INNOVATING BETTER LIFE

SUSTAINABLE HOSPITALS New Hospital Construction - Future Hospitals in Denmark

WHITE PAPER SUSTAINABLE HOSPITALS Future Hospitals in Denmark

About this white paper Steering Committee This white paper presents the Danish approach to new hospital Danish Ministry of Health, Martin Nyrop Holgersen, [email protected] construction and includes a wide range of innovative solutions that Danish Regions, Kristian Taageby Nielsen, [email protected] contribute to creating sustainable healthcare for the future. It is part North Denmark Region, Niels Uhrenfeldt, [email protected] of a series of white papers that show how Danish solutions can con- Region Zealand, Helle Gaub, [email protected] tribute to increase efficiency in healthcare while empowering patients Region of Southern Denmark, Torben Kyed Larsen, [email protected] and staff. Danish Export Association, Thomas Andersen, [email protected] Danish healthcare innovation is not exclusive for the Danes: many Systematic, Jacob Gade, [email protected] years of global presence show that our healthcare products and solu- tions create value internationally. Danish ideas and products are used Contributors every day in hospitals, medical clinics, ambulances, and nursing homes 3XN, Stig Vesterager Gothelf, [email protected] across the world. Agitek, Jean-Paul Bergmann, [email protected] Arkitema Architects, Birgitte Gade Ernst, [email protected] We hope to inspire you and would like to invite you to Denmark to Bim Equity, Ida Maria Sandgreen, [email protected] learn more about the Danish healthcare system. CF Møller, Klavs Hyttel, [email protected] Chromaviso, Ane Søby Eskildsen, [email protected] Photo credits Health Innovation Centre of Southern Denmark, Tina Nissen, Foreword: Steen Brogaard (Minister for Health and Senior Citizens [email protected] Magnus Heunicke), Danish Regions (Chairman of Danish Regions Intelligent Systems, Kamilla Møller, [email protected] Stephanie Lose) Mobile Industrial Robots, Rasmus Smet Jensen, [email protected] Page 6: Top left: Adam Mørk, top right: Konsortium Indigo, below right: North Denmark Region, Anette Leth, [email protected] 3XN, Arkitema Architects North Denmark Region, John Schermer Stefansen, [email protected] Page 7: Top left: Herzog & de Meuron - Vilhelm Lauritzen Arkitekter, PTR Robots, Lone Jager Lindquist, [email protected] top right: C.F. Møller Architects, below right: KHPT I/S Rambøll, Thomas Strecker Leitner, [email protected] Page 8: 3XN and Arkitema Arkitects Region of Southern Denmark, Anne Sigh, [email protected] Page 9: Kirstine Mengel Region of Southern Denmark, Helle Fjord Larsen, Page 10: Niels Nygaard [email protected] Page 11: Julian Weyer Region Zealand, Poul Heller Bunde, [email protected] Page 12: Adam Mørk Semi Staal, Helle Bugge-Hansen, [email protected] Page 13: 3XN and Arkitema Arkitects, BIM Equity State of Green, Charlotte Gjedde, [email protected] Page 14: Top: Adam Mørk, Below: Niels Nygaard UVD Robots, Per Juul Nielsen, [email protected] Page 15: Klaus Vedfelt Wavecare, Eva Wennerwald, [email protected] Page 16: Systematic Page 17: Intelligent Systems Page 18: Mobile Industrial Robots Page 19: UVD Robots Page 20: Semi Staal Page 21: Rambøll Page 22: Hvidovre Hospital Healthcare DENMARK’s partners : Page 23: North Denmark Region Page 24: Region of Southern Denmark Page 25: Getty Images/LSOphoto Page 26: Region Zealand Page 27: Grundfos Page 28: Health Innovation Centre of Southern Denmark Page 29: Konsortium Indigo Page 30: Health Innovation Centre of Southern Denmark Page 31: Wavecare Page 32: Chromaviso Page 33: PTR Robots Page 35: Franne Voigt (HRH The Crown Princess of Denmark)

