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A benchmark in healthcareIn Association With:ROYAL ADELAIDE HOSPITAL:The new Royal Adelaide Hospital (new RAH) is showing the world how technology can vastly improve…
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A benchmark in healthcareIn Association With:ROYAL ADELAIDE HOSPITAL:The new Royal Adelaide Hospital (new RAH) is showing the world how technology can vastly improve patient outcomes in a cost-effective manner: automation and data integration work hand-in-hand to get more people wellOn 6 September 2017, the doors finally closed on the much-loved Royal Adelaide Hospital as an honour guard of about 100 staff members gathered outside its Emergency Department, spontaneously cheering and applauding as the last patient was wheeled out the doors and carefully loaded into an ambulance for the trip to the $2.3bn new RAH.This marked the completion of a progressive ‘soft opening’Exterior from HYLC39process. Minor surgical procedures and outpatient appointments had been taking place at the new RAH for some weeks to accustom staff to the different systems. As many as possible of the 600 in-patients had transferred to other hospitals. The remainder were moved across at the rate of approximately 100 a day on 4, 5 and 6 September. The official opening of the new facility can be best placed at 7am on Tuesday 5 September, at whichpoint the old emergency department closed to new admissions and the emergency department of the new hospital simultaneously took over. It’s more than 30 years since a new hospital was commissioned in South Australia, so the opening was always going to be a landmark event for the state’s 1.6mn citizens. But the new RAH is much more than added tertiary healthcare capacity. It is the most advanced hospital in the whole of Australia, and the single largest infrastructure project in the history of the State of South Australia. The financing, design, construction and operation of the non-clinical services for the next 35 years was undertakenby SA Health Partnership Consortium (SAHP), made up of Hansen Yuncken, Leighton Contractors, Macquarie and Spotless. SAHP, incidentally, has recently rebranded as Celsus. This state-of-the art hospital, delivered as a Public Private Partnership under the State Government’s Partnership SA Model and forming part of the South Australian reformed health system, will provide world-class care for the people of South Australia. Rooms with a viewBut more than this, it can lay a justified claim, at least for the moment, to deliver the mostw w w. r a h . s a . g o v. a u40Passion Innovation for life Together we can save with more livespurpose Getinge is a global provider of innovative solutions for operating rooms, intensive care units, sterilization and endoscopic reprocessing departments, endovascular procedures and for life science companies and institutions. Based on our first-hand experience and close partnerships with clinical experts, healthcare professionals and medical-technology specialists, we are improving the everyday life for people – today and tomorrow.www.getinge.comBill Le Blanc - in Resus roomw w w. r a h . s a . g o v. a u42technically advanced healthcare in the world, including complex medical, surgical, diagnostic and support services and ‘super speciality’ services including renal transplantation, major burns, and complex spinal care. The new hospital takes over all the services of the current RAH and some of the more complex services from The Queen Elizabeth Hospital. It will also provide high quality teaching and research facilities. “We don’t expect the new RAH to rank as the world’s leading high-tech hospital for long,” says Bill Le Blanc, CIO of SA Health. “Technology advances fast these days and each new hospital project learns from the last and leapfrogs to the front.” Le Blanc is responsible for all aspects of ICT across the whole of SA Health, leading a division of 700 ICT specialists with responsibility for capital and operating budgets over $240m annually. Thirty years ago, when medical technology was emerging, the IT team was still looked on as the backroom boys and girls of healthcare, whose main job43was to keep the lights on. The new RAH, since the project was started 10 years ago, has grown up in a different universe, one in which every stage of planning is strategically directed by a partnership of IT and medical professionals. “The technologies themselves are tried and tested,” says Le Blanc. “We have pulled them all together, borrowing ideas from other new hospital builds round the world in the last decade. What is leading-edge is the sheer amount of technology in a single facility. As for the move, it has gone remarkably smoothly. We have had very few issues and we have managed them without affecting our service to the public. I am smiling from ear to ear.” Nobody wants to be in hospital but if you have to be, the new RAH is the place to be. It has 800 beds, but you won’t find a traditional ward. Every single