Download vision and principles for the world`s best children`s hospital

VISION AND PRINCIPLES FOR
THE WORLD’S BEST CHILDREN’S HOSPITAL
THE NEW JULIANE MARIE CENTRE.
VISION AND IMPLEMENTATION.
CONTENTS
I N T RO D U C T I O N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 - 7
1 VISION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11
2 D E S I G N P R I N C I P L E S. . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 - 1 5
3 B A C KG RO U N D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 6 - 1 9
4 P R E R E QU I S I T E S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 0 - 2 7
5 ACTIVITIES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28-35
6 P RO P O S A L S F O R T H E F U T U R E . . . . . . . . 3 6 - 4 3
7 PAT I E N T PAT H WAY S
.. . . . . . . . . . . . . . . . . . . . . . . . .
44-49
8 T E C H N O L O G Y.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 0 - 5 5
9 A RC H I T E C T U R E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 - 6 1
10 S U S TA I N A B I L I T Y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2 - 6 5
11 WO R K I N G E N V I RO N M E N T . . . . . . . . . . . . . . . 6 6 - 6 9
12 A E S T H E T I C S.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 0 - 7 3
13 O RG A N I S AT I O N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 4 - 7 9
IT IS THE PRESENT GENERATION
THAT WILL DECIDE THE FUTURE
OF THOSE TO COME.
6 -
The Juliane Marie Centre for Children and Families is one of Rigshospitalet’s best –
and worst. Professional competency, research and patient treatment are already
world-class, but the facilities leave much to be desired. Ten clinics, four Global
Excellence centres, ten cross-disciplinary units and five Knowledge Centres are
housed in nine different buildings. Patients and staff strive to provide coherent patient
treatment and security in run-down buildings that are hopelessly outdated in terms of
technology and logistics.
This book, the result of a one-year preliminary analysis, documents the feasibility
of creating a new, world-class hospital complex founded on professional competency,
human values and technological excellence.
We have examined children’s needs, absorbed the very best knowledge and practices
from hospitals around the world and are now in a position to build a hospital that
integrates play throughout the treatment process. Children find peace and security
through play. Like their healthy peers, children and adolescents who are hospitalised
for long periods develop their social and motor skills through learning and play,
enabling them to return more quickly to daily life following recovery.
This report documents how and why we can offer a far superior service – but as
always, it is the present generation that will decide the future of those to come.
Bent Ottesen, Project Director
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1 3 - O R G A N I S AT I O N
WE HAVE AN EXTREMELY
GRAND VISION.
8 -
1 - VISION
1.
V I S I O N.
Our vision is simply to create a hospital for children and families that sets new
standards in two key areas – patient care and the interplay between
architecture, organisation and operations.
The new hospital will accord equal focus to treatment, research and training
while striving to be the best in all three. We will establish an Academy where
the hospital can share its professional competencies with educational
institutions, research departments and the wider business community.
We will invent and introduce a new continuity of patient care, bringing
specialists to the patient rather than the other way round. We will make the
hospital accessible to the outside world.
In short, we will enhance the quality of Denmark’s best specialised hospital for
children and family members a hundredfold.
A grand ambition perhaps, but this book offers a more detailed basis for decisionmaking. So let us begin with the three main focus areas: Family, Technology
and Effectiveness.
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FOUR MAIN
FOCUS AREAS.
10 -
1 - VISION
Family.
Technology.
Effectiveness.
Research.
The goal is to revolutionise the patient’s
hospital experience before, during and
after treatment, which also means
taking into account the wider family
experience. In addition to feeling
secure, welcome and involved in the
treatment process, families must help to
shape, design and develop a hospital
with a community focus.
Emotional well-being is only part of the
picture. The new hospital complex will
implement the highest technological
standards – future-proofing them for
generations to come. Coordinated patient
and medicine scanning, electronic
medical records, electronic wayfinding
and continual monitoring of individual
bed locations are just some of the options
already included in our planning.
Logistics. Bed days. Incorrect treatment.
Naturally, it would be self-defeating to
create a hospital project of this calibre
without enhancing treatment
effectiveness. A key part of our vision is
to revitalise and develop the entire
Danish health service, pioneering new,
more effective working procedures that
can be adopted elsewhere.
At the new hospital, we will create true
synergy between treatment, research and
education; a hospital where new
knowledge about diagnostics procedures
and treatment is created and shared with
a view to achieving scientific
breakthroughs. For this reason, education
and research must be an integrated part
of day-to-day clinical work.
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1 3 - O R G A N I S AT I O N
WE WILL PROVIDE OUR
PATIENTS WITH THE
WORLD’S FINEST CARE.
12 -
2 - DESIGN PRINCIPLES
2.
DESIGN PRINCIPLES.
The patient comes first. Always. For many years, our guiding tenet has been
“It is the outcome for the patient that counts.” While this will continue to be
true, our goal is to revolutionise the patient’s experience before, during and after
treatment.
Using our vision of the project as our point of departure, we have implemented a
process of innovation in close collaboration with patients, families, managers
and staff. The innovation process has identified several fundamental design
principles for all hospital construction – and several principles specific to family
hospitals. Our ambition is for these principles to be embedded throughout the
building and organisation.
- 13
2 - DESIGN PRINCIPLES
Five specific design principles
The world’s best hospital for
children and families
Integrated play
The world’s best hospital
Designed for
daily living
See me, ask me,
let me
The good journey
Clear zones
The diagram illustrates general design principles
for user-based hospital architecture and specific
design principles for the family hospital.
14 -
2 - DESIGN PRINCIPLES
Integrated play.
Children do not stop playing simply
because they fall ill. Play must therefore
be an integrated part of design, life and
experience. This entails not only
providing play areas and playtime, but
ensuring that play is fully integrated into
the entire treatment process. Play can help
the child accept illness and treatment, for
example, if the child is allowed to treat
another person or a toy animal. Play must
be a common thread running through
the entire stay in hospital.
We intend to take play seriously.
The Academy will conduct research into
– and providing training in – the link
between play and recovery – with staff,
families and patients.
Designed for daily living.
Daily life is the basis of our reality.
Hospitalisation must not lead to a sense
of stagnation. The world inside and
outside must be in harmony. Family
wards make it possible to pursue daily
routines and activities. The family can
prepare and eat food, watch a film in
the cinema or simply relax in a sofa
and watch television together – simple
activities that combine to give a sense of
daily life and thus reality.
See me, ask me, let me.
Children and adolescents need
recognition as much as adults. The ability
to influence one’s own circumstances can
and must be encouraged in as many areas
and ways as possible.
It is a question of strengthening and
supporting the patient’s own resources
and abilities. We will, therefore,
incorporate input from patients and
families into the building planning phase.
That said, their involvement does not stop
there. During the project design and
construction phase, we will consult
patients and their relatives and use their
insights to validate solutions in an
ongoing process of dialogue.
General design principles for
hospital construction:
The good journey.
clinics, centres and sectors. Coherence and
coordination must be a recurring feature
of the new hospital complex. The
building must not only reflect groundbreaking architecture, but also new
standards of logistics and functionality.
The aim is to create individual and
intelligent patient care for every single
patient – child, adolescent and adult.
Clear zones.
A building whose intuitive layout,
architecture, technology, materials and
colour scheme tell you what is required
of you and what you are allowed and not
allowed to do.
We believe that architecture is created
from within, that architects must embrace
co-creation – working with those who
literally have their finger on the pulse,
those who lack a quiet space in which to
get to know their vulnerable child and
those who know when a sudden change
of scene is needed when complications
arise during birth.
The first five minutes must be the best
five minutes. Patients must experience
coherent, coordinated treatment devoid of
problematic transfers between sections and
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1 3 - O R G A N I S AT I O N
BACKGROUND
– OR HOW WE ENDED
UP HERE.
16 -
3 - BACKGROUND
3.
B A C KG RO U N D.
With the exception of death, illness is the one human condition we have the
greatest difficulty accepting. Sooner or later, we will either experience illness
ourselves or someone close to us will fall ill.
For children and adolescents, the experience is shocking. However, it does not
have to be traumatic. With a serious illness, the initial contact point for the child is
in its meeting with the healthcare system, which can be a highly formative
experience. If the experience is negative, chaotic and painful, it will not only
hamper treatment of the actual illness but affect the person for the rest of their life.
The same mechanism applies if the experience is positive – albeit with the
opposite result.
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3 - BACKGROUND
From the most professional hospital – to the world’s best.
For several years now, the Juliane Marie
Centre has prioritised professional
competence, and today, it offers the most
highly specialised treatment programmes
for children and pregnant women.
Pregnancies with the most severe complications are treated at the centre, which
is the only one of its kind in Denmark
offering treatment for the unborn child
– e.g. blood transfusions and surgical
procedures. Despite a large number of
pregnant women with medical conditions
such as diabetes or heart disease, the
number of Caesarean sections is low and
on the decline.
The survival rate for premature babies
continues to improve, the risk of children
born with spastic paralysis in East
Denmark is falling, while family
involvement from the first critical days is
now a standard feature of treatment.
The children’s cancer ward is a leader in
new treatment initiatives and the
increasing survival rate of these children
is a great source of optimism. Today, it
tends to be the rule rather than the
exception that children and adolescents
18 -
suffering from cancer survive and go on
to lead normal adult lives.
This positive professional trend is the
result of the centre’s focus on three core
areas: patient treatment, education and
research under the motto: “It is the
outcome for the patient that counts.”
Our excellent treatment results and level
of patient satisfaction reflect our success
in living up to this motto.
The rise in external research funding,
the increasing numbers of research
publications and research staff all reflect
the positive development in this area.
Finally, the centre provides a wide range
of basic and further education programmes as well as new research-based
training of the highest international
standard.
Simulation-based training is a focus area
which, among other things, is dedicated
to educating obstetricians, midwives,
neonatologists, nurses and paediatricians.
