DESIGN


View of the cardio-thoraco-vascular care facility.


the triangle is an area for visitors, which is connected to all three buildings. The surrounding green areas have been reorganised and sound absorbing septa have been installed. A tunnel connects the new building to an existing network of underground passages, which provide an essential link for patients and the flow of provisions.


Monitoring and evaluation The medical equipment in the new building is the most technologically advanced available, which includes two hybrid operating rooms.2


Thanks to the co-


ordinated work of multi-professional teams, it is possible not only to perform traditional surgery, but new endovascular and endocardial interventions. The technology makes it possible for surgeons to view results and images obtained during diagnosis as well as to carry out investigations on site. In this type of surgery, diagnostics are of fundamental importance in decisions that need to be taken to optimise the chances of the success of an operation.3


A real time


audiovisual connection enables people located in other areas to be virtually present in the room. This is particularly valuable for educational purposes and therefore for a university hospital is of great benefit.


One of the most significant innovations has been the organisation of functions. The new building is structured using a patient centred model of care that is translated into the organisation of spaces and activity based on ‘intensity of care’.4 Where the patient will be treated depends on how serious and complex their condition is.5


The doctor is responsible for


the care pathway and co-ordinates the other specialists and staff without the patient needing to be transported to other parts of the hospital. As a result, there are no more specialist wards with a fixed number of beds, which avoids inefficiency.


During the construction of the complex


there were multiple challenges. As well as delays due to the discovery of archaeological remains mentioned previously, difficulties came from the decision to substitute the previously planned general surgery and liver transplant area with an area for vascular surgery, a specialty that requires different equipment, space and organisation. The patient centred care approach chosen for the new building also added to the complexity, for example, due to need for staff to adapt accordingly. These issues led to a period of monitoring and evaluation at an early stage of the construction. This continued until the pre-


occupancy phase and became essential as the building started to function and in the process of post-occupancy evaluation, which continues. Feedback has highlighted the need for further intervention and adjustment.


Patient centred care Patient centred care has been a focus for discussion among doctors and scholars.6 However, the current literature offers more analysis and questions than conclusions and it appears that we are still in an experimental phase during which hospitals are facing radical transformation while bridging, redesigning and engaging their organisation and staff.7 On completion of the cardio-thoraco-


vascular pavilion, it became clear that special attention should be paid to the flow of people and goods inside the building and between different parts of the hospital. This led to the creation of a working group, which includes medical and non-medical staff and is still active analysing, measuring, organising and monitoring flow. The responsibilities assigned to this group have grown to include the daily organisational structure of the building that were emerging due to the constraints of its shape and from interaction with the rest of the hospital. The goal of the group was initially to


Part of the archaeological site. 44


Interior view of a hybrid theatre. IFHE DIGEST 2019


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