in-patient has his or her own room with en-suite facilities and, if they are mobile, easy access to outdoor garden areas. A variety of internal gardens, terraces and courtyards provide an interactiveTechnical Suitew w w. r a h . s a . g o v. a u44LEAD THE CHANGE TOSMARTER CARE Allscripts open solutions help you drive smarter, connected care focused on what matters most: The patient. Vendor-agnostic interoperability enables secure, easy access to complete health data and clinical decision support within your normal workflow. And our commitment to innovation on an open platform helps you extend, scale and customize your technology environment. Open for your future. Interoperable for your network. Connected for your patients.www.allscripts.com/smartercareAllscripts EMR. Leading the change to smarter care. Allscripts is a global leader in healthcare IT. Our comprehensive, user-friendly Allscripts Sunrise™ EMR helps hospitals across Australia deliver smarter care with greater precision, for healthier patients, populations and communities. With a 35-year history of excellence, thousands of the top hospitals, health systems, outpatient and healthcare facilities around the globe use our EMR, financial management and population health management solutions with impressive results. We offer the industry’s only vendor-agnostic patient engagement platform. With open access across the care community, providers effectively communicate and engage patients directly, improving patient outcomes and optimising operational performance. The Allscripts dbMotion™ solution is a health information exchange platform that aggregates data from disparate source systems, harmonises the information and delivers it in a usable and actionable format at the point of care, all within the provider’s native and familiar workflow. The solution enables organisations to integrateMore than 2,500 hospitals using our solutions globally, with now more than 100 clients, in South Australia, Victoria and Western Australiawww.allscripts.comdiscrete patient data from diverse care settings, regardless of the IT supplier, into a single patient record that is semantically normalised. Allscripts solutions enable healthcare organisations to analyse and act—right at the point of care—to empower change, improve health and reduce costs. Allscripts solutions also earn industry recognitions. We’re consistently listed as a Black Book™ Rankings #1 Top Outpatient EMR Vendor in various categories and a Best in KLAS® honouree, to name just a few. At Allscripts, we’re helping build open, connected communities of health while strengthening organisations’ clinical and operation foundations.Allscripts FollowMyHealth®, our patient portal, which has more than 3,000,000 active logins per monthTwo Australian Offices—one in Melbourne and another in Adelaide, with teams also based in Sydney and BrisbaneCopyright ©2017 Allscripts Solutions, LLC and/or its affiliates. All rights reserved.YOU SEE AN ICONIC STATE-OF-THE-ART HOSPITAL.WE SEE OUR ESSENTIAL SERVICES REDEFINING HEALTHCARE SUPPORT.New Royal Adelaide Hospital partnering with Spotless for asset management, facility maintenance, catering, cleaning, linen distribution, grounds and gardens, patient support and security services. ∙ Image courtesy of HYLCwww.spotless.com∙enquiries@spotless.com SPOT0633and uplifting environment, with internal and external performance spaces accessible to patients, staff, visitors and members of the public. Depressing corridors and waiting areas are also relegated to history - art integrated right across the 10-hectare site celebrates South Australia’s unique landscape and cultural history, creating a welcoming, attractive place of healing with the overarching creative design theme of “a hospital within a park – a park within a hospital”. Typical of a hospital stay is the trip downstairs for an x-ray, scan, blood test or other specialist check. Patients at the new RAH won’t have much of that to do, as the hospital is equipped with mobile equipment that can be wheeled into their room. Apart from CT and MRI scans, mobile imaging allows the bulk of x-rays, ultrasound procedures, and scope investigations to be conducted in the patient’s own room for in-patients. This cuts down on anxiety as they waitBill LeBlanc, Executive Director and CIO, SA Health “I started my career in IT at a hospital about 34 years ago and I worked there for four years, went into the private sector and then came back here in 2013 in my present role. When I started the IT was a back-office support function. It supported patient demographics, when they came in and left, what beds they were in etc but the medical notes were largely on paper, the biomedical devices were standalone electronic devices. These days you have convergence of technology, computer controlled biomedical devices and digitised electronic medical records. People at the sharp end of the business, delivering services to patients, now rely on technology to do their daily tasks. Ten years ago, if the