The Juliane Marie Centre has reached a
professional standard that puts it on an
equal footing with the international elite.
The centre has also seen a substantial
development in clinical activity – partly
as a result of the hospital service’s
consolidation of several small units into a
few larger ones. However, in consequence, the existing physical facilities
pose a barrier to continued development.
For many years, the centre has therefore
sought to establish a new, purpose-built
hospital for mothers and children that
can house the professional activities and
provide a new, exciting framework for
continued development.
Treatment and care facilities currently
based at many different locations and
addresses can be brought together under
one roof in a building whose exceptional
ground-breaking architecture is in
keeping with the Juliane Marie Centre’s
fundamental principle – namely that the
health service of the future must be
developed through a focus on education
research and patient involvement.
A feasibility study has examined the
possibility of establishing a new, worldclass hospital for mothers and children.
3 - BACKGROUND
The feasibility study includes:
•
Mapping of 100 courses of individual
patient pathways and the design of
future patient pathways based on
four archetypes.
•
Task groups numbering more than
200 staff have made recommendations for the future paediatric
intensive care unit, surgery unit, bed
unit, outpatient unit, home treatment,
laboratory unit and the integration of
treatment, education and research.
•
Visits to all of Denmark’s quality
foundation hospitals to exchange
experience.
•
•
Study trips to a total of 21 hospitals in
Scandinavia, Europe, Canada, the
USA and Australia result in reports
highlighting areas that can make the
future hospital for mothers and
children wholly unique.
Participation in the international
conference on hospital architecture
and design in November 2014 in San
Diego, USA. A summary report of
the 53 different sessions that the
project team covered during the four
days of the conference has been
prepared.
•
Design of future user experience in
close collaboration with patients,
families and staff.
•
‘User camp’ organised for 25 patients,
relatives and staff. Report published
in book form – ‘Børneriget’.
•
Screening of the market for short-,
medium- and long-term technological
solutions.
•
‘Building camp” attended by
130 patients, relatives and staff who
designed sections and rooms.
•
Involvement of patients, families and
relatives in all phases of the feasibility
study from initial steering committee
meeting to individual activity
planning, including establishing a
permanent user panel.
This feasibility study provides the basis
for the project content and design.
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1 3 - O R G A N I S AT I O N
WE RESERVE THE RIGHT TO
GET SMARTER.
20 -
4 - PREREQUISITES
4.
P R E R E QU I S I T E S .
We will build the hospital of the future for families and children, secure in the
knowledge that all we can say about the future is that we know very little. Needs
in 2023 may differ vastly from our current predictions and we intend to use this
insight in our planning.
While our hospital complex will give unprecedented focus to the needs of patients,
their relatives and treatment, it will also incorporate the greatest degree of
flexibility to embrace the needs of the future. We can calculate spatial requirements,
treatment activity and budgets and we know that flexibility will require the skills
of an unusually gifted architect – and that is no bad place to start.
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4 - PREREQUISITES
What we know – and what we can calculate.
The projected treatment activity is based
on the Capital Region of Denmark’s
general capacity calculation model
extrapolated from 2015 to 2025 figures:
Demographic development.
Population projections from Statistics
Denmark from mid-2014 show a 17 per
cent increase in Rigshospitalet’s
catchment area, which includes a sharp
rise precisely in the number of families
with children due to higher influx and
birth rates.
Age limit changes.
The Danish Health and Medicines
Authority has decided to raise the
paediatric age limit from 15 to 18 as of 1
January 2016. In future, a larger group
22 -
will therefore be classified as children.
Thus, the 15-18-year-olds will move from
the adult wards to the children’s hospital.
The basis for calculating treatment
capacity in 2025 is based on the following
capacity utilisation:
Grouping children and
adolescents.
•
The feasibility study has revealed that a
third of all children and adolescents are
currently being treated in Rigshospitalet’s
adult wards. If we are to follow the
professional recommendations for
improving treatment quality by grouping
all children and adolescents in the
hospital in a combined child, adolescent
and maternity ward, we will need to
expand the area with a children’s
operating wing, adding a combined
paediatric intensive unit with more beds
and outpatient facilities.
Beds are calculated on the basis of
7-day beds at 85 per cent capacity.
•
Outpatient clinics are effectively
utilised for 7 hours a day, 245 days a
year.
•
Operating theatres are effectively
utilised for 7 hours a day, 245 days a
year.
4 - PREREQUISITES
- 23
4 - PREREQUISITES
Areas.
Area standards.
Spatial requirements are calculated on
the basis of several general prerequisites
established by the feasibility study
steering committee.
An area standard includes the area of
the actual room itself, e.g. a bed room as
well as the necessary secondary rooms
associated with the given function –
e.g. staff workrooms, depots, toilets for
patients and staff and waiting and
common rooms for patients and families.
Gross/net factor.
The gross/net factor indicates the
relationship between gross and net area.
The net area includes the sum of the
interior areas in all functional areas, i.e.
the so-called ‘carpet area’. Traffic,
technical facility and construction areas
are not included.
The gross area includes the net area and
corridor, other traffic and construction
areas, including connecting corridors
and tunnels. The area programming
assumes a gross/net factor of 2.0.
24 -
4 - PREREQUISITES
- 25
4 - PREREQUISITES
Standard catalogue, intensive care,
children and adolescents.
The calculation of the different functional
areas is based on an outline of the type
of rooms in each and the location of the
26 -
individual rooms in relation to each other
to ensure smooth working procedures for
staff and optimal treatment care for patients.
4 - PREREQUISITES
Economy.
Standardkatalog intensivsenge børn & unge
NB: Not all small rooms are shown!
An intensive care unit, children & adolescent, 24 beds
An intensive unit
Medicine
Single bed ward
Depot
cabinet
Work
station
Single bed ward
Depot
cabinet
Niche
Work
station
Niche
Central
Depot equipment Depot exit
Depot clean Depot unclean
K Central
Common to the floor
Medicine
Single bed ward
Single bed ward
Outpatient room
F offices
Offices
Reception
Staff room
Depot
cabinet
Work
station
Niche
Depot
cabinet
Work
station
Niche
Interview room
Common room
Scullery
Primary function:
single bed ward
Secondary rooms/rooms in addition to
primary function
Air tube system
Training:
single bed ward with bathroom
Access to garden
Public zone
Stairs
Lifts
Example of a diagram outlining room
requirements and relative room proximity in
a paediatric intensive care unit.
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2 - F O RU D S Æ T N I N G E R
COMMUNITY.
28 -
5 - ACTIVITIES
5.
ACTIVITIES.
It is about bringing people together to create focus. Bringing patients together
in order to concentrate the professional focus.
The new hospital will offer patients and relatives a secure environment with
seamless continuity of care. For doctors and staff, the new complex holds the
promise of a new level of integration and synergy.
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5 - ACTIVITIES
The human life cycle as an architectural principle.
The current Juliane Marie Centre treats
children, adolescents and pregnant
women. In addition, the new hospital
will bring together all children and
adolescents from throughout all of
Rigshospitalet, thus accommodating
every area of specialisation associated
with the human life cycle.
The new building.
The new building
Adult
Children/adolescents
Children/
Children/
adolescents adolescents bed ward
From pregnancy and birth to the
treatment of illness in all life’s chapters.
The individual departments and areas
of specialisation will be logically situated
in relation to patient care.
Intensive
PICU HOT
Adult bed unit
Maternity section
HOT
outpatient
Intensive
NICU
Adult
outpaitient
Professional
floor
Surgery
Diagnostics
Children/
adolescent
outpatient
Training
Remainder
of the third
floor
Grouping/desire for
organisational proximity
Primary proximity
Secondary proximity
Arrival
30 -
Family centre
5 - ACTIVITIES
The Department of Paediatrics and Adolescent Medicine (BUK).
Specifically, the new hospital will house
the following departments:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Paediatrics
Neonatology
Paediatric intensive care
Obstetrics
Paediatric Surgery
Anaesthesiology and Surgery
Clinical Genetics
Growth and Reproduction
Psychology, Play Therapy and
Social Counselling
Orthopaedic Surgery
Ear, Nose & Throat Surgery
Eye Diseases
Occupational and Physiotherapy
Lip and Cleft Palate
Plastic Surgery and Burns Treatment
Diagnostics
The departments are spread across the
following centres and clinics:
The Department of Paediatrics and
Adolescent Medicine comprises numerous
areas of subspecialisation that deal with
the specialised treatment of heart disease
(cardiology), diseases of the nervous system
(neuropaediatry), cystic fibrosis, chronic
lung diseases, kidney diseases (nephrology),
blood disorders and oncological
malignancies (haematology/oncology),
bone marrow transplantation, protection
against antigens and microflora
(immunology), diseases of the liver
(hepatology), arthritis and other disorders
of the joints, muscles, and ligaments
(rheumatology) , infectious diseases,
semi-intensive therapy, adolescent
medicine, nutritional therapy, gastroenterology (diseases of the stomach and
intestine), social paediatrics, sexual assault
on children and adolescents and
international paediatrics.
The Centre for Paediatric
Oncology and Hematopoietic
Stem Cell Transplantation
(POST) is the largest children’s cancer
unit in Scandinavia. POST treats children
and adolescents with cancer, serious
blood and immunodeficiency disorders
and children and adolescents who are
to undergo stem cell transplantation.
POST’s overriding goal is to improve the
cure rate of children and adolescents
with cancer and improve treatment and
rehabilitation so that children and adolescents who have returned to health can
quickly resume a normal life. Treatment is
coordinated with other child cancer units
in Denmark, Scandinavia and Europe. The
centre has an outgoing function that takes
care of certain treatments in the home.
The Paediatric Oncology
Research Laboratory, Bonkolab,
is the research laboratory for the
Paediatric Oncology Unit at Rigshospitalet.
