Applying industry solutions to the hospital sector Ole Klinkby by NNE Pharmaplan ScanBalt preentation
Who we are We are the leading consulting and engineering company in the complex field of pharma and biotech. We are1,700 professionals with project experience and knowledge related to pharma. We executed 2,667 projects last year Company revenue 202 M EUR Company revenue 2011 USD 261M 2
Closer to our customers We are global with 25 locations in 12 countries around the world. 97% of our revenues come from the pharma and biotech industries 3
Why hospitals Personalised drugs and treatment The general trend moves away from blockbuster drugs to more personalised drugs, presenting completely new challenges to pharma companies. Stem cell treatments Tissue engineering Personalised drugs Production of pharmaceuticals and treatments will move closer to the patient and into the hospital Both the pharmaceutical industry and the hospitals will be challenged by this development and new regulations 4
Project overview Radiumhospitalet, Oslo, Norway Project Size : 20 000 m2 Architectural Competition; 2000 Construction period 2005 2009 Cell and Gene Therapy Clean room area: 500 m2 The project was executed by a consortium of companies 3D rendering showing the Cancer Research Hospital seen from the South. 5
Relation to realities.. 6 6
Cell & Gene Therapy department overview 1 3 2 1 Main Entrance Research building 2 Entrance Cell Gene Therapy unit 3 Stem Cell Harvest 4 CGT offices and personnel area 5 4 5 6 7 Personnel Airlock to clean room area Quality Control Lab Cell Therapy Laboratory 6 7 8 9 Nitrogen preservation room Gene Therapy Laboratory 8 9 7 R3 Symposium 2008, Case Story CGT Cleanrooms, Radiumhospitalet
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Fast track In traffic, fast is not a virtue. In pharmaceutical engineering we believe it is. And we have pushed the limits many times. This Novo Nordisk project used a modular and fast track approach to supply a lifesaving drug. The facility received the ISPE Facility of the Year award for both speed and design. 11
12 Off site and modular
The Challange Challenges for tomorrows hospitals The hospitals that is established now shall be so flexible that they can adopt to new technology and treatments The existing hospitals is not designed for this 10 % of the buildings on Danish hospitals is under constant reconstruction These reconstructions effects yearly the production of health to a value 1 billion EUR And the treatment of 100.000 patients, half a million beddays and 700.000 visits on ambulatories. 13
The Concept Process oriented mindset, where design is dictated by function and organization Standardize elements in infrastructure and modules Off site construction and industrial quality The Modules is interchangeable in a flexible infrastructure Re defining the hospital of the future 14
Flexhospitals replacing the modules The moduleis lifted an push into position 15
Modules Standardisation and modules is not new flexibility is... studies for Nya Karolinska 16
17 Module configurations
Modules Is optimised towards many parameters Evidence Relations Tracability Integration Function Workflow Sensors Cleaniness Supply Material flow Sustainable Patient flow Communication Medicotechnics Waste Logistics IT & data Staff flow 18
Termonology Applikation modules ( Hospital apps ) Base module Docking station. (Infrastrukture water, ventilation, IT and logistics e.t.c..) 19
Infrastrukture Standardise and off site construction Easy maintance and upgrade Cost effective production Quality ensurence Fleksibility Ventilation Heating and cooling Sprinklers Medical gasses and water pneumatic post Electricity and IT infrastrukture Sensores Monorail 20
Reference hospital project Project; New University Hospital in Aalborg The new University Hospital in Aalborg will be the cornerstone in Region Northern Jutland's health service with an TIC 550M and an area of 135.000 m 2 Project won April 2012 with the Indigo consortium 21
Reference hospital project Projekt; Herlev Hospital 52,000 m2 extension of Herlev Hospital will consist of a new joint emergency admissions section, Intensive care unit, Gastro Centre and mother child center. TIC 385M NNE Pharmaplan is responsible for all installations NNE Pharmaplan provides logistics concept Project won in May 2011with Henning Larsen Architects: 22
Reference psychiatry project Project; GAPS Psychiatric hospital in Slagelse The new psychiatric hospital in Slagelse going to be an academic beacon in Region Zealand psychiatry TIC 44000 m 2 and TIC 133M NNE Pharmaplan is responsible for building installations The project won in November 2010with Karlsson Arkitekter 23
Cost effective operation and facilities Cost effective production is a must to survive in the highly competitive pharma market. Evolution calls for operational excellence, and we can help you get to the next level. 24
Challenges Leanflow Patients does not only need competent treatment, but also a coordinated and effective treatment. Patient treatment takes place across complex organizational boundaries Treatment is given to patients in a timely manner and as quickly as possible so the effect of treatment and the economy is optimal Hospital resources must be optimal allocated for health production
The Goal To ensure patientflows starts as soon as possible in time and that all players in the individual flow can communicate smoothly about the treatment That scarce health resources used for patient treatment and quality parameters are met.
