karl storz innovation day tuesday 8 th december 2015 09:30 – 16:15 the education centre, queen...

KARL STORZ Innovation Day

Tuesday 8th December 2015

09:30 – 16:15

The Education Centre, Queen Elizabeth Hospital Birmingham

Avoiding Costly Mistakes

- what is an OR1™?

Keith Bolton, National Sales Manager, OR1™

2KARL STORZ Innovation Day Tuesday 8th December 2015


London Bridge Operating Theatre Museum



OR1 is a solution

“Don’t find fault, find a remedy.”– Henry Ford



Introduction

KARL STORZ OR1 is a fully-integrated operating room based on a bespoke ergonomic design that maximises efficiency, flexibility, and functionality with significant benefits for the patients and users

The OR1 theatre is designed to reduce theatre clutter, staff workload, increases comfort, safety for both the patient and staff, efficiency and enhances the team and performance

With its unique features (RUI, Telestration) and advanced technology, it is unsurpassed within the integrated theatre division offering full HD 1080p imaging and 3D HD technology



Overview – What do we consider when planning an OR1?



Conventional Theatre



OR1

AV Input Plates

Integration of Medical Devices

42" & Nurses Workstation with Touchscreen

Integrated Surgical Camera

Architectural Arms

26" HD Widescreen Monitors

19" Touchscreen

LED Operating Lights

Room Camera & Speakers Integrated in Ceiling

Bespoke laparoscopic design but multi-functional in use



What are the added benefits of OR1?

IntegrationRUI, Telestration

EfficiencyConfigurations

Manager

Ergonomics

SafetyRisk Reduction

TelemedicineTeaching Links

DocumentationImage capture,

IMAGE 1

• Central control of medical devices• Image routing• Audio control

• Video streaming• Operating lights• General lighting

• Reduced theatre setup time• Central control – less procedure time• Workplace design• Patient call system

• Bespoke ergonomic design• Reduced equipment in

theatre• Reduced cable trail• Ease of use of system of

OR1 (RUI)• Comfortable environment

for all, with added patient benefits

• The science that best suits the workplace for the worker

Patient flow process Equipment design Workplace layout Productivity & efficiency

• Storage of patient data

• PACS integration (HIS, RIS)

• External and internal links

• Multicast options• Staff engagement in

theatre with training aiding professional development



Agenda

Getting it right first time

What happens when others get it wrong

What part does ergonomics play?



Consultative Approach

OR1 is a consultative approach where we need to establish a clear specification – comparing apples with apples!



Before installing OR1 you must consider your needs



HBN 26 (HBN 1991) – Health Building Note

4.72 Research for this guidance has shown that increased space in operating theatres is required for the following reasons:

• for maximum flexibility, all types of surgery can be undertaken in any operating theatre. This will prevent downtimes for certain types of surgery if a dedicated theatre has to be closed for decontamination, cleaning or maintenance;•currently, a theatre for minimally invasive surgery is the largest at 55 m2. As the number of minimal invasion procedures carried out is increasing, for flexibility it is recommended that all theatres be constructed to this same floor area of 55 m2;•not all operating theatres need to be fully equipped for minimal invasive surgery; however, it is recommended that all the medical services are installed from the outset so that every theatre can be reconfigured in the future;•all minimally invasive surgery theatres need to be equipped for conventional open surgery as, due to unforeseen circumstances, patients sometimes need to be converted to open surgery

Key people involved: Project & Design Teams; Estates Directors and their staff; PFI Consortia

Description: Guidance on facilities for in-patient operating theatres in acute general hospitals both emergency and elective.