The laboratory, which mainly conducts
research into blood disorders and oncological malignancies, offers routine and
research analyses for patients with benign
disorders who receive chemotherapy for
other diseases. The primary research
domains are the etiology of childhood
leukemia, individualised therapy based on
pharmacogenetics, pharmacokinetics,
and monitoring of minimal residual disease,
as well as late effects of anticancer therapy.
The Pediatric Respiratory
Physiology Laboratory (DBRFL)
exists as a fully integrated part of the
Danish Paediatric Lung Centre (DBLC),
where treatment, development, research,
and training in children with chronic
lung diseases goes hand in hand with
focusing on developing new and suitably
establis-hed sophisticated methods for
measuring different aspects of physiology
and lung disease at various levels in the
lung in infants, toddlers and children and
adolescent pulmonary function. DBLC
receives diagnostic referrals from all over
the country and the laboratory performs
more than 3,000 specialised examinations every year.
Integration ensures direct, effective
interaction between analysts, clinicians
and researchers. DBRFL also houses the
National Laboratory for the Diagnosis
of Primary Ciliary Dyskinesia.
The Children-Youth Programme
is a cross-disciplinary unit whose function
is to ensure a high level of quality in paediatric and adolescent patient care across the
hospital’s departments. Emphasis is given
to the following focus areas: research and
development, communication and information, social activities, creating a child-,
adolescent- and family-friendly hospital
environment as well as providing cultural
experiences for children and adolescents.
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5 - ACTIVITIES
The Neonatal Intensive
Care Unit (NICU).
The Neonatal Intensive Care Unit is a
highly specialised department that treats
premature babies, children with
congenital deformities, heart disease,
neurological conditions, surgical diseases
and children after the neonatal period
and up to two years requiring intensive
care. The majority of patients are
premature babies who, for a time, often
need intensive care, including life
support on respirators and long-term
hospitalisation.
The unit is responsible for treating
extremely premature babies (born before
week 28, often weighing less than 1,000
grams) from the whole of eastern Denmark.
The intensive care unit is also the
national centre for paediatric ECMO
care. ECMO treatment comes into play
when there is a need to support both
heart and lung function in critically ill
children. In certain cases, this expertise
is used to treat children from other
Nordic countries.
The Neonatal Intensive Care Unit plays a
central role in the treatment of newborns
32 -
with congenital deformities requiring
immediate surgery and the department
therefore works closely with paediatric
surgeons, paediatric heart surgeons and
neurosurgeons.
Paediatric Intensive
Care Unit (PICU).
The unit treats critically ill children,
some of whom are children in postoperative recovery. In addition to
providing respirator treatment, the unit
also treats children transferred from
other hospital departments around the
country by NICU’s transport team.
Department of Obstetrics.
The department provides pregnancy care,
midwifery and maternity care for the local
hospital catchment area, but is also
responsible for the most complex
treatments which in Denmark are only
performed at Rigshospitalet – among these
the treatment of pregnant women with
heart, lung and liver transplants, pregnant
women with severe fetal anaemia
(immunisation against the foetus’ blood
cells or blood platelets) and pregnant
women expecting a child with deformities
and requiring treatment during or
immediately after birth. The department
is among Denmark’s busiest maternity
wards, dealing with more than 10% of
the country’s births.
Centre of Fetal Medicine and
Pregnancy is the centre for invasive
treatment of fetuses, e.g. in the form of
fetal blood transfusions, advanced and
invasive fetal diagnostics. The centre
performs a tertiary function for other
maternity wards across Denmark and to
a limited degree maternity wards from
other countries. In addition, the
department performs a high volume of
routine scans.
The Centre for Pregnant Women
with Heart Disease functions as an
integrated centre for the entire hospital,
providing examination and treatment
of pregnant women with heart disease.
Diagnosis includes echocardiographic
and MR scans. The centre receives
pregnant heart patients from all over
Denmark.
Centre for Pregnant Women
with Diabetes is Denmark’s largest
unit of its kind for this type of patient.
Staff includes numerous professional
groups (obstetricians, endocrinologists,
ophthalmologists, midwives, nurses, laboratory technicians, dietitians, secretaries) and
the unit examines and treats pregnant
women with diabetes, a patient group
which traditionally has experienced an
extremely high risk of developing serious
complications. By virtue of its scientific
research, the centre has for many years
enabled women with diabetes to become
pregnant and give birth.
Department of
Paediatric Surgery.
The Department of Paediatric Surgery
is responsible for paediatric surgery with
diagnostic evaluation, care and treatment
as well as the check-up of children with
congenital abnormalities, acquired
diseases and injuries in the oesophagus,
the digestive tract, liver and biliary
tract, pancreas, urinary tract and
genital organs where surgery is or can
be an important factor in treatment.
5 - ACTIVITIES
Department of
Anaesthesiology and
Surgery.
The Department of Anaesthesiology and
Surgery provides anaesthesia, surgery
and post-operative recovery assistance in
connection with births and operations on
children and adolescents. The departments also specialises in the acute pain
management of children.
The acute pain management unit provides
treatment, research and development, and
education and training in the acute pain
management of children and adolescents.
Department of Clinical
Genetics.
The Department of Clinical Genetics offers
diagnosis, management and counselling
in connection with genetic disorders,
including prenatal diagnosis and
diagnosis and treatment of congenital
metabolic disorders and other rare diseases.
The department is equipped with
state-of-the-art technology for all forms of
molecular genetic diagnosis and metabolic
analyses. The clinic also houses a research
unit which conducts research into molecular genetic and molecular biological
disease mechanisms.
Department of Rare Diseases.
(CSS) is an outpatient department
responsible for the diagnosis, treatment
and genetic counselling of children with
congenital diseases.
Focus is on children with rare, congenital,
complex and often multiorgan diseases
requiring highly specialised and crossdisciplinary treatment involving numerous
specialist units at Rigshospitalet.
Centre for Congenital Metabolic
Diseases (CMS) is a partnership
between Metabolic Laboratory, Molecular Genetic Laboratory, the Department
of Rare Diseases, the PKU Department,
Department of Paediatrics and Adolescent
Medicine, NICU and the Pediatric Nutrition
Unit, but also involves the Department of
Psychology, Play Therapy and Social
Counselling, The Department of Occupational and Physiotherapy and several other
departments at Rigshospitalet.
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5 - ACTIVITIES
The centre has extensive experience
in diagnosing and treating metabolic
diseases caused by enzyme defects.
The Kennedy Centre is home to the
Centre for Fragile X Syndrome, the PKU
Department (phenylketonuria or Følling’s
Disease) and the Centre for Rett Syndrome.
Department of Growth
and Reproduction.
The department’s outpatient clinic takes
in children from all over Denmark with
growth problems and hormonal diseases,
and patients with medical diseases in the
male reproductive organs, such as infertility and insufficient sex hormone production.
Department of
Psychology, Play Therapy
and Social Counselling.
The aim of the department is to treat
patients experiencing psychological
reactions and to provide social counselling in connection with serious illness and
rare disorders.
34 -
Department of
Orthopaedic Surgery.
Orthopaedic surgery is the surgical
treatment of disease in and injuries to the
musculoskeletal system. In addition to
treating all paediatric conditions, the
department offers spinal brace treatment
and treats spinal deformities in children
and adolescents. Such deformities include
club foot, slipped hipped joints, fractures,
congenital osteoporosis, spina bifida,
curvature of the spine (scoliosis) and
children with complications following
cerebral palsy.
Ear, Nose and Throat
Surgical & Audiological
Clinic.
The Ear, Nose and Throat Surgical &
Audiological Clinic treats acute and
chronic medical and surgical conditions
of the ear, nose and throat.
The clinic possesses highly specialised
expertise in treating patients with small,
difficult airways, congenital head and
throat anomalies, head and throat tumours
and in providing life-prolonging nasal
sinus revision of patients with cystic
fibrosis and sensory defects, including in
particular middle ear and inner ear
disorders where the department’s doctors
and audio therapists help deaf children to
hear using cochlear implants, for example.
The clinic also possesses special expertise
in other areas such as obstructive sleep
apnoea, vessel anomalies and genetic
hearing disorders. In addition to clinical
expertise, the department conducts extensive research into the above areas. Naturally, the clinic also participates in various
multidisciplinary teams in the treatment
of patients with syndrome diagnoses.
The Eye Clinic.
The Eye Clinic treats children with
medical and surgical eye conditions, often
those that are rare and serious.
The medical conditions range from iritis
in children with arthritis to extreme dry
eye syndrome following bone marrow
transplantation and monitoring procedures following cancer of the central
nervous system. Surgical conditions
include premature retrolental fibroplasia
(also known as incubator blindness),
congenital green cataracts, congenital
cataracts, congenital blocked tear duct,
squinting, sagging eyelids and traumas.
In Denmark, the treatment of premature
retrolental fibroplasia is centralised, only
taking place at Rigshospitalet, where
children are hospitalised in the neonatal
clinic and treated at the eye clinic.
Some rare deformities are operated on in
collaboration with other departments
– i.e. the department of plastic surgery.
The eye clinic also has a major
supervisory role for other departments at
Rigshospitalet, as many diseases affect
children’s eyesight.
Measuring sight parameters and eye
examinations are therefore important in
the planning of the child’s treatment in
general.
Eye diseases in children severely affect
the quality of life for both child and
family. Treating eye disease entails
frequent visits to the hospital and
treatment at a specialised children’s
hospital will only serve to improve the
quality of treatment and provide greater
security for children and families.
5 - ACTIVITIES
Department of
Occupational and
Physiotherapy.
The department treats and rehabilitates
hospitalised patients. Physiotherapy and
Occupational therapy function as crossdisciplinary units throughout the entire
hospital.
