New modern hospitals are built around the world. In terms of facilities, operations, technologies and individualised care, these future hospitals are very different from the past.
For patients, the future hospitals provide even better care and service. However, new types of safety challenges have also arisen, affecting both staff and patients. Lasse Kylén, Safety Manager of Oulu University Hospital, and Olli Siitonen, Safety Manager and Kirsi Leivonen, Project Manager of Kuopio University Hospital, shed light on the safety challenges faced by the future hospitals and their solutions.
Major hospital investments are currently underway in both hospitals. In Oulu, a totally new hospital known as the Future Hospital OYS 2030 is under construction. The cost estimate of the project is €900 million. Kuopio University Hospital is undergoing a massive renovation and building a new Psychiatric House. The projects are worth €200 million.
OYS 2030
Single-bed rooms – comfortable but harder to control and supervise
In the new hospitals the trend is leaning strongly toward single-bed rooms instead of multiple occupancy rooms. They are more comfortable for the patient, protect their privacy and intimacy and are more appropriate for patient examination and collection of a patient’s history. Because patients in single-bed rooms are rarely moved, medication errors and patient transfer costs are reduced and there is a lower risk of infection. In addition, fewer separate examination and treatment rooms are needed.
On the other hand, when patients are alone in their room they are more vulnerable to various hazards. Also health care professionals face a greater risk when working alone.
Lasse Kylén:
“One major safety challenge in single-bed rooms is the lack of supervision if something happens. It should also be noted that the staff should be able to supervise and control a larger number of rooms. However, in the new hospitals, the locating safety and nurse call system covers the entire property. This way you immediately know who needs help and where. This ensures that help arrives quickly when needed. Monitoring the operation of medical devices also gets easier, when the information is automatically transferred to the nurses mobile devices.”
Kirsi Leivonen and Olli Siitonen:
“The most important functional change in our new wards is that nurses work with patients in patient rooms whenever possible. Despite this, the patient may, for example, fall when they are alone or while attempting to go to the bathroom. Of course, this also happens in multi-occupancy rooms, especially among elderly patients.
Traditional nurse call systems are commonly used in hospitals meaning that each room has at least one button which can be used by the patient to call a nurse. More advanced solutions include automatically responding data- or behavior-based sensors like motion/bed detectors and cameras that help to indicate if a person is at risk of falling. These smart systems respond to abnormal movement or a change in conditions in a room and alert automatically. Alarms are routed to the staff’s mobile devices increasing the safety-awareness without the need for intrusive 24-hour care presence. Unfortunately, the threat of violence has become more common in healthcare. The safety of nurses working in patient rooms can be increased with a locating alarm system.”
Safety extends all the way to the patient’s home
According to the new care philosophy, the patient does not always have to come to the hospital, but can be treated at home with the aid of developed remote care technology and outpatient care. And even if the patient comes to the hospital, he/she is likely to spend less time there and be demobilised faster than before.
Home care sets its own requirements for patient and staff safety. It must be possible to ensure that the patient is in good condition and that, for example, rehabilitation is progressing as planned. Equally, the safety of caregivers visiting the patient at home must be taken into account.
Kirsi Leivonen and Olli Siitonen:
“There are still quite a few services and technology in specialised healthcare that can be brought to home. Treatment times have been shortened and patients are demobilised or transferred to follow-up care as soon as possible. Changing the place of treatment and relocating the patient is always a risk to the transfer of information and the continuity of treatment.”
Lasse Kylén:
“Home visits in healthcare are challenging because the environment is unfamiliar and more susceptible for surprises and threats. Risks can be reduced with good foresight and, for example, by ensuring exit safety. Locating personal safety systems used by the caregivers also increase the staff safety.”
Hospital is a demanding environment in terms of safety
Hospitals are big and complex facilities and therefore demanding environments in terms of safety. Especially in public hospitals people must have free access to which is a critical safety issue and challenge.
Sharing of both facilities and equipment is also a part of the operating concept of future hospitals. Patients no longer have to move as much inside the hospital, but doctors, nurses, and the equipment required for examinations and treatments come to the patient room. This requires that the right people must be easily reachable and equipment easy to find especially in emergency situations.
Emergency departments are the most challenging areas regarding safety in any hospital – also in future. Emergency department is a high-volume traffic area where different, potentially volatile situations can arise daily and patients can be aggressive.
Kirsi Leivonen and Olli Siitonen:
“Risks arising from the free access to the hospital premises can be managed through safety plans, space planning and technology. The access rights are controlled by forming safe zones and only necessary doors are kept open. With the aid of indoor location technology this can be done in a discrete and customer-friendly way.”
AI based camera surveillance is also used more extensively. AI-cameras enable more effective monitoring and detection of hazardous situations as well as automated alarms. However, camera surveillance is strictly regulated by the privacy law.”
Lasse Kylén:
“Unfortunately threatening situations are a reality in hospitals also in the future. To avoid them, we must invest in planning, training, security guard services, and safe space solutions. Attention must also be paid to escape and exit plans. A functioning nurse call and alarm system also plays a key role in increasing safety.
In addition, an indoor locating system can be used to locate both staff and devices like medical equipment and hospital beds for example. That way, staff time doesn’t go into searching for them.”
Technology is a great help but it also a risks
In modern hospitals technology intertwines with almost all activities. It has a wide range of benefits to the hospitals regarding safety and efficiency as activities are managed and patients are treated with the latest technology. This ensures efficient information flow, smooth operations and high-quality care.
In addition, technology frees up time and resources for actual nursing work and interaction with patients. It also facilitates interactions with patients and their relatives. However, technology also brings risks that need to be identified and be prepared for.
Lasse Kylén:
“Technology improves safety in hospitals and is a valuable support for nursing. On the other hand, the hospital environment is quite vulnerable if disruptions occur. We must always be prepared if, for one reason or another, the systems do not work as they should. We must not rely too much on technology. ”
Kirsi Leivonen and Olli Siitonen:
“There are always risks associated with technical systems, such as their failure or difficulty in use. We prepare for these through staff training, contingency plans and exercises, and the creation of functional backup systems for incidents. However, the most important thing in ensuring the safety of the hospital’s operating environment is always a skilled and trained staff.