technology went down there was little risk of patient harm. Now that risk is real and present. The mission critical nature of technology today has changed the role of the CIO in healthcare.” w w w. r a h . s a . g o v. a u48Email: info@imatis.comNOW LIVE AT THE NEW Royal Adelaide Hospital Less time spent on managing logistics More time to deliver excellent health & patient careClinical logisticsClinician whiteboards for patient flow, resource management and interactionPatient logisticsSelf-check-in kiosks for patients to register for appointments and receive instructions on where and when to goService logisticsIntergration, task management and messaging on mobile devices“The doctor is ready to see you now. Please go to examination room 201.” Dr. Johnson“The doctor is ready to see you now. Please go to examination room 201.” Dr. JohnsonEXPLORE OUR SOLUTIONS: www.imatis.com/imatis/promotion/adelaide.html6,500Number of Employees at New RAH for their turn to come round. All this may sound expensive but: “We believe it is efficient because it is designed to shorten length of stay,” says Le Blanc. “We expect better clinical outcomes, lower reinfection rates than you get in ward based hospitals and reduced readmission rates.” Without increasing staff numbers, he adds, more patients can be processed annually with the same number of beds. The simple innovation of having opening windows, looking out on greenery and controlled by the patients themselves, has been shown to speed healing and wellbeing. Designed-in technologyThe team dedicated to deploying technology to this hospital and its systems number around 200, but the people who put it to work day by day are the clinical staff.40,000Number of Employees at SA Health Getting everyone familiar with the systems ready for the move was the joint responsibility of the equipment manufacturers and the IT teams: and part of the planning had to encompass agency staff too. It is no longer enough for agencies to send along qualified temporary nurses, who will always be needed to fill gaps in capacity and cover staff leave and sickness, unless they are ready to hit the ground running, so the hospital had to work with the firms it uses to pre-train the people they would send along to the new RAH. When everything is as smart as it can get it is hard to single out what to feature. After only a few weeks, though, some of the new systems are delivering quantifiable results. “I am very pleased with the investments we have made in the clinical data integration (CDI)w w w. r a h . s a . g o v. a u50technology. We are getting early feedback from doctors that this is already helping them make better-informed clinical decisions, resulting in better outcomes for the patients. I have been given examples where treatment decisions, that might not otherwise have been taken, have been made because of the technology they have access to. Better outcomes are already beginning to emergeâ€?. Le Blanc also referred to the Enterprise Patient AdministrationSystem (EPAS) which has been implemented at the new RAH, replacing paper medical records at the old RAH and now being implemented across South Australia. This will generate significant reductions in medication errors and improve patient safety. This single system for state-wide electronic medical records now has close to 2,000 users at any given time. Automation that benefits patientsThe 25 automated guided vehiclesCarestream’s Clinical Collaboration Platform, highly acclaimed and operating in every state in Australia, is a feature-rich enterprise imaging platform for radiologists, specialists, referrers and patients, supporting true collaboration through the patient journey and improving outcomes. Carestream is a worldwide provider of medical imaging systems and IT solutions all backed by a global service and support network. The company is a leader in developing new technologies that address the needs of healthcare providers.Level 3, 176 Wellington Pde, East Melbourne, VIC 3002 Free Call: 1300 651 786 www.carestream.com/collaborationROBOTS IN FOCUS The largest hospital Automated Guided Vehicle (AGV) fleet in Australia and New Zealand The fleet delivers hot and cold food and beverages, laundry, pharmaceuticals, sterilised items and other supplies as well as several forms of waste between the patient wards and the kitchens, stores and the many other functional areas within the hospital. These flat, stainless steel robotic devices, measuring 1.7m in length, 60cm in width and just over 30cm in height, can carry large trolleys with goods at average walking pace and can talk to lifts, specific doors and portable phones. • • • • • A fleet of 25 RA-GVs. Contour/Range-sensing navigation. Trolley pick/drop stations with automatic RFID signalling. Automatic Park’n’Charge area. Central fleet control station with automatic scheduling of RA-GV movements plus elevator & auto-door activation controls.Benefits include: • Greater efficiency & traceability. • Increased safety. • Reduced costs. • Less damage to