Department of Plastic
Surgery, Chest Surgery
and Burns Treatment.
The department deals with highly
specialised treatment and care of
children, specifically lip-gum-cleft palate
and craniofacial deformities that are
performed in very close cooperation with
several other areas of specialisation
within surgery, severe ear deformities
(including delayed ear development),
congenital melanocytic nevus syndrome
(children born with extremely large
birthmarks covering large areas of the
body), facial paralysis, congenital or
acquired, requiring microsurgery
(moving free tissue on blood vessel stems
from one area to another), major
peripheral vascular deformities, including
haemangiomas, are treated in close
collaboration with diagnostic radiology
and dermatology, major reconstructions
in the form of assistance to other
operations in other areas of specialisation,
cancer, e.g. sarcomas and traumas.
Often the department performs major
reconstruction procedures using
microsurgery as well as treating major
burns.
At regional level, the department is
responsible for treating children with
melanoma, neurofibromatosis and other
benign tumours as well as closing defects
following spina bifida operations
The Diagnostic Centre.
An international leader encompassing
several inter-disciplinary areas of
specialisation, The Diagnostic Centre
performs laboratory tests, diagnostic tests,
procures donor blood and manufactures
blood products as well as providing
medical counselling.
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6 - PROPOSALS FOR THE FUTURE
6.
P RO P O S A L S F O R T H E F U T U R E .
Our proposal is to consolidate all child patient care at Rigshospitalet in an area
dedicated to children aged between 0 and 18. Maternity wards and beds for
pregnant women and women in labour are to be grouped together in order to
achieve logical treatment synergy and exchange of experience.
This will make Rigshospitalet an international centre of excellence, drawing patients
and qualified staff from the whole of the Nordic region.
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6 - PROPOSALS FOR THE FUTURE
Future paediatric intensive care.
Four centres are currently involved in
treating critically ill children – with
intensive treatment taking place in five
different sections.
The sections are organised partly
according to medical specialisation and
partly according to patient age. At
Rigshospitalet, the different departments
offering paediatric intensive care work
together. Thus, it is not unusual for a
child at Rigshospitalet to be hospitalised
in two or three different intensive
therapy units during treatment.
Grouping all children into a paediatric
intensive care centre will mean
Rigshospitalet can treat the most
complex patient types because all
specialities will be represented – both
paediatric specialists and basic specialists
– while maintaining close links with the
adult specialities in the main hospital. It
will also mean that families will
experience simpler patient care because
the specialists will come to the child and
not vice versa.
Rigshospitalet will thus contribute
towards more structured and specialised
training, developing the various areas of
38 -
specialisation and expert education in
the paediatric intensive field.
Future Neonatal Intensive Care
Unit (NICU) – newborns.
An intensive unit for newborns
encompassing several different patient
types – both premature babies requiring
proximity to a maternity ward and
critically newborns with serious illnesses.
Towards 2025, the number of patients
and bed days is expected to rise within
the neonatal field.
Treatment duration will also increase
because developments in the areas of
specialisation will determine the point at
which treatment must be abandoned.
Future Pediatric Intensive Care
Unit (PICU) – children aged 0-18.
The basis for establishing a PICU at
Rigshospitalet will be supported by the
proposed centralisation of paediatric
intensive therapy with only two or three
PICUs in Denmark.
Depending on the degree of national
coordination of paediatric intensive care,
the need for a paediatric transport
scheme will increase and the PICU
function will thus require a transport
scheme that includes a 24-hour decision
support function.
Overall, we expect a growing need for
intensive care in 2025 based on the
expectation that hospitals, in future, will
seek to prolong treatment and that
treatment will become more
comprehensive than that offered today.
Future Paediatric Surgical
Anaesthesiology Unit at
Rigshospitalet.
Four centres currently deal with children
undergoing surgical procedures and sections are divided into medical specialities.
The proposal is to group all children at
Rigshospitalet in a dedicated paediatric
surgical unit aimed at children aged
between 0 and 18. This will pave the
way for Rigshospitalet to become an
international centre of excellence,
drawing patients and qualified staff from
the whole of the Nordic region.
It will also mean that Rigshospitalet can
treat the most complex patient types
because the unit will represent all
specialities and thus provide easy access
to all specialists.
Families will experience simpler patient
care because the specialists will come to
the child and not vice versa.
In a unit dedicated to children aged
between 0 and 18 it will be possible to
tailor layout and design to the needs of
children and families. The unit must be
child-friendly without being child-ish.
All children will have at least one parent
with them in the surgical unit to ensure
family involvement before, during and
after the surgical procedure and it must
be easy for parents and staff to contact
each other. A further important
consideration for the operating unit is to
offer ways of distracting children to
prevent them from becoming anxious in
unpleasant situations.
The aim is to avoid having to restrain
the child.
Future Paediatric Bed Unit at
Rigshospitalet.
In relation to bed planning, children are
currently hospitalised at the Centre of
6 - PROPOSALS FOR THE FUTURE
Head and Orthopaedics, the Heart
Centre and the Juliane Marie Centre.
The proposal is to group all beds for
children and adolescents in the new
hospital to give families the best possible
means of providing support to a sick
child. Being able to include elements
from daily life is an important part of
this – just as it is important to create
greater cohesion between the hospital
and the world outside to ensure that the
patients can continue to develop as
children and adolescents within the
context of their families. Normal life
takes on a special significance when
someone in the family becomes so ill that
they require hospitalisation.
In the hospital of the future, patient
wards will be established on the principle
that patients should be moved as little as
possible and that instead staff should be
brought to the patient.
•
Increased home treatment and home
monitoring.
Future Bed Unit for Pregnant
Women at Rigshospitalet.
Delivery rooms and beds for pregnant
women and women in labour will be
grouped together in the new hospital.
The perception of birth as a natural part of
life will generally lead towards shorter stays
in hospital. On the other hand, the
incidence of pregnant women with chronic
medical conditions such as obesity, diabetes
and high blood pressure is expected to rise,
thus increasing the activity level of
Rigshospitalet’s highly specialised unit.
From a purely demographic standpoint,
the birth rate for Copenhagen as a whole is
expected to rise. Unit activity will therefore
depend on the hospital plan and thus
Several factors will cause bed capacity
requirements to fall in coming years:
Reorganisation of surgical procedures
to outpatient and day surgery.
Increased outpatient diagnostic
activity.
•
•
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6 - PROPOSALS FOR THE FUTURE
Rigshospitalet’s catchment area.
Activity over the past ten years has varied
greatly and the new hospital will
therefore need to exhibit a high degree
of flexibility. This requirement can be
met by placing the bed wards close to the
delivery rooms – bed wards that can
easily be adapted to delivery rooms.
Future Paediatric Outpatient
Care at Rigshospitalet.
In relation to outpatient treatment,
children are treated in all centres at
Rigshospitalet.
The proposal is to combine all out-patient
functions for children and adolescents in
order to give families the opportunity to
support their sick child.
Grouping all children in an outpatient
wing will allow Rigshospitalet to treat
the most complex patient types because
all specialities will be represented, thus
ensuring easy access to all specialists.
Families will also experience simpler
patient care.
An outpatient wing designed for children
40 -
and adolescents demands a design that
supports play. Children must be able to
enjoy an uninterrupted play flow – even
during visits to the outpatient unit. There
must be ample opportunity for staff and
users to give and receive training and
adolescent needs must be incorporated
into patient care on an equal footing with
those of the other age groups.
Outpatient care will be based on a
pit-stop approach, where all specialist
consultation is coordinated and handled
in a streamlined flow. Staff come to the
patient – not the other way round.
General trends:
Outpatient treatment, same-day
surgery and home treatment are on the
increase. The trend in society and IT
development together with video-based
consultation mean that chat, e-consultation and question times etc. will largely
replace traditional consultation methods.
Advances in equipment also mean
that more examinations – e.g. CTG
– will take place in the home.
In line with shorter hospitalisation
there will be a need for expanded
outpatient capacity. In addition to the
•
•
•
need for more outpatient follow-up,
earlier discharge will result in a trend
towards more home treatment.
Future Outpatient Care for
Pregnant Women.
Today, pregnant women are offered outpatient care at several locations. In future,
all check-ups will be centred at the
mother and child hospital – with the
exception of a single midwifery centre in
Østerbro in accordance with the Capital
Region of Denmark’s maternity plan.
This will ensure a coherent flow for
families and that the necessary expertise
is on hand. The pit-stop principle will be
the same as in the paediatric outpatient
centre: it is the experts who come to the
patients. Thus a pregnant woman with
heart disease will be examined by several
experts at her first consultation: an
obstetrician, a heart surgeon, an
anaesthesiologist and a thoracic surgeon.
This team can then plan and inform the
patient about monitoring and any
precautions in the ongoing treatment
process.
It is our vision to provide patients with
the best possible care in the least invasive
way – including the offer of home
treatment when applicable. Our guiding
principle is, therefore, that the hospital
should provide only treatment and care
that cannot take place in the home.
Technological development and the
advent of technological aids in the home
are expected to increase exponentially.
This will pave the way for a wide range
of home-based monitoring and treatment
options. Presumably, the sky is the limit.
Examples include monitoring at-risk
pregnancies in the home, foetal
monitoring and blood sampling.
6 - PROPOSALS FOR THE FUTURE
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6 - PROPOSALS FOR THE FUTURE
Future integrated treatment,
research and education.
The idea is obvious: to learn from all
diagnostic procedures and patient
treatments. To merge research and
education with clinical practice.
To share our knowledge and inspire
each other in achieving the highest
professional standards possible.
Research, development, innovation
Our research vision is to create better
treatment and patient care. More
patients must be cured or enjoy improved
quality of life with their illness.
Digital technologies have revolutionised
our societal infrastructure. The
biotechnological revolution will
revolutionise our ability to integrate
clinical practice with research and
education.
