of a professional partnership.

Source: http://www.bbc.co.uk/news/uk-england-london-13683630

Source: http://www.ehfg.org/862.html

Source: http://in-medica.com/press-release/Global_Telehealth_Market_Set_to_Exceed_1_Billion_by_2016

Source: http://www.pr.com

Source: http://www.healthcareitnews.com

Source: http://www.insidermedia.com

And, for its part, Ireland is behind the pack in terms of healthcare IT. The HSE spends just 0.75% of its budget on IT; our frontline staff are not as tech-savvy as some European neighbours; and just 0.4% of the health workforce are IT specialists – a few hundred computer wizards kept busy with mundane maintenance tasks.

Any hope of playing catch-up will depend on the willingness of the health workforce to buy into the promise of eHealth at a time when budget cuts and staff ceilings are sapping goodwill from the system.

Cross-border challenges

Europe as a whole has hurdles to clear before it can make the most of eHealth. Over the past decade or so, hospital departments have worked with niche IT companies to develop customised computer systems. This tailor-made software might be ideal for the radiology unit or emergency department, but might not be able to ‘speak to’ the system used in, for example, the operating theatre.

If hospitals are running incompatible software, it’s going to take quite a leap to develop interoperable IT systems that would allow cross-border sharing of electronic patient records.

But for the most part, the technology isn’t the problem. It already exists. The stumbling blocks are linguistic and cultural, political and philosophical. They are about security, trust and data protection – and about addressing the disparity between the trend-setting Scandinavians and their less-developed cousins in Bulgaria. It’s a classic EU problem.

Now though, political momentum is gathering behind eHealth as new technologies offer the prospect of shifting patient care away from spending expensive days being treated in city-centre hospitals.

EU health ministers have committed to putting eHealth at the core of governments’ efforts to improve quality and safety, and the European Commission has just completed a consultation process which will feed into a revamped eHealth policy paper later this year.

Power to change

Brussels is limited in what it can do in the area of health care. The Lisbon Treaty is clear: how health systems are funded and organised is a matter for national governments. But standard-setting and cross-border cooperation fall neatly within Europe’s remit and the Commission is gearing up for a major push to break down barriers to the free movement of patients.

The future, we’re told, will see more patients with chronic conditions (like diabetes or heart disease) managed and monitored remotely in their homes – whether they live in the suburbs or on the edge of a rural village.

The impetus for change is the need to reform health systems to deal with Europe’s ageing population, along with the fashion for finding more cost-effective ways to run public services.

On paper, eHealth is a no-brainer – hospitals and clinics should simply change their ways in the morning. Alas, we know well how challenging health reform can be given the numbers employed in the service and the strength of professional groups. And, even if efficiencies are promised in the long-term, finding cash to meet the upfront costs of shifting to eHealth technologies is a hard sell in times of austerity.

Is it worth it?

The ACCA – the charted accountants’ professional body – hosted a conference in the European Parliament recently at which speakers wheeled out examples and pilot studies where e-health had saved time and money.

Whether it was by early diagnosis and intervention, or simply by saving the time of specialists who currently have to drive between hospitals to review files, the accountants seem to think it will work.

EU Health Commissioner John Dalli, himself a fellow of the ACCA and a former Maltese finance minister, also sees IT as the kind of game-changer that could put Europe’s health services back on a sustainable path.

Along with MEPs, he helped to ensure that the new EU cross-border healthcare directive includes a specific section designed to accelerate cooperation between national health authorities on e-health.

His colleague Máire Geoghean-Quinn, the commissioner for research, innovation and science, has made healthy ageing the subject of the EU’s first ‘Innovation Partnership’. This, in short, means money will start to flow to projects that develop telemedicine and ‘ambient assisted living’.

Skills deficit

So the moneymen and the politicians are on board. The big problem remains frontline staff. There is talk of developing a new grade of allied health professional – the eHealth technician. But in a world of staff ceilings and falling budgets, what will this mean for doctors and nurses?

At the HSE, the man in charge of steering the ship towards a high-tech future is Gerard Hurl, national director of information and communications technology. He says the evidence supporting the benefits of ICT in health care is ‘becoming mature’ now and the returns on investment and patient care are clear, if it is done right.

However, big-ticket ICT projects have something of a chequered past in Ireland – think ‘PPARS’ – so winning over the public and staff is key to successfully deploying new technology.

‘To get where we want to be is an issue given economic climate,’ Hurl tells me. ‘We need buy-in from politicians and the public. But we also need commitment from the healthcare workforce.’

That means all staff. The HSE will need to train doctors, nurses and administrators in how to get the most out of IT. Of the 110,000 employed in the public health service, ICT directly accounts for 310 within the HSE, with a further 200 or so in voluntary hospitals.

A good chunk of these are the people you call when your email server crashes. They are not programmers, data encryption experts or IT architects. Those guys work in multinationals, financial services and management consultancies.

Silver lining

Health care has been slow to adopt IT, especially when compared with other sectors like banking where customer information is also sacrosanct. And Ireland is playing catch-up compared to the investments made in France, Denmark and some of the Spanish regions.

But the good news is that late developers get to learn from the mistakes of others. This helps us spend our scarce resources in a less speculative and wasteful way. We can look smarter, even if we’re not.

