TEMPORARY BUILDINGS
temporary facilities to be put in place at short notice and for periods ranging from a couple of days to months and, in some cases, even years. Balancing the economics is a key consideration of the estates and hospital management teams. Using data from a temporary facility
deployed for day case ophthalmic surgery in a hospital in England, for example, Vanguard teamed up with British Association of Day Surgery (BADS) to evaluate the cost- effectiveness of using a mobile solution. One month’s activity data was analysed (the theatre was operating for 23 days within the month, from Monday through to Friday) and it was found that the activity through the theatre generated net income to the hospital of £207,959 (€262,307) after deduction of costs relating to surgery. The deployment of interim surgical space
and resources enables hospitals and other healthcare decision-makers to establish a surgical service quickly, without the need to commit to long-term costs – an issue very much front of mind for estates professionals who need constantly to gauge employment of assets against budget. Mobile facilities can also be assembled within hours of arrival at the site. The estates challenges facing healthcare
providers in the UK are echoed in other parts of Europe and in many respects, other parts of the world too. The installation team needs to work closely with the host’s estates department during the planning process to ensure a smooth integration of service with the other departments. Having a flexible solution enables healthcare providers to treat more patients without any loss of service, standards or significant capital whether for refurbishment or new build projects. Of course, time is a precious commodity
when tasked to find alternative facilities during a refurbishment project, so a detailed planning process needs to be put in place to ensure that every element of the estates management strategy has been considered. A comprehensive pre-deployment site visit
by both logistics and estates teams is required to identify the most suitable location for the mobile unit. Factors can include patient flow, infection control, fire, security, utilities connections and maintenance. Linking corridors to the main hospital
building will also be discussed at this point to help ensure that the unit does not disrupt any aspect of the running of the hospital, from the installation phase through to clinical delivery. Emergency exits, inter- departmental pathways, patient accommodation and communications are other essential elements of the planning process to ensure that the same standard of service continues to be provided as when surgical procedures were conducted in the original facility.
Collaboration and teamwork Collaboration and teamwork need to be at the centre of estates operations. Working
IFHE DIGEST 2013 The mobile surgery unit deployed at Moorfields Hospital.
closely with client estates and clinical professionals, will allow external companies to solve the challenges associated with short- term refurbishment and/or build projects. This is especially important where the estates team is not experienced in working with external suppliers on projects of this type. As a result, estates managers should expect service delivery to include site inspection and specific site recommendation; delivery; installation and connection to a 125 Amp
3 Phase power source; unit equipment commissioning; maintenance; and collection. A 2011 survey undertaken on behalf of the
company revealed that 95% of Vanguard’s customers would use its mobile healthcare facilities again. The NHS is the largest and most complex
estate in Europe, compromising around 25 million square metres of occupied floor area, with a value of around £36 billion (€45 bn) comprising buildings and
47
Moorfields’ experience
Moorfields Eye Hospital deploys mobile healthcare services to provide temporary ophthalmic facilities during major refurbishment.
Moorfields Eye Hospital NHS Foundation Trust is one of the world’s leading eye hospitals, focusing on the treatment and care of NHS patients with a range of eye problems requiring treatment. The medical team treats patients at the City Road hospital in London, in addition to 21 other locations in and around the capital, making it one of the largest centres for ophthalmic treatment in the world. Moorfields treats more than 400,000 patients a year.
To continue providing expert care closer to patients’ homes during a major renovation process at one of its main satellite sites, the hospital deployed a mobile operating theatre and adjoining ward to enable surgery patients to continue to be treated locally by Moorfields medical staff.
The hospital required a modern temporary facility with the latest technology to be on site, so they could continue serving NHS ophthalmic patients while a major refurbishment project was underway at their facility at Northwick Park Hospital, in Harrow, one of Moorfields Eye Hospital’s major satellite sites (calling on the expertise of the central hospital and providing delivery of ophthalmic services to dispersed local communities). The new development plans included turning two whole floors of the facility into a Moorfields day surgery centre.
To help ensure a smooth flow of patients and continuation of specialist services, service delivery manager at Moorfields Eye Hospital NHS Foundation Trust, Ann Arnold, made the decision to initially call in a fully specified mobile operating theatre – compliant to all regulations and hospital hygiene and other standards – to increase capacity while development of their service provision took place between 2006 and 2011.
“The mobile unit – a self-contained day surgery facility, complete with operating room, anaesthetic, recovery and utility areas and a staff changing room – enabled the specialist teams and consultants to deliver continued and convenient access to treatment that we regularly carry out at the hospital, without any disruption to our patients”, explained Ms Arnold. “Then, in 2008, a ward unit was deployed together with the mobile operating theatre for an additional three years to form a ‘satellite’ treatment centre while the refurbishment was still taking place. Patients were admitted, prepared, operated on, received in recovery and discharged without requiring admission to the main Northwick Park facility, all the time being treated and supported by Moorfields doctors and staff.
“The development was a major change at Northwick Park. It was particularly important to ensure that with the mobile units we were able to continue to provide an excellent standard of care and treatment for our patients in Harrow, while this work was taking place.”
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