Essentially, it is about the new
possibilities of mapping the human
genome on an individual patient basis.
Only a few years ago, the cost of such
mapping ran into six figures. Today it
can be done in a few hours at a fraction
of the cost. We will routinely be able to
map the genomes of all future children at
42 -
an early embryonic stage. A simple blood
test will enable us to diagnose a long list
of embryonic genetic deformities which
were previously impossible to detect until
considerably later. In other words, we
will be in a position to dramatically
leverage our knowledge and options.
Rigshospitalet’s maternity unit will be at
the forefront of this development,
developing both ethical and educational
standards for managing this new
knowledge.
The new knowledge about the individual
patient’s genome will also revolutionise
future medical treatment in the form of
customised treatment and dosages. In
Denmark, we have unique conditions for
linking environmental and genetic data
with new knowledge about the incidence
of disease, and thus new possibilities for
preventing such diseases.
Biotechnological advances and the
ability to map the molecular structure of
a wide range of diseases will result in the
development of biological drugs targeting
unique cellular functions. This will
create a huge need for phase 1 and phase
2 biological drugs testing, which in the
case of paediatrics is hampered by the
extremely low incidence of the diseases.
Rigshospitalet has established the first
units in Denmark for testing such drugs
for children with cancer (the only unit of
its kind in Scandinavia) or children with
congenital metabolic disorders.
At the new hospital, phase 1 and phase 2
will be organisationally consolidated into
a single unit, exploiting its knowledge to
include patients from the other areas of
specialisation in paediatrics. This will
also enable us to treat patients from the
rest of the country as well as those
outside Denmark – and from a European
standpoint, the unit could function as an
important and highly attractive
collaborative partner for the pharma
industry.
The specialist floor – the Academy.
We will establish research and
educational facilities in all clinical
departments, simultaneously establishing
an entire floor dedicated to scientific
research. The floor will feature research
laboratories, meeting rooms, offices,
guest laboratories and guest offices. Our
ambition is to stimulate synergy between
research environments across disciplines
and areas of specialisation, and attract
the finest talents in the field. Excellent
facilities that support research and
development will make it an attractive
environment in which to take breaks and
hold meetings. In short, we will create an
innovative hub where numerous
specialist areas can interact.
Education
Our vision for education and training is
that learning must be supported in all
procedures and that everything that can
be trained– must be trained. We will
continue to focus on this area,
strengthening research-based
educational efforts, integrating training
and learning in our daily work routines
with an emphasis on patients and their
families. We will conduct research into
learning methods and monitor derived
learning in order to assess the quality of
our clinical work. We will establish a
framework in which education is an
integrated part of operations on equal
footing with patient treatment, ensuring
that education and learning are present
for all professions in outpatient units,
6 - PROPOSALS FOR THE FUTURE
treatment rooms, surgical wards, etc.
Education of the future must include
learning facilities that ensure learning
– both with – and without patient
involvement. In other words, teaching
facilities that facilitate different types of
training, and clinical facilities that
support learning, supervision and
feedback. From an education standpoint,
there will be a need for hands-on
learning, with easy access to areas where
supervisors and students can review
training material and have feedback
discussions.
In future, relational learning will play a
major role, and areas devoted to scenario
training of interprofessional
communication with patients and
families will not only be necessary, but
will also be given priority. Clinical
teaching will be largely based on
training in close proximity to the patient,
affording an increasing degree of student
autonomy and peer-to-peer training
under competent supervision.
Outpatient training
Developments in medicine and treatment
technology will result in shorter periods
of hospitalisation and thus more training
via outpatient care and day surgery.
Outpatient units must support video
supervision, enabling observation
without the need for the consultant to be
physically present. Outpatient units must
provide extra room for students and
independent work in adjacent rooms
under close supervision (e.g. so-called
backup outpatient function).
Simulation-based training
Shorter and more effective healthcare
training and patient safety requirements
mean that training must increasingly be
simulation-based, with an emphasis on
learning – as opposed to patient
treatment, which must always prioritise
the patient. There will be a growing need
for individual and team-based
simulation-based training targeted at a
wide range of professions and levels of
experience.
Looking to the future, healthcare
personnel can expect more stringent
formal requirements with regard to
mastering high-risk procedures such as
surgical interventions prior to such
procedures being carried out on patients.
This will require the establishment of
simulation-based training facilities and
the redesigning of operating theatres,
maternity units, neonatal wards and
wards that are well suited to simulationbased learning and competency
assessment.
New technologies
We will integrate more active participant
training. It will require hybrid courses
that integrate physical courses with
online courses. All rooms must be
transmission-enabled with a view to
teaching, learning, supervision and
feedback.
technologies must support teaching and
reflection close to patient areas.
Patient involvement
In this context, patient empowerment
means that the active involvement of
patients and families in their own
treatment can provide students with a
direct understanding of the patient’s
perspective on their own illness.
Teaching situations must offer the
possibility for national and international
input and feedback.
Increased digitisation will offer the
possibility for log books for all students.
Log books can be linked to operation
lists or patient ward rounds, for example.
Digitisation will also mean that
knowledge will be updated more
speedily, which in turn will necessitate
increased access, user-friendly
instructions and online guidelines. IT
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7 - PAT I E N T PAT H WA Y S
7.
PAT I E N T PAT H WAY S .
Patients must experience coherent, coordinated treatment without problematic
transfers between departments and clinics, centres and sectors. Coherence and
coordination must be a recurring feature of the new hospital complex.
The building must reflect not only ground-breaking architecture, but also new
standards of logistics and functionality. The aim is to create individual and
intelligent patient care for every single patient – child, adolescent and adult.
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7 - PAT I E N T PAT H WA Y S
Expertise with a human face.
The first five minutes must be the best.
Patient care must be one continuous flow
– one is almost tempted to say painless.
From the initial contact by phone, letter or
email to completed treatment and potential
follow-ups. The first meeting is crucial to
the overall impression and its design –
whether written or spoken – must put
people at their ease.
Paradigm shift: the experts come to the patient.
The feasibility study has mapped 100
courses of individual patient pathways.
See the example on the right:
Figure: Illustrates a patient care flow.
In between the two bold lines we see the patient’s
many different contact points with the hospital.
46 -
7 - PAT I E N T PAT H WA Y S
Patient carecare
flowchart
Patient
flowchart
The Department of Paediatrics and Adolescent Medicine, acute, congenital, chronic blood diseases, 15-18 patients/annually
Consultation
Administrative
procedures
Diagnosis and treatment + follow-up care
Referral from
own
GP/hospital
Samples
(sent)
BAS test
analysis
UL dept., RGT.
Thorax
Images etc.
(patient transfer)
Continue in JMC until they
are approx. 18. Transition to adult
haematology
Walks home
Other bed
wards in clinic
Own
outpatient
Hospitalised
for OP
Hospitalised for
blood transfusion
Own bed ward
Preliminary
consultation in 5002
5002
Walks home
Other depts. at
RH
Walks home
BAS test analysis to Herlev,
Clinical biochemistry,
Microbio., Blood bank
Consultation by other
clinical depts.
Other
collaborative
units
Echocardiogram
5003
BAS test analysis to Clinical
biochemistry and Blood bank
Hospitalised for
blood transfusion
Walks home
Follow-up
x2
Follow-up
Walks home
Other sections
in JMC
Hospitalised for
blood transfusion
Walks home
Follow-up
x2
Operation or
Port A Kath
Recovery
Ophthalmologist
2061
Ophthalmologist
2071
GR dept. 5064
Blood pressure 5002
Clinical biochemistry
and Blood bank
Blood pressure
5002
Days 1-2
Annual follow-up – possibly
half-yearly follow-up
Echocardiogram
Audiometry
Eye Clinic
GR dept.
MR scan, brain/liver?
Flow cerebrum
UL abdomen
Interpreter
Social counsellor
Social worker
Medical educator/school
teacher/hospital ward instructor
throughout patient care
Hospitalised for blood trans.
every 3-4 weeks.
In between: (clinical follow-up)
+ blood samples x 2 months in
outpatient in 5002.
Blood bank
Day 3
Interpreter
assistance for ?%
of patients
Timeline
Day 28
Neurological dept. BBH.
Central. Blood/?
Day 21
Day 28
Herlev MR
scan/Heart/Lung
BBH:
Neurological
Herlev: MR dept.
From 3 months
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7 - PAT I E N T PAT H WA Y S
We have approved a paradigm shift,
ensuring that in future the experts come
to the patients. This reduces the number
of patient visits to the hospital to consult
a variety of experts for a diagnosis.
This can now be dealt with at the initial
consultation, as all the relevant clinicians
are on hand and all examinations have
already been planned.
The diagnostic unit is located next to
the outpatient and operating theatres,
ensuring easy access and immediate
diagnosis.
The many follow-up consultations and
some treatments can be replaced by home
treatment and telephone consultations
– once again easing conditions for
patients and families.
Figure: In the new hospital, pit-stop philosophy
will be integrated into the design. Specialists will
visit the patients so the diagnosis can be given at
the initial consultation.
48 -
Patient care flow/elective
Patient care flow/elective
Future patient care flow – the patient’s physical journey
Clinic: The Department of Paediatrics
and Adolescent Medicine
Names of participants: Lise, Marie, Marianne, Inger, Anja, Susan, Jesper
Patient profile: brief, difficult, complex process/elective
Coordination of diagnosis/treatment/observation
Home
Consultation/treatment
Referred by another
hospital/known by BUK.
Other
hospital
Own section
Ordinary ward:
At the quiet end.
Same staff as before.
Know the department.
Shared with
others
Day hospital:
In outpatient unit.
Familiar staff.
Have own room/ward.
Other
locations at
RH
Timeline
Diagnostic Centre:
Phys., Diet., Psych.
Specialised examinations.
