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Robots like in Star Wars: Inside the plans for the new children's hospital

It could revolutionise care in Ireland, with space for parents, electronic patient records and a roof garden. Kim Bielenberg talks to the ­consultants, architects and tech experts planning the new children's hospital

Kim Bielenberg ·

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Vision: Frank McGuinness, ICT director for the Children's Hospital Group, beside a 3D model of the new hospital. Photo: Steve Humphreys

Children will stay in single en-suite rooms with a spare bed for a parent. They will be able to play games, watch films and order their meals on their bedside "patient portal".

In the new children's hospital, set for completion in 2022, some of the work will be done by robots.

Food, bedding, waste and equipment will be transported around the hospital by Automatic Guided Vehicles, which will give the new facility an aura of a Star Wars film set. They will be programmed to move through the corridors like a self-driven trolley.

These robots will even be programmed to operate the lifts.

More significantly, it is planned that the new hospital will signal the arrival of the Electronic Healthcare Record in an Irish public hospital.

Rather than filling out endless forms repetitively in the primitive paper information systems still prevalent in our healthcare system, patients will have a single electronic record, accessible to nurses and doctors.

After more than three decades of planning logjams, frantic debate and postponements, doctors and nurses are relieved that the massive new children's hospital in Dublin will soon appear on the horizon.

They hope that with its hi-tech equipment, single rooms with space for parents and elaborate rainbow roof garden, the immense oval-shaped structure next to St James's Hospital will set the standard for hospital care in Ireland.

The medical community, parents and other interested parties argued intensely over whether St James's Hospital was the most suitable site for the hospital, which will be size of Dundrum shopping centre.

Revolutionising healthcare

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An Automatic Guided Vehicle similar to ones that will transport various items around the new hospital. Photo: Steve Humphreys

But now that the hospital is being built, the recriminations are giving way to concentrated effort by its planners to make it the best facility possible.

Much of the focus is on turning the building into the most technologically advanced digital hospital in the country.

At an office near the site, paediatrician Michael Riordan and the hospital's head of technology, Frank McGuinness, are keen to show me how the innovations in the hospital have the potential to revolutionise healthcare in Ireland.

The massive new facility will bring together the three children's hospitals at Crumlin, Temple Street and Tallaght.

Until now, kidney specialist Michael Riordan has had to work treating patients between two sites, Temple Street and Crumlin Hospital. He travels between the hospitals by bicycle. Sometimes children also have to move between the two hospitals.

As early as 1984, there were concerns that Temple Street Hospital, part of which was the former home of Charles Stewart Parnell, was outdated and should be replaced. Now, at last that wish will be fulfilled.

"It's going to revolutionise the way we care for patients. In Temple Street, it's almost impossible to get medical-grade Wi-Fi, and there is not enough space for workstations on wheels (WOWs).

"To move a step further in terms of technology is not possible."

One of the big changes at the hospital will be in the way in which information is gathered about patients, and how they interact with hospital services.

"Say, if a child breaks an arm, a parent will be able to interact with the hospital before they arrive, using an app in the back seat of their car," says Riordan.

"The system will be designed, so that by the time a child walks in the door, staff already may know why they are there. They won't have to tell 15 people why they have come."

Arriving at an outpatient clinic at the new facility will be more like going to an airport than a traditional hospital.

Instead of checking in at a reception desk, parents of children will go to a self-service kiosk, where they will swipe their mobile phones.

Parents will be able to use apps to book their parking and their child's precise appointment time. It is hoped that this will cut down the number of administrative staff needed to run the new hospital, and prevent a deluge of patients all arriving at the same time for a clinic.

Patients will be advised by digital notification to go to waiting areas just before staff are ready to see them.

Frank McGuinness, who is planning the technology system for the new hospital, says: "Information about a patient will be collected once, entered once, and it will be available throughout the whole of the hospital."

Riordan says hospitals can learn a lot from the automated safety systems in aviation in order to improve patient care.

"If you are a pilot on a plane, there is an automatic warning system if you have not put down landing gear.

"In the new hospital, with information stored digitally, the system should be able to ensure that a child can't be prescribed a medicine that they are allergic to."

Dr Riordan offers other examples where the Electronic Healthcare Record will improve patient safety.

"It could prevent a premature baby being given a dose of medication which would be too much for an adult.

"It could alert a surgeon so they know there is a discrepancy between the side they plans to operate on and an X-ray report from five years ago."