Editor in Chief Healthcare DENMARK, Anne Smetana, [email protected]

Associate Editor Healthcare DENMARK, Tina Liljendal Larsen, [email protected]

Future Hospitals in Denmark white paper version 1, August 2020

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Executive summary

Growing demands, budgetary restraints view of total capacity, allowing the coordination of and new patient expectations dramatically patient flow, including in each specialty, and even be- increase the need for healthcare services tween hospitals. In another region, a central cleaning in Denmark. The solution to these trends facility has raised productivity and hygienic standards are not just to build new hospitals, but to for beds, mattresses and assistive aids. deliver healthcare in new ways, in order to make our healthcare system sustainable for the future. Sustainable buildings and environmental challenges The new hospital construction program aims to es- In keeping with Denmark’s ambitious energy policies, tablish the future hospital landscape for Denmark, the healthcare sector is meeting the demands posed where our hospitals are designed to support our by climate and environmental challenges through transformed, coherent and patient-centric future strong initiatives to reduce the footprint of its con- healthcare system. Digitalization and new technolo- struction and operation. Wherever hospitals are being gy, often driven by artificial intelligence and robotics, built or renovated, focused efforts are being made, are critical enablers for the success of our future hos- often as part of public–private partnerships. Solar pitals. energy is being tapped at one new university hospi- tal, while elsewhere, the world’s largest wastewater This white paper presents the key innovations and treatment plant has been constructed. Other local solutions which we believe are relevant to modern solutions have found that energy audits can help healthcare systems across the world. finance new projects, while an eco-labeled hospital laundry has drastically reduced plastic waste by using Architecture and healing architecture thinner linen covers. Healing architecture is becoming increasingly im- portant in the healthcare sector’s efforts to create User-driven design and innovation environments that can stimulate patients’ recovery The focus on high quality, combined with efficiency, and in attracting workers who thrive in the buildings. will continue to bring innovation to Danish hospitals New hospitals across all the regions of Denmark are by involving patients and staff in the development making use of the healing effects of light, air and and implementation of new solutions. A few exam- pleasant surroundings, both inside and outside the ples can be given here of the many successful initia- buildings. Single-bed rooms are another design fea- tives from across the country: ture that not only help patients recover faster, but also have financial benefits, as hospital infections Involving psychiatric patients in designing the fea- and medication errors are reduced. The results of tures of a new type of bed has reduced self-harming these endeavors can be seen in the BoerneRiget chil- behavior and brought more comfort to admissions. dren’s hospital, where users were involved in plan- An ergonomic lighting system demonstrates the high ning-stage VR sessions, and in the new psychiatric priority given to patient safety and the work environ- hospital in Vejle, which has seen a 50% decrease in ment in operation rooms at a university hospital. physical restraint measures. Delivery rooms with a less clinical feel have a soothing effect on both birthing women and staff. Hospital logistics While the highly specialized functioning that is typi- In another innovative project, the high costs and lim- cal of the new Danish hospital landscape has been itations of conventional patient transfer solutions instrumental in significant productivity increases, it were overcome with the introduction of a robot. also involves very high logistical demands. Efforts to reduce patients’ length of stay and to coordinate pa- We hope you will find inspiration in the innovative tient flows and logistics are being helped by just-in- concepts and technology cases described in this time solutions and the use of data for novel technol- white paper, which aims to give an impression of ogies, such as robots and artificial intelligence. One Danish hospitals’ role in a coherent and integrated Danish region has introduced a system that forecasts healthcare system of the future. occupancy for a week ahead and provides an over-

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ASSISTED LIVING A dignified elderly care in Denmark

Magnus Heunicke Stephanie Lose Jette Skive Minister for Health and Senior Citizens Chairman of Danish Regions Magnus Heunicke Stephanie Lose Chairman of Local Government Minister for Health and Senior Citizens Chairman of Danish Regions Denmark's Health Committee