Highly specialised
examinations.
Few days
7 - PAT I E N T PAT H WA Y S
Patient care flow/acute
Patient care flow/acute
Future patient care flow – the patient’s physical journey
Clinic: The Department of Paediatrics
and Adolescent Medicine
Names of participants: Lise, Marie, Marianne, Inger, Anja, Susan, Jesper
Patient profile: brief, difficult, complex process/acute
Arrival/diagnosis/treatment start
Home
Acutely ill. Known/
unknown diagnosis.
Other
hospital
Acutely ill. Known/
unknown diagnosis
Own section
Shared with
others
Ongoing treatment
Discharged
home
Acute ward:
Close to PICU/NICU.
Parent recess with dialogue.
Advanced diagnostic imaging.
Isolation doors.
Antechamber with work station.
Room for small sterile procedures.
Telemedicine.
Laboratory equipment.
Referring unit of PICU staff.
Moved after 24 hours.
EEG, ECG, SAT, BT.
Ordinary ward:
Interview, staff
Other
locations
at RH
Timeline
Max. 24 hours
Days
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WE WILL GIVE THE WORD
‘HOSPITAL’ A WHOLE NEW
MEANING.
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8 - TECHNOLOGY
8.
T E C H N O L O G Y.
Not content to follow developments in healthcare technology, IT, functional
design and sustainability we aim to lead development. We will embrace
technological development, continually implementing and developing
technology – an ambition and complexity made no easier by the fact that
solutions must be robust in relation to future technological advances.
But the goal is a simple one – to free up resources for the best treatment,
education and research in the world.
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8 - TECHNOLOGY
The technological part of the medical profession.
In the years ahead (not to mention
months) we will see the introduction of
IT systems and software that can support patient care, regardless of whether
the patient is in hospital or at home.
Healthcare staff must therefore be
trained to screen and identify the
needs of patients and/or their
parents’ resources in terms of home
treatment.
patients and the hospital always know
where we are in the process and what
lies ahead.
Telecommunication with sound and
images that enables face-to-face
communication between nurses in the
home and the primary department,
between patient and the primary
department and between the patient
and health visitor or the interdisciplinary departments involved in
treating the patient. The patient’s
clinical state can also be monitored in
the home.
The common electronic medical
record system and documentation
program used by the entire healthcare
system, including patients themselves
– equipment, respirators, pumps etc.
can be hooked up to the system and
accessed by all parties, making quality
assurance and treatment monitoring
possible.
Home treatment is rooted in the
desire to return as much as control
as possible to patients; we must view
them less as patients.
Patients will become introduced to
teleconsultation during initial
examination, e.g. recording of own
medical history, monitoring or
registering data in advance of clinical
diagnosis (initial physical contact with
the hospital). Home treatment and
monitoring can occur throughout the
patient care process in connection
with both outpatient and hospitalised
treatment. The type of home treatment will range from video consultations regarding own treatment and
monitoring to home treatment by an
outgoing function such as home
nursing care. The patient’s physical
contact with the hospital will to a
large extent be replaced by electronic
communication, something we are
already familiar with from e-trading.
To ensure secure, professional patient
care we must be at least as good at
managing our joint patients as e-trade
is at managing our orders so that both
In the coming years a significant and
increasing number of patients will be
found to have congenital diseases or
disease with a genetic component.
This finding is an essential and
integrated part of diagnosis, treatment,
prognosis and follow-up, including the
possibility for family diagnosis and
prenatal diagnosis.
The possibility and need for tailored
treatment will grow exponentially over
the coming decades. This will affect
analysis of the patient genome and
tumour genome for cancer patients,
medicine consumption and detailed
registration of patients’ disease and sideeffect phenotypes. Going forward we
expect an increased use of point-of-care
monitoring (POC) and treatment. This
will entail on-the-ward laboratory
examinations and diagnostic imaging
and that equipment such as respirators
and dialysis equipment is brought to the
patient rather than the other way round.
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Future Laboratories and
Diagnostic Imaging.
Diagnostic Imaging.
When it comes to diagnostic imaging,
Rigshospitalet already ranks among the
world’s finest and the diagnostic imaging
service will be both a focal point and the
point of departure for providing the best
patient care. The diagnostic imaging
function will become a professional and
technological spearhead unit which,
by virtue of its palette of sophisticated
modalities, will ensure world-class
diagnostic imaging. X-ray and ultrasound
examinations, PET-CT-scanning
(positron emission tomography) for rapid
cancer diagnosis, MRI scanning
(magnetic resonance imaging) which uses
a magnetic field and radio waves to
display images of bones, sinews and
muscles, CT scanners that can display 3D
X-ray images and SPECT (single photon
emission computed tomography) that can
chart activity in the central nervous
system. This unique service will require
substantial capacity and focus and will
need to be made a high priority. However,
we firmly believe that the need for
diagnostic imaging examinations will rise
sharply in the coming years to ensure
quick, targeted and accurate diagnosis
– and thus swift treatment.
8 - TECHNOLOGY
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8 - TECHNOLOGY
Breaking news – as late as
possible.
The feasibility study has categorised
relevant healthcare technologies into
three groups: immediately accessible,
accessible within a five-year period and
pipeline or drawing board technologies.
Our conclusion is that the electricity grid
must be dimensioned so that it is geared
to all future technological solutions – “the
cables can’t be thick enough” – but we
must delay purchasing specific equipment
as long as possible to ensure we have
state-of-the-art technological solutions.
We will ensure two-way communication
in as many clinical workplaces as possible,
paving the way for real-time communication with patients at home, collaborative
partners at other hospitals, second opinion,
training, supervision etc.
Two-way communication will also help
meet our demands for a high degree of
flexibility and the integration of clinics,
education and research, just as it will
reduce the need for physical space for
telecommunication.
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Technological development.
Intensive wards of the future must be
able to function as isolation wards, both
to protect the patient from outside
infection and to protect other patients.
Bacteria and viruses of the future will
continue to develop resistance, thus
increasing the need for protection as
well as for cleanliness and sterility.
8 - TECHNOLOGY
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PHYSICAL MANIFESTATION.
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9 - ARCHITECTURE
9.
A RC H I T E C T U R E .
How competent can a hospital feel? Is it possible to imagine a building so manifestly well-conceived that its very design inspires hope and confidence?
Where wards and departments are logically organised, providing users with a
clear overview and sense of direction? Where the patient ward has a healing effect
on both patient and family? Where you know – and can feel – that you are in the
world’s best hospital? This is the hospital of our dreams – situated in the heart of
Copenhagen.
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9 - ARCHITECTURE
Building plot, landscaping, building and engineering.
Building plot.
Rigshospitalet’s plot is situated in the
heart of the city in Copenhagen’s
Østerbro district. Dating back to 1910,
Rigshospitalet’s original building is
located on part of Blegdamsfælleden –
an open green area which still flanks two
sides of the hospital grounds:
Amorparken to the south west and
Fælledparken to the north east. To the
northwest, Rigshospitalet is encircled by
an approach road to central
Copenhagen, Nørre Allé, and to the
south east by a building complex typical
of Copenhagen on Blegdamsvej.
The illustration shows the outline of the
building plot situated in the western part
of the hospital complex towards
Amorparken and the skate park in
Fælledparken. Henrik Harpestrengs Vej,
an important bicycle thoroughfare
spanning the city, intersects the plot.
The road runs between the 1970s
hospital and the recently built patient
hotel on one side and the edge of the
hospital complex towards the skate park
and Amorparken on the other.
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Spearheaded by city architect Tina
Saaby, City of Copenhagen is committed
to creating a vibrant urban environment
with ample urban spaces for its residents
and visitors.
The project group is in ongoing dialogue
with City of Copenhagen regarding how
the hospital complex can open itself to
and act as a resource for the city.
Landscaping.
In addition, the garden and patio designs
must underpin the three design principles
– integrated play; see me, hear me, let
me; designed for daily living – by
providing:
•
•
•
The dialogue process has resulted in
several focus points that are to be
incorporated into the competition
material:
•
The boundary bordering the patient
hotel, a minimum of 15-20 metres
separation distance depending on
building height.
Maintaining trees worthy of
preservation towards Amorparken
and Edel Sauntes Allé.
The experience of Henrik
HarpestrengsVej.
Borders towards Rigshospitalet.
Borders towards the city.
•
•
•
•
The Municipal Plan Supplement suggests
a maximum height of 60 metres.
•
•
•
•
Direct access to the outdoor patios
from the common areas.
A clear view of the surroundings as
part of the wayfinding strategy.
Patios designed with integrated play
in mind – with a design that
appeals to all age groups.
Patios technically equipped like the
indoor common rooms with good
Wi-Fi coverage, visible ‘displays/
number systems’ in the outpatient
areas, staff intercom, etc.
Recreational experiences and
activities, outside as well as inside.
Possibilities for year-round use.
A choice of plants and surfaces that
reflect the changing seasons.
9 - ARCHITECTURE
Illustration of building plot.
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9 - ARCHITECTURE
The building.
Despite the size of the new hospital
complex, the building must not feel
overpowering. It must be clearly
structured and divided into distinct
zones, almost like a town with a main
street (e.g. the public zone by the lifts and
reception areas), side streets (the semipublic zone, common areas in the sections,
for example) and private zones (bed
rooms, for example).
The zones must be clearly marked and
distinguishable from one another – in
terms of individual design and the design
features that complement the building’s
architecture and design.
Furniture and equipment.
The design of furniture and fixtures must
enhance the experience of the three
design principles – integrated play; see
me, hear me, let me; designed for daily
living – by:
•
•
•
Differentiating the design according
to the zone you are in.
Creating everyday experiences in the
private zones and common rooms.
Incorporating integrated play to
stimulate curiosity.
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•
•
•
•
•
Stimulating sensory experience
through surfaces and textures.
