Part of Smart Theatres - St Georges Hospital, London
Operational, IT and procurement - lessons learnt
Workflow integration and adaptability
- Seamlessly integrating new systems into existing clinical workflows was essential to maintain uninterrupted patient care.
- Collaboration with a clinical reference group ensured alignment with operating theatre needs and critical metric visualisation.
- A phased implementation minimised disruption to ongoing operations and allowed for iterative improvements.
- Emergency theatres required special measures, such as dedicated cleaning staff, to remain operational during retrofitting.
Integrating the new system into clinical workflows while maintaining uninterrupted patient care was a challenge and the main priority. The project formed a clinical reference group, who played a pivotal role in ensuring the outputs of the new system aligned with theatre environments and agreed the critical metrics to be displayed on a visualisation dashboard.
Using wireless technology enabled work to be carried out as unintrusively as possible with after-hours installation done whenever possible to minimise downtime. Special attention was given to emergency theatres, where a cleaner was assigned during installation to ensure the theatre could be operational again with 15-minutes notice.
Despite these measures to minimise the impact, clinical teams still faced inconvenience in daily operations and delays in IT patching of data points led to bottlenecks for the work. Using a phased rollout for installation, and having a robust communication strategy, project management resource and an action tracker, helped address and limit the impact of these issues.
Staff training and resource allocation
- The 'train-the-trainer' model was effective but required support to ensure consistent knowledge transfer across shifts.
- Clear communication about the system's benefits helped manage resistance to change from staff accustomed to traditional methods.
Training staff on the new equipment and processes across different shifts presented logistical challenges. To help resolve this a 'train the trainer' approach was used to support knowledge sharing and development of new standard operating procedures (SOPs). With the changes there was resistance from some engineering staff, who were accustomed to traditional risk mitigation practices. Clear communication and collaboration to ensure they understood and adopted the new processes was required.
Resource allocation needed to be carefully managed to balance project demands with operational needs. Estates operational teams assigned engineers to work out of hours, reducing reliance on contractors and avoiding charges for cancelled visits. Phased work schedules and providing advance notice of works ensured that there was adequate coverage for emergency theatre lists, preventing the need for additional personnel or shifts.
Recurring issues and resolutions
- Complex environments and multiple stakeholders required stringent task verification processes to avoid errors, such as misconfigured virtual local area networks (VLANs).
- A robust communication strategy and action tracking improved accountability and efficiency.
- Balancing project demands with operational requirements involved assigning engineers for out-of-hours work, reducing reliance on contractors.
- Advanced scheduling ensured emergency theatre availability without additional personnel costs.
Complex theatre environments and the involvement of multiple stakeholders led to recurring issues, such as incomplete or incorrect task execution. For example, data points were sometimes patched to the wrong VLAN, an issue which was identified only during commissioning. To resolve this, a data point tracker was set up and shared with stakeholders to provide a consistent and up-to-date view.
IT and network
- Early issues, such as intermittent data transmission and congestion, were addressed by prioritising critical data and optimising infrastructure compatibility.
- Decentralising data collection reduced risks associated with single points of failure, ensuring consistent data delivery.
- Real-time data and alerts enabled timely interventions, reducing downtime, and improving the availability of theatres.
The initial implementation faced network reliability issues, with sensor data only transmitted intermittently due to congestion on the VLAN which was shared with public Wi-Fi for segregation purposes. IT resolved this by prioritising traffic flow for critical data sets.
Infrastructure compatibility posed additional challenges, requiring some data to be transmitted via a current loop network, which had to be carefully managed to avoid overloading. The current loop network was required as the legacy BMS outstations communicated via current loop. To safeguard security, data transmission was isolated on an external VLAN outside the trust’s core network, minimising cybersecurity risks.
Mid-project, IT resource limitations emerged when team changes slowed implementation. Contingency plans, such as distributing data collection across Trend Ton controllers rather than relying on a centralised IQ Vision server, reduced the risk of single points of failure, ensuring consistent data delivery.
Procurement and support measures
- Support measures ensured project stability, with no reliance on third-party IT support.
- Clear procurement strategies, commercial support and expertise were required to ensure SLAs were met consistently, and compliance and regulatory risks were managed.
Procurement challenges primarily involved appointing contractors from the pilot phase, which required use of a reseller via a framework, adding a 5% additional cost.
Delays in establishing the framework contract further impacted timelines. Different procurement routes were employed, with the main equipment installation procured through a framework, data points via direct award, and the visualisation platform through a mini-competition tender.
Last edited: 31 March 2025 1:06 pm