Whether doctors and others are in the mood to embrace high-tech reforms will decide the fate of ehealth in Ireland.”

Source: http://www.euractiv.com

“Patients and staff have a right to use and deliver the service in an atmosphere of mutual respect and safety and we look forward to working with the Department of Health and Design Council on this important project ”The Design Council, on behalf of the Department of Health (DH), has selected PearsonLloyd to lead a year-long project exploring how the layout and operation of A&E departments can have a direct impact on levels of aggression and violence.
 
The design agency was selected from a field of 47 applicants by an independent panel of 20 experts. It will work in conjunction with the Helen Hamlyn Centre for Design, the Tavistock Institute, Tavistock Consultancy Service, Tavistock and Portman NHS Foundation Trust, Dr Nigel Caldwell of the University of Bath, and Professor Jonathan Benger from the University of the West of England.

The team will now produce suggestions for design improvements following consultation with frontline staff at three NHS hospital trusts in England. The resulting solutions will be unveiled in October and could address a wide range of issues including service transformation and interior design.
 
PearsonLloyd is already known to the healthcare sector, having been successful in securing funding as part of the DH’s Design Bugs Out Challenge, which looked at new designs for key pieces of hospital furniture that would assist with infection control. That resulted in the launch of an easy-clean patient commode and bedside chair range.
 
Commenting on its success in the A&E design challenge, Sunand Prasad, chairman of the judging panel, said: “This project stems from the belief that the experience of going to and working in an accident and emergency department can be hugely improved by rethinking their design. That has to mean design in its widest sense, from organisations aspects to the physical settings in which they will spend time.

“The applications to take part in the challenge were hugely impressive in the evident talent of the teams, as well as their focus on people’s experience, PearsonLloyd’s submission demonstrated exceptional capabilities to creatively analyse and address key issues across their breadth and depth.”
 
Welcoming the funding, Tom Pearson of PearsonLloyd added: “The team is delighted to have been awarded funding to tackle such a challenging role as reducing violence in A&E departments through design. Patients and staff have a right to use and deliver the service in an atmosphere of mutual respect and safety and we look forward to working with the Department of Health and Design Council on this important project.”
 
According to research from the Care Quality Commission, 11% of NHS staff experience physical violence from patients or their families. Further research by the NHS Security Management Service shows this figure is increasing every year, with more than 150 assaults a day on staff. The cost of this is estimated to have reached more than £69m a year in staff absence, loss of productivity and additional security.

The ambition now is that innovations emerging from the project will be applied universally at NHS facilities across the country.
 
Commenting on the possible impact the initiative could have, Chris Howroyd, who is leading the project for the Design Council, said: “I think it is foolish not to think there is a link between the environment and the way we feel and behave, and previous research shows design can have an impact.

“The bottom line is to reduce violence and aggression in A&E and we will be looking for anything that shapes the experience with reference to design.
 
“We will look at the layout, including how the space is used and furnished, and the information provided to the patient during their visit.

“The value of design is, and has been, undervalued in the NHS and healthcare sector generally. We are also behind other countries in valuing the impact of design for the provision of healthcare and the experience of patients and staff. What we are trying to do is put together common solutions that can be applied across all NHS estates.”

Source: http://www.bbhealthcare.co.uk

Currently, some hospitals are paying nearly three times as much as others for the same products, such as surgical gloves and stents. But the new system from standards specialist, GS1 UK, will make it easier to track and compare purchases, helping to eradicate price variations and slashing spending by cutting down on surplus stock.
 
The use of a single barcode system has already been widely adopted across the retail sector, enabling the introduction of supermarket price comparison websites and ultimately driving down cost.
 
And it is also expected to improve patient safety as barcode systems have been shown to reduce medication errors and the risk of wrong-site surgery, while boosting the tracking and tracing of surgical instruments, equipment and other devices to improve record keeping and reduce error, malfunction and contamination.

The system was unveiled last week by Health Minister, Simon Burns, who said: “The NHS cannot afford to continue paying different prices for the same products. By simply using barcodes, NHS procurement will become more efficient as organisations can see how much they are paying for products compared to others. It’s a simple idea that could save the NHS millions.
 
“Most importantly, this is a vital opportunity to save money for re-investment in frontline care at a time when the NHS needs to make efficiency savings. The NHS has enormous buying power if it works consistently and GS1 barcoding is a key foundation block to improve it.”

Leeds Teaching Hospitals NHS Trust has been trialling the system and has already saved £570,000 in a year.
 
By scanning barcodes as equipment is used on wards, the system can track available stocks and forecast future orders. This means the trust no longer needs to ensure that surplus stock is available in case it runs out as the system tells them exactly how much equipment they have in stock in real time.
 
Graham Medwell, information manager in the supplies department at the trust, said: “Leeds Teaching Hospitals NHS Trust fully supports the Department of Health’s recommendations that the GS1 barcoding system should be adopted throughout the NHS.
 
“Since adopting the standards there have been real improvements in stock control, with levels available to view in real time. This has led to significant efficiency savings and improved productivity”
 
Now ministers want those businesses supplying the NHS to identify and label their products with GS1 barcodes.
 
Burns said: “The Department of Health expects that all products should be identifiable by, or carry, GS1 barcodes by the end of 2012.”

Source: http://www.bbhealthcare.co.uk