Creating tranquillity and coherence
throughout the building.
Fulfilling formal functional
requirements.
Supporting proper hygiene and a
high degree of patient safety.
Offering patients self-service options
based on internet and mobile
solutions.
Automating large parts of the supply
chain and ensuring sustainable and
intelligent use of resources.
•
Architectural flexibility and
robustness.
Flexibility-flexibility-flexibility!
A range of factors affect future
requirements for a mother and child
hospital: healthcare developments,
technology, cultural trends, political
initiatives, demographic changes,
economic challenges, family constellations,
epidemics, etc.
Flexibility is therefore a fundamental
requirement for the new hospital complex.
Today, the individual clinics have a certain
number of beds at their disposal;
tomorrow, this number will presumably
have changed. We will therefore group all
beds together into areas where ownership
between the clinics can change effortlessly in
line with specific needs. Neighbouring wards
can easily be merged with one another.
The following are illustrative examples:
Standardisation of all rooms.
The new hospital must be able to meet
extra capacity requirements related to
healthcare developments. Outpatient
clinics can be converted into wards, which
can be converted into intensive wards,
which in turn can be turned into
operating theatres.
Naturally, a simple outpatient room
cannot be turned into a sophisticated
operating theatre at the drop of a hat,
but the general building construction –
e.g. height of the individual floors – must
support the ongoing adaptation of
hospital functions.
Future-proofed rooms.
Operating theatres are dimensioned to
accommodate future requirements for
sophisticated diagnostic equipment and
robot-assisted surgery.
The diagnostic unit.
The development in diagnostic imaging
equipment is an area currently experiencing explosive growth. The new hospital
will be equipped with state-of-the-art
facilities.
At the same time, the building will have a
reinforced structure to accommodate
future heavy machinery and equipment
with easy access assured through the
façade structure.
Multifunctionality.
Bed wards in the paediatric section will be
designed as single-bed wards. That said,
they will be able to accommodate two
beds in the event of disaster or epidemics.
Similarly, wards can easily be converted
into isolation wards.
IT.
Wall cabling must be of a standard such
that it can meet the demands of the
future.
Capacity.
A description must be provided as early as
the planning stage and in the architectural
competition prospectus of how the
finished building can subsequently be
expanded.
9 - ARCHITECTURE
Logistics.
We envisage the following:
The logical structure must ensure that
clinical staff can focus on their core tasks:
treatment, education and research.
Internal and external zones must be
clearly separated. Internally, delivery of
equipment and goods to departments and
units must be made efficiently without
disturbing patients and families.
•
Logistics comprise:
People flow.
Goods flow.
Equipment flow.
Medicine flow.
Waste management.
•
•
•
•
•
The new hospital must have a logistical
infrastructure that supports ease of
access and short distances throughout,
with facilities locations that encourage
labour-saving work processes and good
operating economy – not to mention good
working conditions for staff.
Infrastructure and logistics must ensure a
high degree of operational security of
supply, optimal hygiene and working conditions as well as correct storage and transport standards that promote patient safety.
A central goods reception area next
to the Regional Sterile Centre.
•
•
•
Coordinated and automated
distribution of goods, samples, linen
and meals.
Logistics and transport facilities
based on an internal/external
principle with separation of clean/
dirty and goods/patients/staff.
An acute emergency lift to transport
patients and staff between key units
(ambulance entrance/diagnostics/
operating theatre/intensive delivery
rooms/bed wards).
The AGV system facilitates the reliable
transport of goods and products,
including food, textiles, central depot
goods, sterile goods, laundry and waste.
The AGV system will operate between
the goods terminal, the Regional Sterile
Centre, the main kitchen, the individual
clinical areas and the rest of the hospital.
We will subdivide the logistics/lifts into
the categories: goods, ‘vulnerables’
(bedbound patients, acutely ill patients)
and everyone else – staff and relatives.
The logistical solutions in the new
complex must match our vision to become
the world’s best children’s hospital and as
well as streamlining work procedures, the
introduction of AGV (automated guided
vehicles) will also significantly improve
the working environment by reducing
heavy goods handling.
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A HEALTHY BUILDING.
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1 0 - S U S TA I N A B I L I T Y
10.
S U S TA I N A B I L I T Y.
While a building of this size and with these functions cannot be climate neutral,
it can point towards a future where sustainability is not simply incorporated into
projects of this size but is a natural prerequisite.
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1 0 - S U S TA I N A B I L I T Y
The minimum is the most sustainable.
Both internally and in terms of energy
production, the complex offers potential
for incorporating heating pumps, solar
heating and solar cells in the power supply
strategy.
The hospital is equipped with district
heating and district cooling systems,
the most sustainable alternative to
own-energy production for Copenhagen
hospitals.
The emphasis is on sustainable
construction and the building will be
dimensioned according to the Danish
Building Regulations 2015, energy class
2020, which require the building’s energy
characteristics and indoor environment to
be monitored and analysed throughout
the project period so that all decisions are
well-informed.
In terms of the indoor environment, the
goal is to create a healthy building with a
pleasant indoor climate (thermally,
atmospherically, acoustically and visually)
incorporating all parameters affecting
comfort and health.
The daylight and artificial light in the
building must combine to provide a good
overview of the surroundings, effective use
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of daylight and artificial light not to
mention optimum light quality with
minimal glare.
1 0 - S U S TA I N A B I L I T Y
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WE WANT TO CREATE A
WORKPLACE TO BE PROUD OF.
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1 1 - S A F E T Y, H Y G I E N E A N D T H E W O R K I N G E N V I R O N M E N T
11.
S A F E T Y, H YG I E N E A N D T H E WO R K I N G E N V I RO N M E N T.
The new complex stands on the strongest foundation imaginable – namely
professionalism. It is also the most relevant foundation for patients and society as
a whole. However, professionalism as a foundation has an added dimension.
Professional challenges are crucial for attracting the best minds – just as job
satisfaction is key to retaining them.
At the new hospital we aim to create a working environment where commitment
and professional development are inextricably linked. We will integrate treatment,
education and research in constant interaction with patients, healthcare
professionals and working environment specialists.
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1 1 - S A F E T Y, H Y G I E N E A N D T H E W O R K I N G E N V I R O N M E N T
The key words are safety, hygiene and working environment.
Safety.
The demand for single-bed wards
reduces the risk of infection and the
spread of infection among patients.
Single-bed wards also reduce noise and
disturbances, thus promoting faster
recovery and confidentiality between
patient, relatives and staff.
The option of having relatives with you
in a single-bed ward not only promotes
the patient’s sense of security but
simultaneously reduces the risk of mix-ups
and dispensing errors. Good physical
working conditions, including ceilingsuspended lifts on the wards, will further
reduce sickness absence due to lifting
injuries.
Design must also take into account
possibilities for staff to monitor individual
patients. In terms of patient safety, we
will focus on patient, staff and supplyrelated factors.
Hygiene.
“We must make it hard to make mistakes.”
Better hygiene reduces staff sickness
absence, periods of hospitalisation and
the number of readmissions.
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Simply establishing single-bed wards
significantly reduces the risk and spread
of infection.
Hygienic, behaviour-regulating solutions
must also be built into the building
structure – both technological solutions
and specific solutions such as easy access
to wash basins and hand disinfection –
one of the most important ways of
promoting good hygiene.
Cleaning is paramount. It is important
that the building design accommodates
preventive measures in terms of
behaviour, layout and choice of materials.
For example, the regular use of strong
cleaning agents must be possible without
damaging hospital surfaces or materials.
In this context, waste management
focuses on removing waste immediately
and minimising contact with the
surrounding area.
Working environment.
Safety and working environment
considerations must be of the highest
order during the construction phase, the
operational phase and during subsequent
conversions. We must ensure that the
working environment and patient safety
– two priority focus areas during the
programme phase – continue to enjoy
top priority.
A good working environment also means
ensuring that rooms are located with
proximity in mind so that work tasks can
be performed where staff work and that
hospital functions are planned in such a
way as to avoid worry and stress.
To the greatest extent possible, the new
complex must be the workers’ hospital
– the best workplace to be. Exciting work
offering international and professional
development opportunities for all staff is
only part of the strategy. We will also
promote staff health by providing the
best possible physical and psychological
working environment. Ensuring that the
guidelines of the Health and Safety at
Work Act, including daylight for
permanent workplaces, are observed at
all times is a minimum requirement.
The working environment must have a
holistic, systematic, preventative and
health promoting focus. Working environment conditions must be incorporated
into priorities and solutions for the
complex throughout the construction
phase.
However, the working environment must
first and foremost support the hospital’s
core ambition to become the world’s best
treatment, education and research centre.
We must create an environment that
stimulates integration between different
professions and specialities in order to
strengthen working relations that result in
cooperation of the highest order.
The new hospital building should inspire
movement – e.g. by means of attractively
designed and highly visible staircases.
1 1 - S A F E T Y, H Y G I E N E A N D T H E W O R K I N G E N V I R O N M E N T
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CAN YOU BE CURED BY THE
DEEPEST BLUE?
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12 - AESTHETICS
12.
AESTHETICS.
Aesthetics as in ‘realisation through sensory experience’ is not simply a question of
taste but a healing potential that we should take every bit as seriously as all other
kinds of treatment and medicine.
Healing architecture is based on the concept that aesthetics and physical
surroundings directly and indirectly affect people’s physical and mental health
and general well-being. We have considerable expertise in this area. We know
how to design the optimum surroundings using tools like light and shade, light
design, art and colours. We know how texture and sensuality affect people’s
experience of quality and competence.
We also know how little this knowledge is put into practice in times of fiscal
constraint. It is difficult to fund a beautiful colour scheme in the face of public
cut-backs. However, the overall economy of faster recovery, with fewer days in
hospital and fewer complications is a strong financial argument in the case for
a beautiful colour scheme.