Aims & Objectives:

•Based on 8 theatres, 1 designated as emergency

•Increase space in theatres to make them flexible enough to carry out various types of surgical procedures including minimally invasive techniques in the best environment

•HBN provides standards on the built environment required to support clinical and diagnostic invasive procedures

•Facilities for training and education to maximise professional development



HTM 03

Health Technical Memoranda (HTMs) give comprehensive advice and guidance on the design, installation and operation of specialised building and engineering technology used in the delivery of healthcare

HTM 03-01 provides guidance on the design and management of heating and specialised ventilation systems in health sector buildings

HTM 03-01 applies to new installations and major refurbishments of existing installations



BIM: Building Information Modelling

Building Information Modelling (BIM) is a collaborative way of working, underpinned by the digital technologies which unlock more efficient methods of designing, creating and maintaining our assets. BIM embeds key product and asset data and a 3 dimensional computer model that can be used for effective management of information throughout a project lifecycle – from earliest concept through to operation



Mid Cheshire Hospital Trust



Recent installation of two OR1 theatres: MCHT



Morriston Hospital, Swansea



Nuffield Health Cambridge Hospital



Agenda






Hygiene factors?Safety?

Efficiency and workflow?

Ergonomics?



Head clearance!

Less than 2m (1.8M) at highest position : head clash!



Evidence of poor planning/design

Two different suppliers trying to provide a working solution!



Positioning and head clearance issues

Pendant positioned right next to a door on the left of picture with a head clash concern

Pendant is clearly not in use due to poor design positioning and is a hazard/risk



Agenda






Importance of an ergonomic workplace for the surgeon

Surgeons are experiencing body part discomfort and indicators of fatigue that may be associated with performing laparoscopy

Awareness, knowledge, and utilization of ergonomic principles could protect surgeons against symptoms that lead to occupational injury

The importance of ergonomic principles in the operating room, specific to laparoscopic surgery and surgeon injury/illness symptoms cannot be understated



Ergonomic Guidelines for Endoscopic Surgery



Invasion of Space Eating Technologies



Ready for the journey?

Before embarking on a long journey you always ensure everything is optimally positioned to ensure a comfortable and safe ride

– Adjust the seat so that the pedals are comfortably reached and back and neck are well supported– Check the mirrors to ensure best possible vision while travelling– Make sure all controls are reachable without having to stretch for them

This enables you to arrive safely at your destination in the best possible physical condition and without suffering aches and pains from poor posture



Safety first

ERGONOMIC PRINCIPLES, think about the passenger - your patient. You have a responsibility to them, their safety, performing the task with the best possible equipment with the best ergonomic principles



Ready for takeoff?

You wouldn’t dream of taking off without first running through several checklists designed to ensure optimum levels of safety – WHO

OR1 theatres are similar to a modern airliner – highly technical equipment designed with safety at the forefront, while ensuring the people in control have everything they need close at hand

6 C`s – communication, courage, compassion, care, competent, commitment



Efficiencies (Study Cantonal Hospital Switzerland)Based on Hysteroscopy Procedures

0 60 120 180

Conventional OR

Fully Integrated OR

Setup time main procedure Incision to suture time Suture to arrival recovery room

Operating room type

Duration (minutes)

34.05

Total Duration Main Procedure

90.10 14.15

58.13 108.39 20.11

Source: Patient Care, Innovation & Cost Efficiency Study, Sven Becker and Diethelm Wallwiener



KARL STORZ Realistic User Interface



Customer feedback

“With the installation of the very latest KARL STORZ digital theatre here at the Guildford, we are now able to offer a really exciting and optimal surgical environment for complex laparoscopic surgery to take place. There are benefits for the surgeons and the whole theatre team but most importantly patients can be assured that they are receiving their medical care in the very best, most efficient and safest surgical environment. The new environment improves surgical efficiency, reduces some risks and gives the surgeon the best high definition imaging that modern technology can offer.”

Prof. Timothy Rockall, Specialist Bowel & Liver Surgeon, Royal Surrey Hospital



OR Future?



KARL STORZ OR1™The Integrated Operating Room

Thank you very much for your

attention!

karl storz innovation day tuesday 8 th december 2015 09:30 – 16:15 the education centre, queen...

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