equipment. • More staff time can be reallocated to direct patient care.w w w. r a h . s a . g o v. a u52John Edge, co-Directors of the IT implementation programme at the new RAH John Edge brings a pedigree in running very large-scale mission critical IT from the big end of town. With the dependence that modern health services now have on reliable technology, health’s unlikely sister industries from an IT standpoint are banking, defence and advanced manufacturing. Edge’s extensive background in executing technology projects in large banks and global motor vehicle manufacturing ensured he brought a take-no-prisoners approach to deliver a medical grade technology service that is responsive, highly resilient, and always on.53(AGVs) that deliver linen, food, surgical instruments and medicines across the hospital work round the clock and provide efficiency savings in terms of porterage and logistics. “The pharmaceutical robots give us efficiencies in staffing but, more importantly, reduction in errors, picking the right drug and dose, and getting that to the right patient,” Le Blanc enthuses. “There are huge benefits in terms of volumes that can be picked in a day and accuracy. This allows the pharmacists to do what they are trained to do which is to consult with the clinicians on treatment and medical outcomes rather than process-based tasks.” Both of the new RAH’s pharmacies use medication dispensing robots. The system decreases turnaround time for dispensing and reduces the amount of inventory required by 20-30% and reduces wastage from expired stock. In addition, there are more than 100 automated dispensing cabinets in patient wings. Nurses input the patient ID and biometric authorisation using staff fingerprints. The cabinetejects a drawer containing only the medication (and correct dosage) prescribed for the patient. This technology also contributes to the physical security of medicines, cutting the opportunities for drugs, especially narcotics and other controlled drugs, to go astray. Another smart application is the wireless system that tracks such assets as wheelchairs, infusion pumps, barouches. Over 3,200 wireless access points throughout the hospital can locate them in real time via embedded chips and IoT technology, much like triangulation from mobile phone towers. This locates the nearest available asset when it is needed by staff. Additionally, the system allows security officers to locate and attend staff quickly when they operate a wearable alarm. Within the operating theatres, the integration of clinical data onto monitors allows surgical teams real-time access to medical record information, data captured by cameras on medical scopes,Geoff Peach, co-Directors of the IT implementation programme at the new RAH Geoff Peach is a hospital IT guru based in Queensland. He has lived out of a suitcase, away from his family for three years to help deliver the new RAH work program. His ability to calmly lead technical teams through complexity while making it all look straightforward has been very impressive. There are a lot of new technologies in this hospital that Le Blanc’s established team were previously unfamiliar with. Peach’s know-how with these emerging technologies combined with a comprehensive big picture view of hospital business operations and deep understanding of supplier sub-contracts has been a critical success factor.w w w. r a h . s a . g o v. a u54OPERATIONAL EXCELLENCEThe hospital’s 40 operating theatres, or technical suites, give surgeons a data-rich environment thanks to the ‘clinical data integration’ approach. • Each suite measures 65 square metres • Most suites have large windows to allow in natural light • Critical trauma suites linked to the emergency department and the helipad by “hot lifts” for fast transport of patients • Ceiling mounted swing arms carry up to six computer monitors • Simultaneous data feeds from medical scopes, electronic medical records and biomedical metrics in real-time from the operation • Imaging, including x-rays, CT scans and MRI • Equipped with Clinical Digital Integration (CDI) technology high definition video cameras that capture all procedures on video • Ability to consult with specialists during the operation • Students observing the procedure see more but don’t crowd the theatre • Result: less risk of infection, better outcomes55RAH exterior biomedical metrics and x-ray, CT and MRI imaging. High definition video capture and transmission in all theatres and treatment rooms allows junior doctors and students to be virtually present at an operation. The surgeon can consult with other specialists, and with only key participants present the risk of cross-infection is much reduced.Premiums from partnershipDesign changes as technology advances. The building was originally designed to have three separate IT networks - one for biomedical traffic, one for conventional e-health and EMR patient administration data traffic and another for the PP
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