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12 - AESTHETICS
Can you use something that isn’t 100 per cent proved?
Clinically randomised, double-blind,
controlled trials are few and far between
in the design world. However, that should
not stop us from using evidence-based
design as a basis for building a new mother
and child hospital.
Plentiful daylight is important – all day.
The blue morning light resets our
circadian rhythm and boosts our activity
level while the red light towards the end
of the day prepares us for the dark of
night and sleep.
We acknowledge that aesthetics and
design influence human well-being and
physiology. While aesthetics alone perhaps
cannot cure, daylight, atmosphere, rooms,
colours and sound can unequivocally aid
the patient’s healing process.
As important as light is during the day, so
is darkness equally important at nighttime.
Lower levels of lighting at night give
children and premature babies longer
sleeping periods and deeper sleep with
less movement. A marked difference in
lighting levels during the day and at night
increases the activity level of premature
babies. A good night’s sleep aids recovery.
This is a rapid developing area, and the
design of the new hospital must be based
on the latest and most relevant insights.
Which colours calm children best during
examinations and consultations and what
can we do to help women in labour better
focus on their breathing rhythm.
Light.
If we could only choose one tool as a
foundation for healing architecture, it
would be light. All forms of light and
colours: daylight, artificial light and the
absence of light – administered as
precisely as hospital medication.
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Nothing new there – light during the day,
darkness at night – but in a hospital
environment punctuated by bells, alarms
and constant activity, achieving this can
be a major challenge. In the new hospital,
we will create a homely environment in
the wards, using glass to ensure a plentiful
source of light. We will use artificial light
that mimics natural light, combining the
necessary night activities with as much
darkness as possible for the patient.
Wayfinding.
People will have a multitude of reasons
for visiting the new hospital. Often, they
will be affected by the situation and feel
more or less out of control. The new
complex will support the feeling of
security and control over one’s own
situation by making it as easy as possible
to navigate around the building. The
design must be rooted in evidence-based
wayfinding research, with a clear overview
of north, south, east and west, fewest
possible options and clear landmarks.
Gardens and nature.
Numerous studies support the positive
effect of visual or physical contact with
nature.
While the best option is ‘real’ nature,
other options can be equally viable.
Studies show that the more we mimic
nature by means of long sightlines and
scenic 3 D objects such as trees and
varied terrain, the greater the effect. The
garden elements that exert a positive
effect on mood are trees, plants and
elements involving sound, smell and sense
of touch – smells, absence of noise, birds,
sunlight and shade.
Adults want to sit and relax in the sun
while children want to play, explore and
discover.
The new hospital will be equipped with
well-situated, accessible patios that are
connected to what is going on in the
building and geared to all age groups.
In other words, gardens and garden
access must be clearly indicated, and
people must be encouraged to use them.
Art.
The new building will feature art.
More specifically, art to the tune of 1.5
per cent of the total labour budget. Art
must give pleasure, inspire curiosity and
offer distraction to the more than 2,400
people who will use the new hospital daily
– patients, relatives and staff.
Art must be visible in the public zones,
reception areas, gardens and corridors as
well as the less public areas such as
common rooms and bed wards,
outpatient units and offices. Art in the
bed rooms or other more private rooms
must be adaptable to the person using the
room. Adults and children. In other
words – dynamic art.
12 - AESTHETICS
When we think of art, we do not envisage
framed art works hanging on the wall.
We see art as an integrated part of the
building, incorporated into the building’s
very DNA and uniquely created for the
hospital project. We also hope that art
can be used to support one or more of
the new building design principles:
integrated play; see me, hear me, let me;
designed for daily living.
We would also like to see art moved
outside as an integrated feature of the
natural experience landscapes of the
building’s gardens (roof gardens).
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AND HOW EXACTLY IS ALL THIS
GOING TO BE ORGANISED?
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1 3 - O R G A N I S AT I O N
13.
O RG A N I S AT I O N.
By now, the attentive reader has probably deduced that the new hospital building
is a complex project of epic proportions requiring stringent management. That said,
the building must be nothing less than a textbook example of competent
management and organisation.
In connection with the decision to build the new hospital, a project organisation
has been set up and is described in the following pages.
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1 3 - O R G A N I S AT I O N
Responsibility and management.
The client function is organised under
the executive board for Rigshospitalet,
with the hospital director acting as the
project manager responsible for overall
project development and implementation.
Daily project management is anchored
in the project organisation headed by
the project director. It is the responsibility of the project organisation to ensure
a systematic, well-documented implementation process that creates value.
Organisation
1. Steering committee, where the group
managing director is the chairman and
the foundations are active participants.
Steering committee
Chairman
Group Managing Director
Jens Gordon Clausen
2. The project steering committee, where
the hospital director is the chairman and
where the centre management, the two
foundations and the project director are
active participants.
Project steering committee
Chairman
Hospital Director Per Christiansen
3. Daily project management/project
organisation, where the project director
is responsible.
The project organisation will participate
in several networks and partnerships
across newly built hospitals for women
and children – both those in Denmark
and those in the rest of the world.
We are already partnering with 20
internationally recognised mother and
child hospitals in the USA, Canada,
Australia, Europe and Scandinavia.
The project is organised in much the
same way as quality foundation
construction with three administrative
decision-making levels:
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Project organisation
Project Director
Bent Ottesen
Building
Byggeri
Redesign and
transformation
Børneriget –
the Academy
1 3 - O R G A N I S AT I O N
Following an EU tender, the engineering
firm NIRAS was chosen in November
2014 as the chief client consultant with
C.F. Møller acting as sub-consultant.
The chief client consultant is tasked with
assisting the client in preparing and
implementing the overall project.
The goal is to create ground-breaking
new knowledge that can underpin
evidence-based design in the new
hospital complex.
The project organisation’s competencies
are rooted in three main tasks:
•
•
•
Construction.
Redesign and transformation.
The Academy.
The three main tasks are seen as
integrated, and the challenges and
solutions in the three task areas will have
mutual effects. For example, patient care
where specialists come to the patient and
not vice versa, places entirely new
demands on work procedures and work
planning (redesign and transformation),
which in turn place new demands on
building and interior design (construction),
which must be supported by new
technologies (the Academy).
At the same time, our ambition is to
generate new knowledge about organisation, management and operations
through various research projects.
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The goal.
Similarly, our ambition is to establish
research projects dealing with children,
play and recovery that can generate new
knowledge about children and disease
and describe how we can safeguard
children’s natural development despite
chronic or acute illness.
We will set a precedent for patient and
family-based treatment at home and
abroad. This will include individual,
targeted information to patients and
relatives, patient networks and knowledgesharing in connection with highly
specialised treatments. The established
user panel must be involved in selecting
innovation areas, research areas etc. and
participate in the construction, redesign
and transformation processes.
We will open our doors to the other
hospitals currently being planned and
built and share our work and new insights
with one and all.
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Innovation & development
•Research
• Collaboration with industry, • educational institutions, international
research environments
Organisational development
•Communication
• User involvement
• Training – both patients
• and staff
processes
• Work
of occupancy
• Planning
and relocation
– physical building
• Architecture
and design
•Competition
Project design
•Tender
•Demolition
•Construction
•Initialisation
•Occupation
•
BørneRiget – The Academy
Redesign and transformation
Construction
1 3 - O R G A N I S AT I O N
The Academy – a partnership.
The new hospital is committed to partnering with private and public companies
on an unprecedented scale. The building
will therefore have an entire floor
dedicated to new ideas, innovation
projects, education and research.
partnership with Philips that enables us to
influence this research and development,
participate in scientific studies and test out
new ideas.
Our philosophy is to bring together
passionate souls from many fields and
areas of interest to create a hotbed for
ongoing development.
This will guarantee not only that we
create the world’s best hospital during the
project phase but that continued
cooperation and openness help the
clinical departments maintain an
international standard of the highest
order.
The firm Tobii has developed a set of
glasses that can register what the eye is
focusing on. The technology is applied
extensively in connection with
marketing where it is used to assist shop
design and layout, advertising designs
and packaging illustrations – all with
the aim of achieving optimum customer
contact.
Two examples:
Health-related technologies.
Intensive care of premature
babies (Neonatal clinic).
The Philips Group in Holland has
established a research unit to develop
health-related technologies. Future
monitoring of premature babies is one of
their projects. We have entered into a
Eye tracking
It may come as a surprise that we in
the healthcare system have not adopted
the same scientific approach to
designing our hospital facilities and
managing acute, life-threatening
situations, etc. We have entered into a
partnership with Tobii and are pilottesting the system. Initially, we have
pilot-tested wayfinding at the hospital
and the design and layout of medicine
rooms. In both instances we have had
encouraging results and will therefore
continue working with the firm,
applying the technology to life-threatening situations in emergency and
delivery rooms, etc.
Other collaborative partners include
academic institutions such as CBS,
DTU and the IT University as well as
such companies as Radiometer, Epic,
Blue Ocean Robotics, Storz,
Experimentarium and the Blue Planet.
The integration of research, development, patient care and education is not
limited to the Academy located on the
middle floor. It is also an integral part
of the individual departments where
specific areas are set aside to house
these tasks – close to daily clinical
activities.
capacity and technology to provide
scenario training in delivery wards,
operating theatres, neonatal
departments and paediatric and
adolescent departments. It is important
that staff training simulates reality as
much as possible so we can optimise the
competencies that enable us to take
relevant action in rare but nonetheless
life-threatening situations. The hospital
will be designed with training and
simulation in mind to ensure the
integration of education, research and
patient treatment.
“Everything that can be trained, must be
trained”.
Technological development now enables
us to utilise simulation-based training
models. Currently, the new methods are
being used to train obstetricians,
midwives, neonatologists, paediatricians
and nurses. A new hospital complex
must therefore possess the necessary
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