Foreword

Denmark has a modern and effi- infrastructure allows patients to access their future treatment needs and challenge our cient healthcare system with free own health data online from anywhere, and healthcare systems, this is how we imagine Forewordand equal access for all. This is the healthcare professionals have access to that the healthcare systems of the future something we need to preserve relevant data across the different sectors will look like. for coming generations. Therefore, of the healthcare system. This digital infra- Denmark has come a long way in de- needs and preferences. The goal is to main- Denmark will keep continuing to develop and Denmark has invested approx. EUR 6.5 bil- structure opens for a fundamental change We believe that these hospitals represent veloping the elderly care. Through tain their independence and gain control of expand the use of new assisted living tech- lion in a new hospital structure that will be in the way healthcare is provided - and our the future of hospitals in modern, coherent a citizen-centered approach and their own life. nologies – in collaboration and dialogue with the physical pillar in the Danish healthcare hospitals are part of it. and sustainable healthcare systems. We are targeted efforts including assist- elderly citizens, their peers and care staff – system of the future. therefore proud to present this white paper ed living technology, the aim is to The citizens are involved in their own recov- to the benefit of citizens, healthcare profes- We use the digital infrastructure to enable pa- on the innovative new Danish hospitals and assure that elderly citizens more often ery with focus on their individual needs. sionals, and society. By building new, modern, and innovative hos- tients to be active partners and to be treated we hope you will be inspired reading it. can maintain their independence and pitals with state-of-the-art equipment and in the primary sector, closer to and in their quality of life. New assisted-living technology play an im- Magnus Heunicke highly specialized treatment, we can continue homes, instead of in hospitals. We know that Magnus Heunicke portant role within the sector of elderly care. to raise treatment-quality in hospitals. Fur- by making the patient an active partner the re- The overall ambition for developing the elder- Danish municipalities and hospitals in the thermore, these hospitals are an integral part sults of treatment improve. At the same time, ly care is to improve quality of life for elderly regions are implementing innovative tech- of the coherent and patient-centred health- it allows the hospitals to focus on specializing citizens with focus on values such as influ- nologies that support citizens in their daily care system we continuously improve, and in treatment only possible at hospitals, and it ence over one’s own life, respect for diver- routines, keeping them connected, physical- Stephanie Lose they will be hospitals fit for the medical needs frees up resources in the healthcare system Stephanie Lose sity, focus on humanity, self-determination ly active, and safe. These innovative Danish of the future, but also for the healthcare pro- to provide extra care and attention to those and worthiness in the last part of life. solutions can help improve the quality of life fessionals and patients that will use them. patients needing it the most. for elderly citizens as well as support health- In Denmark, we have a dignified elderly care care professionals in creating an efficient, Jette Skive Denmark has the perhaps most digitalized In an increasingly digital world where chronic with focus on involving and empowering coherent and high-quality framework for healthcare system in the world. Our digital diseases and changing demographics define every citizen with focus on their individual care, rehabilitation, and prevention.

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Index

3 Executive summary 4 Foreword 6 New hospital con- struction in Denmark

8 Healing architecture 9 Single-bed rooms im- 10 Visionary design sup- optimizes the well-being prove patient recovery ports psychiatric hospi- of both patients and and staff workflows tal patients’ recovery staff

11 A next-generation 12 The North Wing: 13 Involving users and patient-centered Healing architecture VR in designing a new hospital for the future children’s hospital

15 High performance 16 Optimizing capacity 17 Aalborg University hospitals with innova- management with intel- Hospital improves sam- tive logistics solutions ligent hospital planning ple quality with an intelli- gent sortation solution

18 Artificial intelli- 19 Robots disinfect 20 Automation of gence improves hospi- hospital with ultravio- cleaning processes tal robot traffic let light improves hygiene and ergonomics

21 Automated service 22 Sustainable hospi- 23 District cooling of village improves hospi- tals and environmental New Aalborg Universi- tal logistics challenges ty Hospital

