New Surgery Center in Grosshadern
A core component of high-end medicine
The new Surgery Center in Grosshadern opens on 1. September. The Center accommodates all surgical specialties under one roof, and is equipped with the very latest in medical and communications technology.
Needless to say, in spite of its broad and attractive glass facades, the new Surgical Operations Center (OPZ) in Grosshadern is a clinical institution, and no one would wish to become a patient here. But everyone who is referred here for treatment can be assured of the best possible care. The new Center provides state-of-the-art therapy and nursing care, with 32 operating theaters on two levels. Five intensive-care units can cater for a total of 70 patients, and can be reconfigured as required, for example to enable patients infected with highly contagious or multiresistant pathogens to be isolated from others. A special section comprising four operating theaters devoted to outpatient surgery, and a well-equipped Emergency Department staffed by specialists in various medical disciplines, complete the line-up.
In conception and design, the Center reflects a general trend in modern medicine, insofar as very strong emphasis is placed on interdisciplinary collaboration between the various surgical specialties. This approach to surgery was already a feature of the old surgical section of the Grosshadern Medical Center, but the new OPZ provides the corresponding architectural context, which facilitates and fosters interaction and cooperation. “The so-called soft specialties - Heart, Thorax, Vascular and Visceral Surgery, Gynecology and Urology - are concentrated on the first floor, and on upper level we have the hard or ‘bony’ disciplines - Orthopedic and Trauma Surgery, Hand and Plastic Surgery, Ear, Nose and Throat Surgery and Neurosurgery,” says Professor Karl-Walter Jauch, Medical Director of the University Medical Center in Grosshadern, and a surgeon himself. He sees the OPZ as a core institution in high-end medicine, which has no parallel elsewhere in Germany. He points out that “great care has been taken to ensure that, everywhere in the new building, architecture and technology serve the needs of patients and their caregivers.”
Natural light dominates the atria behind the glass front, which are decorated with greenery. Diagnostics and therapy are closely linked spatially: Emergency Room, Intensive Care Area and the Operations Levels are each equipped with a computer tomograph and on one of the floors there are two hybrid operating theaters. “This spares our patients, and ourselves, the long trips that were previously necessary, because diagnostic and therapeutic departments were often located in different parts of the old building,” says Professor Bernhard Heindl, Head of the OP Management Unit in Grosshadern, who, together with his team, is currently engaged in coordinating preparations for the opening of the Center.
Live transmission of surgical procedures
The two hybrid OPs are the technical highlights of the OPZ: Each is equipped with an angiograph. Professor Heindl explains why this is so: “If a patient needs an artificial heart valve, nowadays the procedure can be carried out in a minimally invasive fashion via an incision in the groin. With the aid of the angiograph, the surgeons can directly follow the progress and assess the success of the intervention. Conversely, should problems arise in such a case, it is possible to perform the operation in the conventional way, which involves opening the thorax, in the same operating theater.”
Imaging data, such as X-rays, endoscopic images or tomographs, are displayed on large, wall-mounted touch-screens that allow images to be rotated in any direction. These monitors form part of a unique system with the unwieldy name “Integrated Medical Imaging with Audio and Video Distribution”, which makes it possible to transmit all types of imaging data to remote locations. It also enables a surgeon engaged on the removal of a tumor to confer directly with a pathologist in the neighboring building, before deciding how much tissue must be resected, for example. Up to now, a theater nurse had to communicate the surgeon’s findings to the pathologist via intercom. - The IMI-AVD system also allows operations to be transmitted in real time to lecture halls or fed into video conferences with experts all over the world.
Work-load reduction and hiring of staff
The entire OPZ is designed to allow medical and nursing personnel to devote as much of their time as possible to their patients‘ welfare. Not only has the disposition of the various sections reduced the distances that must be traversed, the logistics of material flows - from selection to unpacking and distribution of consumables – is no longer a matter for the nursing staff. Previously, supplies of all necessary materials were kept in storage in the operating theaters. Now they are delivered on demand. An order for all materials and instruments required in any given case is sent to the Central Sterile Processing and Distribution (CSPD) Unit in the basement of the building, and the requested items are then selected, loaded on a trolley and dispatched to the appropriate theater. In the past the nursing staff was responsible not only for obtaining these materials from the CSPD, but also for their subsequent disposal.
For Iris Baier, Head of Theater Nursing Care and Controller of the CSPD, these labor-saving arrangements for nursing staff also constitute an important advantage for the recruitment of personnel. “Intensive-care nurses have undergone five years of training. It makes much more sense for these professionals to apply for a position which allows them to concentrate on what they have been taught to do.” The OPZ will eventually employ approximately 1000 people, and many new posts must be filled – no easy task in an environment like Munich, where the cost of living is very high. But the Medical Center began to implement a dedicated recruitment program at an early stage, with the result that 90% of the OPZ’s total capacity will be usable when it opens. The positions that are still open will be filled during the coming year. The Center’s Business Director Gerd Koslowski compares this with the situation 40 years ago, when the complex in Grosshadern first opened: “According to eye-witness reports, only 20% of the buildings were initially ready for use, and it took 6 years to bring the remaining 80% into operation.”
Koslowski is therefore justifiably proud of the smooth progress and successful completion of the OPZ project. “It is particularly worth noting that, in spite of three years of planning and a construction phase lasting for 6 years, the whole project was completed without cost overruns. This is in large measure a tribute to the efforts and commitment of the public planning and building authorities, who have cooperated very closely with the Medical Center.” After all, Koslowski points out, many things can go wrong in the course of such a time-consuming project, and one has to cope with many unforeseen situations – bankruptcies of suppliers and contractors or unexpected price rises in the building industry can drive the total cost of such a project well above the original estimate. But, in this case, the cost of the building itself was held down to the projected 135 million euros, while 60 million euros was spent on fittings and equipment. For Professor Karl-Walter Jauch, however, the OPZ is only a first step. “We must at some stage,” he says, “face up to the fact that the whole complex in Grosshadern will have to be refurbished and, in part, completely rebuilt, if we are to continue to provide state-of-the-art patient care and keep pace with advances in research and medical training.”