The Patient Safety Operation Room of the Future at the New Karolinska University Hospital

The Patient Safety Operation Room of the Future at the New karolinska University Hospital

The First part – A New Patient Safety System in the OR of Future at Karolinska Ortopedic Department

Objective
The purpose of this system is to enable
– real time digitalized monitoring of air quality in the OR
– digitalizing manual critical routines and
– to develop an investigative tool assessing known risk factors for prosthetic joint infections (PJI).

Methods
The system includes one OR Ipad-checklist one real time Bio Aerosol Monitoring System, door opening logging devices, air climate indicators and a TV-screen on the wall in the OR showing air quality and alarms in real time. Parallel measurements between a traditional air sampler (Sartorius MD8, Sartorius AG, Germany) and the real time monitoring system (BAMS) were made in 15 live elective arthroplasty surgeries.

Results
Digital feedback in the OR and in the corridor had an immediate positive effect on the outcome of the routines. Real time values of Fluorescence Bio Particles (FBP) during elective arthroplasty surgery showed a high correlation with parallel traditional aerobic (CFU/m3) measurements. The R-value between mean values of FBP/50dm3 ≥3µm and CFU/m3 sampled during 15 operations was 0.85.

Discussion and Conclusion
Real time data feedback is important to create awareness and optimize patent safety.
This system has the potential to minimize complications, engage staff, give feedback, and create a learning culture for the entire staff. By serving as a real-time checklist, it has the potential to prevent complications in complex situations. It can also serve as a means for cognitive support.

Real time values of FBP during arthroplasty surgery can be used as a surrogate measure of air bacterial load. Together with the routines logged and visualized, the OR staff are made aware of and can improve routines and logistics. The results of this feasibility study indicate that this quality system has the potential to lower PJI and strengthen the OR staff´s knowledge over time.

The second part – New Nordic Guideline in OR Design
The New Karolinska and the Nordic Ortopedic Surgeon Teams and have changed their approach of how to Design new Operation rooms. Presentation of a new Guideline on Hospital Ventilation. This design guide provides guidance and solid basis for design as well as for verification of the technical performance of ventilation systems. It also gives guidance for the users to assess the realization of the critical indoor parameters
as well as life-cycle quality assurance of the systems performance. The guideline outlines basic requirements for proper design of ventilation systems for hospital applications. The guideline expresses what is perceived to be best practice in the field