24 Solar cell park at 25 Plastic recycling at 26 Energy services New Odense University hospital provides both project improves en- Hospital environmental and ergy efficiency at new economic benefits university hospital

27 State-of-the-art 28 User-driven design 29 Promoting collabo- wastewater treat- and innovation ration and innovation ment plant at Herlev through physical Hospital integration

30 Users design their 31 Innovative sensory 32 Ergonomic hospital own psychiatric bed concept at new mother– lighting improves mini- child department mally invasive surgery

33 Taking patient hand­ 34 Danish hospital con- 35 About ling and rehabilitation to struction for the future Healthcare DENMARK the next level

5 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Top left: North Wing at Rigshospitalet (© Adam Mørk), top right: New Aalborg University Hospital (© Konsortium Indigo), below left: New Odense University Hospital, below right: BørneRiget – Children’s Hospital Copenhagen (© 3XN, Arkitema Architects)

New hospital construction in Denmark

Danish healthcare is undergo- The Danish healthcare system is commit- lives. The Future Hospital Program is the re- ing rapid transformation to meet ted to ensuring a focus on patients’ needs. sponse of the Government and Regions of patients’ changing needs. More As more and more people live with multiple Denmark to these expectations. An invest- healthcare services will be pro- chronic conditions that require manage- ment of approximately 6.5 billion euro (2018 vided in primary care and through ment and treatment, their medical needs prices) in 16 new “super hospitals” will bring outpatient treatment. Therefore, future will change. Modern technology enables us us there. hospitals will play a very different role as to treat patients much closer to home, and part of an integrated and coherent health- even in their homes, rather than in a hospi- All facilities will be designed for the people care system. A restructured healthcare tal. Patients can take an active role in the using them – patients and healthcare pro- sector with new and innovative hospitals management or treatment of their illness, fessionals. This means individual rooms for is the key to creating sustainable health- while health professionals provide optimal patients, hi-tech data-driven logistics sys- care for the future, with patients in an ac- care. We know that hospital admission tems, state-of-the-art technology, flexible tive role. brings disruption and distress to patients’ multipurpose rooms and a building design daily life, and the positive effects of technol- to match. Danes enjoy the benefits of a universal ogy affect not only quality of life, but also healthcare system based on the principle of quality of care and treatment. Denmark’s hospital infrastructure will free and equal access for all. Its high-quali- change – with fewer but larger hospitals, ty services are mostly paid from the public Treatment in hospitals will, of course, still be reducing the number of emergency depart- purse. Only a minor part of health expendi- needed. Patients will expect medics to be ments from 40 to 21. In return, the new, ture is out-of-pocket payments, primarily for highly specialized, in order to ensure the best more highly specialized hospitals will have dental care and prescription drugs. outcome with the least disruption to their stronger professional environments that can

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Top left: North Zealand Hospital (© Herzog & de Meuron - Vilhelm Lauritzen Arkitekter), top right: Aarhus University Hospital (© C.F. Møller Archi- tects) below left: Regional Hospital West Jutland, below right: Zealand University Hospital (© KHPT I/S)

Facts handle even the most critical and complex The national aim of replacing a significant fraction of hospital admissions with out- cases, in terms of both competence and patient treatment will allow hospitals to focus their highly specialized services on equipment. All catchment areas with more treating the critically ill or injured. The primary healthcare sector will be tasked with than 300,000 inhabitants will thus be cov- offering less specialized and less intrusive treatments at a lower cost. ered for all major specialties and will offer It is crucial that the design and use of the new hospitals lead to improvements 24/7 emergency ward services. in healthcare and treatment. Transformation should be ensured, not only by con- structing newer and larger buildings, but also by designing the hospital environ- The Future Hospital Program is a key com- ment of the future in ways that support a new model of care. ponent of a major structural and organiza- tional reform of the Danish healthcare sector Vision for hospital construction projects to establish sustainable services, with hos- Focus on patients: Quality levels must be raised by building with a focus on pa- pitals playing an integral role in a coherent tients and their safety, and by optimizing workflows healthcare system that supports patients as active partners in their treatment, while Improved efficiency:Efficiency should be improved by ensuring greater cohesion at the same time meeting future healthcare in patient treatment, new technology and innovative organization and procedures requirements. Flexible hospitals: Flexibility must be ensured by enabling the extension or conver- sion of facilities and rooms without major expense