The medical record will even be integrated with the food ordering system, so that children are not given meals that are inappropriate for their condition

"We are not reinventing the wheel here - these systems exist elsewhere in the world and this is a fantastic opportunity to provide current technology for the children we look after," adds Riordan.

Frank McGuinness says children in the hospital should have a better quality of life, partly because many more medical devices are now portable and operate through Wi-Fi.

"Rather than being locked to the bed where a stand is, the patient can move around the hospital."

The chief architect of the children's hospital is Benedict Zucchi from the British firm BDP. He has also worked on similar ventures in Brighton and Liverpool.

BDP have worked on the project with Irish partners O'Connell Mahon, another firm with experience designing hospitals.

The site may seem unprepossessing in the busy heart of the south inner city, but Zucchi has created a Hanging Garden of Babylon effect with his elevated green space in the middle of an oval shape.

Child-friendly design

He has avoided putting long corridors in the hospital, because he believes they are forbidding and make a hospital seem more like an institution.

One of the architects who has worked on the project, Clare White from O'Connell Mahon, says: "The importance of the huge garden on level three is based on the idea of evidence-based design.

"It has been proven that patients benefit from access to the landscape and views of the landscape. It can even reduce the length of stay.

"Even though it's a very urban location, we have worked hard to build landscape into the design."

White says the architects have also had to ensure that the design is child-friendly and family-focused.

"Children are not stupid and understand that they are going to a hospital.

"You want to take the fear out of it and avoid it being a scary experience, but you can't trick them and make out it's fun.

"We are conscious that we are building it for a huge age range from babies up to adolescents. You can't have pictures of Mickey Mouse and Donald Duck everywhere when many of the children are teenagers."

When they were coming up with the design, the architects not only consulted doctors, nurses and other healthcare staff.

They also had extensive discussions with parents and children who had been in hospital for long periods.

"The biggest change in hospital design is that you now have single rooms with en-suite bathrooms," says White.

"That will be across the board in public and private hospitals. It has better outcomes medically, including control of infections. It also allows for greater dignity and privacy."

The new hospital will allow for the fact that many parents want to stay overnight with their children, and a bed is provided in each room.

Clare White talked at length with children about the design and was struck by how they were concerned that there should be facilities for parents.

In the new hospital, there will be cooking facilities, enabling parents to make meals for themselves and their children.

Some families will also be accommodated in Ronald McDonald House, a residential facility which adjoins the hospital.

The provision of the accommodation by a charity linked with the fast-food chain has prompted some criticism, most notably from Donal O'Shea, a leading consultant who specialises in treatment of obesity.

O'Shea likened McDonald's being involved with a children's hospital to Heineken sponsoring a liver unit.

A spokeswoman for the new hospital said: "There is no funding or sponsorship relationship between the Ronald McDonald House and the new children's hospital. However, the charity will provide a welcome and invaluable service to families whose children are ­receiving treatment in the hospital."

Of course, the success or failure of the new hospital will depend on the quality of the medical treatment.

"We are asking all the staff we are interacting with to not only have a vision of what treatment will be like not now but in five years' time," says Michael Riordan.

"Some aspects of treatment may be the same, but in other areas there will be huge changes."

The hospital planners have had to future-proof the building in order to allow for these changes.

One of the huge areas of development is in clinical genetics, the diagnosis and management of inherited disorders and defects.

"We will be able to carry out genetic tests that check for a range of diseases," says Riordan. "We can harness genetics for much better diagnosis and prevention."

The new hospital will also be adapted for the greater use of wearable technology, such as smart glucometers. These devices are worn by diabetes patients - they check blood-sugar levels and connect with a mobile phone.

Goods may be moved around by robots, as children play games on their "edutainment system", but Riordan emphasises that the dazzling array of technology in the new hospital will not just be a gimmick.

"It's not just the difference between having an iPhone 4 and iPhone 10.

"It is not just technology for technology's sake. This is really driven by clinical need and clinical care."

@KimBielenberg

 

Hi-tech healthcare

* Check in with self-service kiosks

* Key information stored on ­Electronic Healthcare Record

* Robots move goods and supplies

* Patient edu-tainment system for entertainment, food ­ordering and ­education

 

Indo Review

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Vision: Frank McGuinness, ICT director for the Children's Hospital Group, beside a 3D model of the new hospital. Photo: Steve Humphreys
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An Automatic Guided Vehicle similar to ones that will transport various items around the new hospital. Photo: Steve Humphreys
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An Automatic Guided Vehicle similar to ones that will transport various items around the new hospital. Photo: Steve Humphreys