Lean flow Aim to gather patient pathway across sectors and organizations Ensure overview of responsibilities and contacts in the flow Ensure overview of the tasks in the flow and provide early warning Provide overview of the patients included in several treatments Create an ability to patients and caregivers for an overview of their treatment plan Quality assurance and detect bottlenecks Family doctor X ray Neuro logic Neurosurgical dept X ray Onkologic dept Family doctor Municipal rehab Edifact MR scan MDT PREEXAM NEURSUR Surgery Post SUR MR scan MDT Oncology consult. chemo therapi control
Lean flow Aim to keep track of many parallel processes and ensure consistent communication and transitions in the process Henvisning MR scan MDT FU NEURKIR OP Post OP MR scan MDT Onkologi konsult. Stråle/ kemo terapi Kontro l Henvisning MR scan MDT FU NEURKIR OP Post OP MR scan MDT Onkologi konsult. Stråle/ kemo terapi Kontro l Henvisning MR scan MDT FU NEURKIR OP Post OP MR scan MDT Onkologi konsult. Stråle/ kemo terapi Kontro l Henvisning MR scan MDT FU NEURKIR OP Post OP MR scan MDT Onkologi konsult. Stråle/ kemo terapi Kontro l Henvisning MR scan MDT FU NEURKIR OP Post OP MR scan MDT Onkologi konsult. Stråle/ kemo terapi Kontro l Henvisning MR scan MDT FU NEURKIR OP Post OP MR scan MDT Onkologi konsult. Stråle/ kemo terapi Kontro l
Automation and IT Automation & IT are key to obtaining competitive advantages by achieving faster, more efficient delivery at lower costs without compromising flexibility and quality. 29
Patient safety medication Automation General challenges: The hospital is a busy workplace where there are many contacts with colleagues and with a large flow of patients in a fast paced and varied work. This, in combination increases the risk of errors 6800 patients is treated with inappropriate medication, and up to 1200 people die every year in Denmark Source: SST 2008 og Akershus Sentralsykehus (N) 2001 30
Design og implementering af medicinsikkerhed The challenges include: The medicine is too old The staff is disturbed when the dispensing the medicals The dispensed is not in accordance with the prescribed There is no assurance that the patient has taken the medication There is used to many resources on the medication process 31
Design og implementering af medicinsikkerhed The goal: To obtain fewer medication errors The ability to document every step of the way medicine from stock to patient To create a better working environment and reduce the number of critical tasks Rationalise area and achieve economic gains 32
Quality assurance of process and economy Procurement Supply Prescription Dispensing Validation Employee and culture Work Transition indication,, Safety Uniform quality in the process Automation of manual tasks Registration and documentation Full tracability Technology Medical module in EHR, Patient administrative RFID tracking Logistic by Pneumatic Tube System ERP Medical effect registered in medical sensors 33
Design and implementation of medication safety All part of the medicines path from the pharmacy to the patient is documented and automated Medication process integrated with Medicine Module, inventory management and accounting. Process is both clinical, logistical and financial documented and validated Full traceability in the medication process with RFID tags Automating tasks that potentially contain danger of failure. 34