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Healing architecture optimizes the well-being of both patients and staff

In Denmark, research results show ty and healthy work environments are other successful course of treatment. While a pa- that the principles of healing ar- priorities. tient’s recovery is the result of many individ- chitecture such as light, sound, ual acts of treatment and care, whose indi- nature, colors and art can support No two hospital construction projects are vidual contributions are difficult to measure, patients’ recovery and even con- alike, and great expertise is required to peer reviewed research has established the tribute to a faster recovery. It also helps custom-design each building to fit into the positive effect of architecture on the healing patients gain more control of their own sit- natural surroundings with consideration for process. uation, and creates a healthy work environ- the building’s functions. This is illustrated by ment for the staff. Vejle Psychiatric Hospital, where good over- Evidence-based practices have established sight and safe spaces for patients and staff the effect of the architecture of a healthcare With many new hospitals being built in Den- are a focus point. This has proven to have a building on a number of outcome areas, mark over the last decade, the concept of significant effect, as physical restraint mea­ such as efficiency, stress and fatigue among healing architecture has reached a higher sures and isolation of patients have seen a staff and patient safety, stress and well-be- level as it has become an integral part of ar- drastic fall. The design of BoerneRiget, by ing, as well as overall clinical results. chitectural design. 3XN and Arkitema Architects, the future national children’s hospital in Copenhagen is The Danish healthcare system is focused on As research has shown that well-designed another example of how design can create a further improvement and on creating even environments contribute significantly to the home-like ambience for children and parents better hospitals. By focusing on healing ar- healing process, several aspects should be that allows for play and makes the stay as chitecture, the goal is to ensure that treat- considered in creating the optimal architec- close to normal life as possible. ment in Denmark will continue to achieve ture for a hospital. Among these are: ena- excellent results using both outstanding bling easy physical and visual contact with Measuring the effect of healing architec- clinical practices and well-planned, well-de- nature, securing ample daylight and creating ture signed buildings. spaces that offer patients a choice between Several factors must be considered when at- privacy and social interaction. Patients’ safe- tempting to identify elements that support a

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Single-bed rooms improve patient recovery and staff workflows

In new Danish hospitals, all pa- as it is easier to achieve privacy and involve Single-bed rooms have brought many new tient rooms are designed as sin- the family, but there are also financial ben- benefits, such as enabling teleconferencing gle-bed rooms. This is a necessary efits. from the patient’s room for communication priority to ensure a high level of with primary healthcare services and bedside hygiene, support patient empowerment With only one patient per room, hospital in- handling of medication, thus preparing pa- and independence, as well as enable effec- fections and medication errors are effective- tients to coping on their own after they are tive, high-quality treatment and encourage ly reduced. The undisturbed calm provided discharged. Overall, the possibilities for indi- shorter length of stay. by single-bed rooms allow patients to sleep vidual planning of care routines are greatly better, often decreasing the need for pain- enhanced. Providing single-bed rooms for every patient killers and sleeping medicines. As a result, is a cornerstone of all new hospitals being many treatments can be performed without constructed in Denmark. A wealth of evi- moving the patient, admissions are shorter, dence supports the decision to make this a and the pressure on special examination mandatory feature: patients recover faster, rooms is reduced.

