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November 30, 2016

Karolinska University Hospital builds flexible operating room around surgical team

With help from the latest technology, the Karolinska University Hospital (Sweden) has obtained an entirely new surgical environment that is supposed to be among the most modern in the whole world.35 new operating rooms have been build to be flexible, while recognition has been a guide word for the design team. Every room has basic equipment that is the same for all of the operating rooms.

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The rooms are adapted to be able to take care of the university hospital’s various kinds of surgeries. Several of them are being used already. The basic equipment includes surgical tables, surgical lamps, a large set of mobile surgical equipment and an integration solution – which is entirely new for Karolinska. It has more refinements and consists of control systems for medical technology equipment, documentation systems for logging data, telemedicine systems and a video communication system with cameras, several large display screens and video conferencing equipment.

The integration solution is managed over a control panel that is placed for easy access next to the surgical table. It works by the surgical team controlling the medical technology equipment on the panel, choosing what will be displayed on the screens and if they want to communicate with anyone outside the room. Besides the control panel in the operating area, there is another control panel in the room that enables other surgical staff to control certain MT equipment, cameras and where images should be displayed.

Screens part of integrated solution

Three 84-inch screens are a part of the integration solution and are strategically placed on the walls, in a similar fashion in every room. On the large screens, the team has several possibilities to monitor the surgery. The system is flexible and it is the team in the room that chooses what will be filmed and what will be shown on the various screens.

"By just looking up, we can see what we are doing in the room on a big screen. We get both an overview and see details, and we can also get images into the room from outside. With the integration solution, we are now bringing modern technology into the care environment, technology that many of us are already accustomed to from the home environment," says Linus Blohmé, Vascular Surgeon and a member of the project group for the operating rooms.

Everybody involved

"The large screens make it clear what is happening. Everyone immediately sees if anything acute happens. This makes everyone feel like a team and everyone is involved," adds Beatrice Harris, who is a surgical nurse at the Thoracic Clinic and handles instruments in cardiovascular and pulmonary operations. She is one of several people who have tried working with part of the new integration solution in a test operating room.

It is the new digital technology and the possibilities it provides that are the greatest change of the new surgical environments. Harris: "We now have a screen in the operating room with a control panel that we can sterilely cover. With it, the surgeon or somebody else in the team can independently control various parameters. The light and the surgical table can be controlled, the surgical wound can be filmed and, with video-assisted technology, it is also possible to film from the optics."

Working around the patient

The entire new hospital building in Solna is built and planned for new ways of working around the patient, Blohmé  underscores. "What’s important is that the technology shall facilitate and improve the work. Here, we have an environment that is of use for both the patient and the team. By quickly managing the medical technology equipment in the room, we can get around a number of steps in the work process. This involves quickly being able to take an X-ray or to independently, in sterile clothing over the control panel, be able to find earlier images and easily look into the records. This saves time during surgery and increases patient safety."

Video communication support and training

A system for video communication is also a part of the new integration solution. "With the system we have in the new hospital, we can communicate between operating rooms without having to walk between the rooms. It’s also easy to communicate with on-call rooms or the rest of the world from the operating room," says Johan Nordenadler, a graduate engineer and project manager for the supply of MT equipment for the operating rooms.

This means that it is possible directly in the operating room to communicate with and get support from a more experienced colleague in another operating room for example, or talk with another hospital in Sweden or elsewhere in the world by simply connecting to an external specialist on one of the screens to discuss matters during surgery.

The idea is also that the integrated solution will provide a better possibility for training. It is easy to display and monitor the on-going surgery from another location or to record the surgery and then view the film at a training session. Blohmé  believes this part is very important. “We can now more easily communicate with others and we can strengthen learning. We see that the technology will be a way to combine and improve the work both in training and to provide care on equal terms."

Common platform

A common platform has been important to the development project. The rooms are adapted to be able to take care of the university hospital’s many different kinds of surgery where one works based on the basic equipment, which is the same for all and then special equipment is added for more specific surgeries and interventions. "We have strived for recognition between the rooms and there is a set of basic equipment in every room. This makes it easy for the staff to switch between the rooms," Nordenadler states.

"It is exciting to see new ideas being tested and hopefully, these environments will be able to become a well-functioning reality for those of us who will work in the new operating rooms. The rooms will support the ways of working around the patient. Many procedures in healthcare now place high demands on technology. In this new environment, we have tried to join together new technology and new ways of working. What has been important to develop has been the possibility of information technology in all of the operating rooms," says Linus Blohmé.

Karolinska University Hospital has taken over part of the new hospital building. The first patients have moved in on 20 November 2016. The entire hospital will be finished in 2018.

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