Patients and healthcare workers are central to the hospital of the future

Harry van Goor is a surgeon and professor of surgical education at Radboudumc in Nijmegen. He explains how smart innovations are changing the hospital and explains what influence this has on patients and employees. He also advocates a shift in thinking around building design to build future-proof hospitals.

When a hospital uses smart technologies that contribute to the well-being of the staff and the patient, we call it a Smart Hospital. Van Goor explains this using an example: “Nurses can spend an enormous amount of time looking for a free infusion pump. Thanks to sensors on the IV poles and low energy bluetooth location determination, a free infusion pump is easy to locate. An additional advantage is that you use the number of pumps more efficiently and flexibly.”

The next innovation is room sensors connected to an Artificial Intelligence platform. Thanks to this technology, a signal is generated and analyzed when a patient is in danger of falling out of bed. “We tested an American system that combines patient information with these sensors. When a restless patient threatens to get out of bed, the light automatically switches on and a signal is immediately sent to the nursing staff or a control room.” By having the health data of patient wearables available at the same time, an estimate can be made of the cause of the unrest.

Welfare

Van Goor states that the ultimate goal of more technology is an improved well-being experience for users. By this he not only means the patient, but also the staff: “The patient is often central, but the hospital employee is just as important.” At Radboud University Medical Center, more and more attention is being paid to the experience of patients instead of just the hard outcomes: “A hospital stay is painful and stressful. You spend a lot of time in bed and sleep little. We try to take this into account with the help of building technology choices. In addition, we work with innovative technologies on solutions that we cannot realize with the building.” For example, virtual reality glasses can transport patients to a completely different environment, where they escape the monotony of the patient room and suddenly find themselves on their favorite beach.

A Smart Hospital integrates various data sources and sensor information to improve the quality of care and at the same time relieve the hospital employee. At Radboudumc they combine building-related sensors with wearable sensors in one model. “In the new hospital you can close the curtains from bed at the touch of a button. But if a patient has not moved much that day, even though he or she is capable of doing so, this remote control does not contribute to recovery. In the future, we want the curtains to not close automatically and the patient to receive an explanation as to why it is important to get out of bed and close the curtains manually. That is an example of building interaction that contributes to the patient's healing.”

Bricks, bytes and behavior

The construction of a hospital usually follows a fixed pattern: first the building is designed (bricks). The building is then equipped with building technology (bytes) and is ultimately put into use by the users (behaviour). “It often happens that the spaces are used very differently than what they were designed for. In fact, when a building has just been completed, plans are already ready for the renovation. The lead time for construction, from idea to delivery, is approximately six to eight years in the Netherlands. In those six to eight years the world does not stand still.”

Van Goor proposes a different way of thinking in which the order of bricks, bytes and behavior is reversed. “Start with behavior and work processes. Have stakeholder conversations and involve them in future working methods and how these can be facilitated by digital technology.” No one can see into the future, Van Goor acknowledges, but at the same time he emphasizes how important it is to think about this. “We conducted sessions with nurses where we encouraged them to think about the future of their work and how this will change when new technologies become available. We discussed all kinds of scenarios with a block box and a sheet of paper. We then thought it through with the questions: which digital technology will help you, how does it change your work process and your behavior, and what are the consequences for your building technology and building design.”

At the moment, this method is still in the future. Van Goor: “You have to compare this process with a mammoth tanker that changes course, it is very slow. To accelerate this change of course, we can learn a lot from sectors other than health. I therefore argue that as a hospital organization and the companies involved, we should look around us more.”