9 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Visionary design supports psychiatric hospital patients’ recovery

The new psychiatric hospital in covery — for instance, by ensuring ample The design encourages physical activity while Vejle, in the Region of Southern light throughout the building, easy access reducing the need for coercive measures. Denmark, is designed to support to green outdoor spaces and transparent Since its opening, the hospital has registered the Region’s focus on outpatient wards with easy overviews. a 50% decrease in physical restraint mea­ services. The healing architecture sures, and has been widely acknowledged concept stimulates patients’ recovery and To utilize the healing effect of light, the de- for its healing architecture. well-being, effects that are also enjoyed by sign provides ample natural and artificial staff. light, with glass panels and interior court- The psychiatric hospital was inaugurated in yards allowing daylight to flood the build- 2017 as the first healthcare project in Den- Protected by a forested hillside, the hospi- ings. The withdrawn ceilings and interior mark to be built as part of a Public—Private tal’s individual units merge with the land- glass surfaces help the light extend even fur- Partnership (PPP). The hospital is operated scape at perpendicular angles, allowing a ther through the building. The wards further- by the Region of Southern Denmark, de- maximum of greenery. more offer 24-hour colored light therapy to signed by Arkitema Architects and financed support patients’ natural circadian rhythm. jointly by Sampension, PensionDanmark, The architectural principles underlying the The result is better sleep, leading to faster MTH, DEAS and MOE as investors, owners, hospital’s design have led to an optimal recovery. Staff likewise benefit from these builders and maintenance providers. environment for patients’ healing and re- features.

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A next-generation Facts patient-centered hospital • Completed in 2019, it is Denmark’s largest healthcare construction, which merges the two former uni- Showcasing cutting-edge design The design of the exterior was guided by versity hospitals of Aarhus Hospital in healing architecture, Aarhus an ambition to achieve flexibility and fu- and Skejby Hospital. Aarhus Hospi- University Hospital represents the ture-proofed functionalities while allowing tal was itself a merger from the next generation in patient-cen- the extensive gardens and landscapes to four individual hospitals of Aarhus tered care. provide opportunities for relaxation and tran- Municipal Hospital, Aarhus Coun- quility. ty Hospital, Marselisborg Hospital Designed by C.F. Møller Architects in collabo- and Samsø Hospital in 2007. ration with Cubo Architects, this leading hos- By keeping its users in focus, Aarhus Uni- • 216,000 m2 new build and pital in the Central Denmark Region stands versity Hospital has successfully promoted 159,000 m2 conversion = 375,000 as testimony to the systematic application the involvement of the patients’ families and m2, total area: approx. 970,000 m2 of evidence-based knowledge of healing ensured optimum working conditions and • 797 beds, 43 dialysis stations and architecture. This approach has influenced streamlined workflows for all employees. 80 hotel beds for patients and every decision in the hospital’s physical de- their families sign, from the exclusive use of single-bed • Received the 2017 Building Better rooms, to ensuring daylight everywhere, to Healthcare Award as “Best Inter- intuitive wayfinding favored by a city-like national Design” layout.

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The North Wing: Healing architecture for the future

The North Wing is the latest exten- treatment and thus support the hospital’s light to flood the building, connecting the sion to Rigshospitalet, the leading new role in the future healthcare system. building’s interior with the greenery outside hospital in the Capital Region. In- to create a therapeutic and calming effect formed by the ambition to improve The new extension’s 54,000 square meter that stimulates recovery. patient well-being and healing, the features more than 200 single rooms, oper- building’s design accommodates health- ating rooms, outpatient clinics and an inten- Two spiral staircases and four central eleva- care professionals’ expectations for the sive care unit. The unusual zig-zag building tor towers connect the floors with the cen- hospital of the future. design was inspired by the image of a cardi- tral common area. The daylit atrium gives ogram intersected by a main “artery” route. access to the staircases. As a step towards a more modern Rigshos- While the zig-zag structure invites patients pital, the new building for outpatient treat- to take a leisurely stroll or a rest in a se- The artwork exhibited in the atrium brings ment will provide the framework to ensure cluded zone, the straight artery route allows color and life to the building, while soften- continued delivery of high-quality care and staff to navigate quickly from one end of ing the sterile hospital environment. The the building to another. Pa- works can also be enjoyed from outside of tients’ rooms offer recovery the hospital. The result is a hospital building in comfort away from the that welcomes its visitors, while providing busy hospital environment. patients with optimal conditions for well-be- ing and recovery. Throughout, the design of the North Wing has been The design and layout of the North Wing are guided by the concept of the result of close collaboration between two healing architecture. Large architectural firms, LINK arkitektur and 3XN glass sections allow the day- Architects.

