The Operating Theatre journal April 2021

The Hospital of the Future
As a recent paper by Iqrar Ahmed examines, the concept of the Hospital
of the Future (HoF) has gained much traction in recent years. And,
as the global pandemic has highlighted significant further strains on
the acute healthcare setting, we’re seeing a collective attention on
resuming business “better than usual(1)”. This means enhancing the
way in which healthcare services are provided to patients, while also
optimising resource and protecting frontline workers.
There is an increased body of
evidence that noise can have
a very detrimental impact on
an individual’s performance
and wellbeing, from a lack of
concentration to stress. Within
an office environment, research
suggests workers can be up to
66% less productive when exposed
to just one nearby conversation.
Within a high pressure
environment such as an OR, the
implications of such noise related
stress are even more significant.
With staff under inordinate
amounts of pressure and a
focus on mental wellbeing, it is
essential to grasp any opportunity
to minimise stress; a challenge
that wireless communication is
proven to address(4).
Thinking beyond Boundaries
Tom Downes CEO Quail Digital
Wireless communication plays an important role in the HoF, as a means
of connecting people, processes, technology and premises in a seamless
communication highway. The ultimate aim, as Tom Downes, CEO, Quail
Digital says, is to provide the best possible healthcare to patients; and
balanced, safe and productive working conditions to hospital staff,
while operating in an efficient, cost-effective and sustainable manner.
Lessons from COVID
The early days of the pandemic rapidly highlighted the challenges
frontline workers faced as a result of PPE. Amongst those was the
reduced capability to communicate effectively.
According to Dr. Ziv Tsafrir(2), “Protective suits afford no ability to
communicate, so people resort to using sign language. When that
doesn’t work, fewer members of staff wear the suits, which risks
exposing them to the virus.” In other cases, front-line staff had to
physically leave their unit to resolve a communication issue, resulting
in wasted PPE and a loss of time to care.
Clearly, finding a way of improving communication without compromising
either healthcare workers’ own health and safety, or impacting patient
care, has been critical and will remain so as part of the NHS’ future
preparedness plans.
As Associate Professor Andrew Holden, Director of Northern Region
Interventional Radiology Service, Auckland City Hospital, New Zealand,
adds: “During the initial months of the Covid-19 global pandemic, our
department needed a communications system that not only enabled
clear communication but was also easily cleaned and portable.
“As an Interventional Radiology department, we also needed to enable
clear and safe communication between the designated ‘clean’ and
‘contaminated’ staff during operations on patients who are either
confirmed or suspect COVID-19 positive. Digital headsets solved
the immediate communications barriers we encountered, as well as
enhancing communication in our operation rooms and enabling us to
continue treating patients with the latest in innovative technologies.”
Care Beyond COVID
There is strong evidence pointing to the importance of effective
communication and teamwork in patient safety more generally(3).
Deficiencies in teamwork and communication contribute to adverse
events, highlighting that non-technical skills are as important as
technical surgical skills in preventing adverse patient outcomes.
Moreover, it is clear that such pressures on frontline staff are set to
remain high throughout most of 2021 as a result of the pandemic. This
is evidenced by new statistics from NHS England which show that more
than 200,000 patients across the country are now waiting more than
a year to receive hospital treatment, and that the number of people
waiting over a year for their treatment is now 150 times higher than
in 2019.
Within the concept of the Hospital of the Future, it is also important
to think beyond the physical boundary of the hospital site. As the NHS
moves towards the introduction of Integrated Care Systems, the HoF
concept might also involve home- or remote-care facilities, as well as
having the capability to connect multi-disciplinary teams regardless of
their physical location.
As Professor Holden explains, wireless communication is a great enabler
for this. “Before the Covid-19 global pandemic, our department often
hosted international teams with new devices, and trials,” he says.
“Now, with intense travel restrictions into New Zealand, we have begun
to utilise streaming capabilities to enable our patients to still have
access to the latest in advanced technologies. Digital communication
has been seamlessly integrated into our broadcasting system and we
are able to communicate with not only our own staff onsite, but also
with company representatives across the globe.”
Conclusion
As we begin to reconceive what the optimal care pathway might be in
a post-COVID – or always-present COVID – world, managing scarce acute
resources efficiently and sustainably is key, whilst also safeguarding
frontline workers and providing the best possible healthcare to patients.
Technology, such as digital and wireless communication, will play a
fundamental role in achieving this objective.
1. https://www.nuffieldtrust.org.uk/files/2020-06/nhs-returning-tonormal-nigeledwards-nuffield-trust.pdf
2. https://hmcisrael.com/doctor/ziv-tsafrir/
3. Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors
reported by surgeons at three teaching hospitals. Surgery. 2003;
133:614–21. https://doi.org/10.1067/msy.2003.169 PMID: 12796727
4. Lingard L, Espin S, Whyte S, Regehr G, Baker G, Reznick R, et al.
Communication failures in the operating room: an observational
classification of recurrent types and effects. Qual Saf Health Care.
2004; 13:330–4. https://doi.org/10.1136/qshc.2003.008425 PMID:
15465935
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