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A portrait of the future – a look at one of Europe’s most modern hospitals


20 July, 2010  

University Medical Centre Hamburg-Eppendorf is an ultra-modern – and paperless – hospital making the facilities of the future available in the present

Wolfgang Bastler
Healthcare writer

The University Medical Centre Hamburg-Eppendorf has been designed as an ultra-modern hospital with a total capacity of 1,400 beds, 100,000 outpatient contacts and 55,000 patients treated in-house annually. It consists of 45 public and ten private wards.
The hospital has a total of 5,500 staff. This includes 1,100 physicians, 3,500 nurses, a number of technical assistants and 900 affiliated staff. The current economic crisis does not appear to have had a negative impact on staffing levels. “In terms of employment, we have a total of 150 more
people in various positions within the hospital than we had one year ago,” Prof Dr Jorg F. Debatin, CEO and chief medical officer, explained.
The rise in the number of personnel was an absolute requirement, as the hospital has increased its patient turnaround times. “In April of this year, we had a 20% rise in the number of hospital procedures and patients, but fortunately, this growth has stopped and we are now at a level that is roughly 5-6% more than the preceding year,” Dr Christoph U. Herborn, representative of the Board for Clinical Process Management, said.
For the Hamburg region, a large number of therapies and complicated surgical procedures, especially in the field of transplantation (heart, liver, kidney as well as bone marrow), can only be performed at the University Medical Centre Hamburg-Eppendorf. Furthermore, the hospital has more than 160 clinics for complex, rare and chronic syndromes, such as the treatment of muscle diseases, impaired vision, and blood coagulatory disorders, heart rhythm and obsessive-compulsive disorders.
The older university medical centre opened its doors in 1889 and, at that time, various buildings were constructed to house each medical discipline. “We had a total of 160 separate buildings and this was logistically, for the patients and the physicians, extremely demanding,” Dr Herborn explained. These have been replaced by a single building covering 85,000m2, which, in effect, centralises the various clinical departments. “Centralisation and making things more effective were the main goals of the architectural structure,” Dr Herborn added.

Natural light
The internal structure is equally impressive. For example, in the CT scanner room, the hospital has integrated artificial light concepts, which allows a patient under examination to feel more comfortable. “Nevertheless, we believe natural light is good for patients and so we have designed the hospital to allow as much natural light in as possible,” Dr Herborn said.
The cost of constructing the University Medical Centre Hamburg-Eppendorf was €180m. As it is a public hospital, the local and federal governments provided the funds for its construction. “The vast majority of the project was financed by the state of Hamburg; however, there is always a federal add-on, which is paid by Berlin,” Dr Herborn explained. The federal contribution is in the region of 10% of the total cost.
The new hospital was constructed between 2004 and 2008. During this process, a research building was incorporated in 2007 and a teaching building was completed in 2008. The hospital has recently started constructing a new psychiatry unit, at cost of €20m. “Generally, and certainly logistically, this is not quite as big a task as building the main hospital,” said Dr Herborn. This is partly due to the fact that the patients in this sector require less care in terms of monitoring, interventions and operating theatres.
Despite its relatively young age, the hospital has already embarked on a number of other restructuring and rebuilding projects, such as the renovation of the cancer centre. “These projects are paid from the public purse, however a tentative building plan for the new children’s hospital will be partly financed by private investors who have set up a fund for this purpose,” Dr Herborn noted. Hamburg is well known in Germany for its funding tradition and, in this case, the vast majority of the funds will be donated by the Otto family, which owns a distribution firm that is similar to Amazon. The goal is to have the construction of the children’s hospital started by 2010.

