‘Smart hospital’ works out the kinks
to complete his hospital stay.
Although some of the steps are done in fast-forward — for example, the surgical procedure itself and the mock intubation after the patient’s vital signs become unstable on the operating table are completed in seconds — others are followed in precise detail. Transport staff follow an exact route between departments; nurses communicate and issue orders using the electronic medical record; bar-coded samples are whisked from the emergency department to the hospital laboratory via a pneumatic tube.
“We were working with as much equipment and technology as is operational at this point in time to get the look and feel of being in the hospital,” said Wilson, adding this surgical scenario was proposed months ago because accepting a patient from another facility into the emergency department is a common occurrence at Mackenzie Richmond Hill Hospital.
The same week, staff worked through three other mock scenarios: one involving a patient referral from a family physician, one that tracked a patient in a mental-health crisis, and one that cared for a pregnant woman whose unborn twins were in distress.
In each case, more than two dozen staff, primarily from the hospital’s quality and patient safety department, observed the hours-long scenarios, and a videographer recorded the simulations, which were viewed and evaluated during a series of debriefing sessions.
Melissa Rowe, a registered nurse and Mackenzie Health’s project lead for operational readiness, said the four simulations incorporated as many different hospital programs and workflows as possible, as well as several worst-case scenarios, including a medical emergency code blue.
And while her team wanted the scenarios to generally go well after months of preparations, Rowe said it was even more important to find ways to improve
hospital care, from the placement of hand sanitizer in the emergency department to improving the workflow in the operating suite.
“We were looking for failures, and when we found them, we celebrated them,” she said. “Because finding failures now, months before we open, means we have the opportunity to rectify them, to make it better, before we begin to train our front-line staff.”
Physicians, nurses, transport staff and others from the Richmond Hill hospital
participated in the mock scenarios, primarily as themselves, while the roles of patients were taken up by hospital volunteers. To preserve personal protective equipment, participants used surgical masks and gloves rather than the N95 masks and sterile PPE that would be protocol for a patient with suspected COVID-19.
Retired nurse Kim Dooner, who played the part of 84-year-old Henry, said she jumped at the chance to help her former colleagues get the new hospital ready for patients. It also gave her a first peek inside the building.
“The technology is unbelievable,” she said, while lying on a stretcher in a critical care room and gesturing at the computers, tablets and smartphones being used for her care. “There would definitely be a learning curve for someone like me.”
Mackenzie Health is recruiting 1,500 staff and training more than 3,000 ahead of opening the new hospital.
Although the pandemic has put additional pressures on its hiring strategy, with health-care workers in high demand, Wilson said the two-year recruitment plan has included offering internal training to staff for hard-to-recruit positions, such as critical care nurses.
“We are in the same boat as other hos
pitals in trying to recruit and maintain staff in the pandemic,” Wilson said. “We’re providing support for long-termcare homes. We’re staffing (COVID-19) assessment centres. We’re moving staff into a lot of different spaces. Staffing is something that we’re watching very carefully.”
Just about everything inside the building, from the hand sanitizer stations to in-patient beds, will be aided or controlled by a computer. And all of it must go through a trial run before the “smart hospital” sees its first real patient, said Rowe.
“We’ve done a thorough test of our nurse call system; it’s the life-saving system within the building,” she said, noting teams have tried out and doublechecked each of the hundreds of red nurse call buttons and pull cords.
“We’ve tested our pneumatic tube system over and over because it will deliver all the patient specimens to the lab and bring blood products to patient care units. We’ve run different scenarios through our PA system, including code blue announcements, to ensure they can be heard in every room, every unit.
“We know we are going to find problems, but then we have an opportunity to fix them before we actually have patients in the building.”