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INTENSIVE CARE FACILITIES


The success of the design will be evaluated in the autumn of 2019 via a post-occupancy evaluationconducted among staff


results indicated that, for a hospital of this size, unifying the facilities made logical and practical sense, because the staff’s wide-ranging expertise can be harnessed more efficiently, and both the quality of care and outcomes improved. The hospital’s intensive care unit, neurological intermediate care unit, coronary care unit, and gastro-surgical observation unit, were thus brought together to form one ‘united’ intensive and intermediate care unit. The interventional cardiac unit – equipped with six observation beds – was also accommodated within the plans. The second challenge was to


determine whether all the rooms should be single rooms, because the original space allocated was insufficient to allow this. Plans for a 100 per cent single room facility and for a set number of rooms were, however, maintained. The new ICU incorporates 24 single patient rooms for intensive and intermediate care. The 2,400 m2


facility, on two floors, was


formed via the refurbishment of an old ward with two extensions. The new ICU is on the same floor, with offices, meeting rooms, and a staff cafeteria one floor below.


Opaque glass To ensure good visibility, the walls between the patient rooms and the doors are glass. To maintain patient privacy the electric glass windows can be changed from clear to opaque ‘in seconds’ (Fig. 2), while the nurse stations provide good visibility to patient rooms. All the rooms feature a standardised design, while mobile cabinets accommodate the same medical equipment. Adequate space around the bed and ceiling supply system, conveniently positioned sinks and hand disinfection dispensers, and ceiling lifts, facilitate the work of staff (Fig. 3), while dialysis is available in all rooms. While it proved impossible to provide


natural light and windows in all the rooms, all feature dynamic lighting to support circadian rhythms, and nature-themed photos on the walls (Fig. 4). Special attention was paid to acoustics


in the new unit, and as a result they are rated as ‘excellent’. The ability to carefully


46


monitor and observe patients is key, and here the new unit supports staff in many ways. For example, the doors to patient rooms can be left partly open, while although staff cannot constantly be at the bedside, technological innovations such as alert systems transfer vital information, while alerts from the monitoring devices are automatically routed to staff smartphones. The display terminals of the smart control centre show the shift- leader the situation in all the patient rooms (Fig. 5), making managing the unit much simpler.


Layout was critical The ICU’s new layout was another critical factor; the design needed to minimise travel distances for nurses. The wards were divided in four modules, each with six beds, and with each module equipped with its own office and small supplies. Among the technological innovations


incorporated were no-touch operation patient room doors that can be opened fully or partly, or locked open, and the ability for staff to control and adjust the internal temperature. The unit also features the hospital’s first ‘smart’ (electronic) medicine cabinets (Fig. 6).


Advantages of the use of ‘VR’ Although the concept of designing all the spaces in the new unit using ‘virtual reality’ was discussed, only the patient rooms, nurses’ station, and bathrooms, were thus designed, due to time and cost restraints. Both the size and configuration of the rooms settled upon were key. The approaches harnessed in the EVICURES project supported staff involvement, and helped to prepare them for a significant change in working conditions. The use of co-design and ‘virtual models’ aided mutual understanding, and meant that all parties could express their views.


Figure 5. The display terminals of the smart control centre.


Conclusions The new intensive and intermediate care unit and the interventional cardiac unit became operational in April 2018. Prior to start-up staff received three months of practical training. All the medical equipment was new, the layout was three times bigger than the old premises, and the new patient data management system was installed at the same time. Overall the staff are happy with the new premises, with their pleasant indoor conditions, and because everything is new. The success of the design will be evaluated in the autumn of 2019 via a post-occupancy evaluation conducted among staff. At this point patient care statistics will also be carefully studied and compared. The Seinäjoki Central Hospital provides


care for 200,000 local inhabitants. The new ICU, with its six intensive care, and 18 intermediate care (including two isolation rooms) beds, offers the best available care in new premises, staffed by 10 doctors and 100 other staff. The unit will receive around 3,200 patients per year, although predictions suggest that this number may increase by up to 25 per cent.


Major reforms Finland’s biggest reform in health and social services to date will commence in 2021, with the preparations already under way all over Finland. The country will be divided into 12 emergency service units, with the Seinäjoki Central Hospital set to be among the 12 ‘around-the-clock’ emergency service units following this reform.


Further reading l A user-orientated, evidence-based design project of the first Finnish single room ICU, Results of EVICURES project (2016). VTT Technology 252. www.vtt.fi/ inf/pdf/technology/2016/T252.pdf www.youtube.com/watch?v=TC-wrfP6TQY


Figure 6. The new unit has ‘smart’, electronically operated, medicine cabinets.


Acknowledgement l This article, entitled ‘Designing the ICU for the future - Seinäjoki Central Hospital, Finland’, first appeared in Healthcare Facilities, the magazine of the Institute of Healthcare Engineering Australia (IHEA). IFHE Digest thanks the author, the magazine’s publisher, Adbourne Publishing, and the IHEA, for allowing its reproduction, in slightly edited form, here.


IFHE DIGEST 2020


IFHE


©Samuel Hoisko


©Samuel Hoisko


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