Accessible to the public
Another welcome factor about the hospital is that it is easily accessible to all the public. “We are not on the periphery, but pretty much in the heart of Hamburg, in a part of the city called Eppendorf,” Dr Herborn stressed. This is contrary to the traditional approach to hospital building, where clinics are often paced outside the city on the green belt. “We decided in effect to have our new hospital in almost the same place where the old hospital had been situated,” he added.
The hospital is equipped with an enviable array of large-scale medical devices. “The most impressive installation that we have is a full electronic patient record system,” Dr Herborn boasted. Manufactured by Siemens Medical Sol­utions, the Soarian system offers patient-centric solutions, which deliver a unique workflow-driven approach that helps improve operational efficiency, optimise the revenue cycle, and support patient and user satisfaction initiatives.
“We planned the hospital to be a paperless environment and this is what we have achieved,” Dr Herborn explained. During the planning process, all proposals for archive rooms were simply sidelined and, as a result, staff are simply required to use the electronic system.  
“We started the installation of the electronic patient record system before moving into the hospital,” Dr Herborn explained. In September 2008, parts of the electronic system were installed within the old hospital complex and since February of this year, the Soarian system is available throughout the entire hospital.
The system has not, however, been without its challenges in the early phases of its incorporation, particularly in the field of staff training. “Already in the middle of 2008, we started to educate so-called ‘key users’ of the system. They were physicians, nurses and technical assistants who were directly educated by Siemens to know somewhat more than other staff,” Dr Herborn said.
The key users then trained other hospital personnel and online modules were also made available for this purpose. “The education process was pretty demanding and also very time-consuming, but we achieved what we set out to do,” Dr Peter Gocke, chief information officer, noted. Siemens stationed some 50-100 personnel in the hospital throughout the training phase.

Diagnostic equipment
The hospital also sports an impressive array of diagnostic scanning equipment. “We have been working with a rather cutting-edge level of technology both in terms of CT and DRI within our radiology department,” Dr Herborn said. Following the completion of the new hospital, a 256-slice CT scanner was installed. Dr Herborn conceded that machines that offer more slices are available, but stressed that this was still one of the newer models. 
In addition to this, the hospital also operates Centricity, a picture archiving and communication systems (PACS) from GE Healthcare. Centricity PACS-IW is a powerful web-based PACS for acute care and ambulatory institutions, designed for the web from the ground up. “We also signed a lighthouse project contract with GE Healthcare concerned with our sonography systems throughout the hospital,” Dr Herborn said.
The agreement will provide the hospital with 25 new sonography machines for use throughout the hospital, and it is accompanied by a dedicated evaluation programme. “This basically allows the user to take the machine virtually everywhere inside the hospital and when the machine is then returned to its original position, it can simply be connected to the hospital intranet and the entire information can then be sent to the online archive,” Dr Herborn added. In this way, all the information related to the patient becomes available to every person who is involved in the treatment process of a particular patient.
“Finally, we also have an extremely interesting audio and video system inside the operating theatres,” Dr Herborn said. There is a total of 16 operating rooms in the hospital, connected to each other, the video system and Centricity. Inside the operating room, it is possible to link together four monitors that are able to offer an endoscopic view of a procedure performed in that room or even a microscopic perspective.
“But you could also upload information from previous examinations, such as endoscopies that may have been performed in the outpatient unit,” Dr Herborn explained. An additional bonus is the ability to transfer results from the operating room to the hospital’s teaching site, thereby offering students the possibility to follow an operation from the lecture hall. This innovative technology is supplied by Olympus.
The array of new technologies is something that makes the hospital stand out in its field. “Basically, we are promoting ourselves as supposedly being ‘Europe’s most modern hospital’,” Dr Herborn said. There are indeed other hospitals that have these technologies, but the impressive and unique aspects of the University Medical Centre Hamburg-Eppendorf are that it has all the innovations on a single site.
The hospital also aims to be environmentally friendly and therefore energy-efficient. For example, it has installed cooling mats on the top level of the building. They serve to seal in warmth in the winter and allow for lower temperatures in the summer.
The University Medical Centre Hamburg-Eppendorf is simply what every hospital should strive to be, offering the best possible care across the board in a single location. In essence, it is a glimpse of the future in the present.