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Involving users and VR in designing a new children’s hospital

BoerneRiget, the new children’s m2 building was tested in virtual reality by “Doctors, nurses and midwives may have dif­ hospital in Copenhagen, has im- 200 hospital employees. The innovative VR ficulties understanding design drawings or plemented a unique approach to environment enabled them to roam the plans. It makes a huge difference when they treating children, aiming to reduce building interior and interact with 1:1-scale can experience the building in a more intu­ stress in children and improve itive way, which lets them understand and compliance and outcomes. This involve us- “It makes a huge difference participate in the process of development of ing technology such as VR sessions to sup- the building they are to move into.” - Toke port implementation of the new approach. when they can experience the Laugesen, Architect, BoerneRiget. building in a more intuitive Located alongside Rigshospitalet, the lead- BoerneRiget is designed by 3XN in collab- ing hospital in the Capital Region, Boerne­ way, which lets them under- oration with Arkitema Architects, NIRAS, Riget will offer treatment to children, adoles- stand and participate in the Kristine Jensen Architects and Rosan Bosch cents and pregnant women. The structure’s Studio. futuristic shape resembles two children’s process of development of hands with fingers reaching for the light, the the building they are to move city and the greenery. A healing environment is provided by the high-quality air, ample day- into.” light and lush winter gardens. Children and their families will find rich opportunities for 3D models. The joint experience offered by play and creativity there. this technology sets it apart from other VR Facts solutions. • 58,000 m2 To foster communication and mutual under- • 15 operating rooms standing between project advisers, health- Moving around in the 3D model as a team, • 57 outpatient clinics for children care staff and patients, the development users can virtually understand, develop and and adolescents process included user sessions in a comput- test the project from a shared point of view. • 30 outpatient clinics for adults er automated virtual environment provided VR thus translates plans into something • 14 delivery rooms by the software consultancy BIM Equity. In much more intuitive and easily grasped for • Expected opening in 2025 the course of a single week, the new 58,000 the layperson and for healthcare staff.

13 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

The North Wing at Rigshospitalet in the Capital Region of Denmark (© Adam Mørk)

The psychiatric hospital in Vejle in the Region of Southern Denmark (© Niels Nygaard)

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High performance hospitals with innovative logistics solutions

With the new hospital landscape including innovative logistics solutions to op- solutions will help to enable. New robotic in Denmark, our hospitals will be timize efficiency and reduce patients’ length solutions controlled by software and sensor playing highly specialized roles. of stay. To optimize patient flows in the new technology will facilitate the use of applica- At the same time, the healthcare hospitals, the next step will bring new logis- tions for a wide range of tasks at different system is under pressure to meet tics solutions using previously unavailable locations in the hospital – even among pa- patients’ expectations of efficient and data for novel technologies, such as robots tients on the wards. high-quality treatment. Therefore, inno- and artificial intelligence (AI). vative just-in-time logistics solutions are Freeing up time for the core tasks of hospi- necessary to optimize patient flows and to Mobile robots have already been implement- tal departments through the use of artificial reduce patients’ length of stay. ed in some of Denmark’s university hospitals intelligence for planning and optimization and in other large hospitals to handle logis- will ensure better hospital services that will Denmark’s focus on hospital logistics has tics tasks, thus easing staff workloads and benefit both patients and staff. been instrumental in achieving a significant freeing up time for patient care. Self-driving increase in productivity. New processes and autonomous mobile robots (AMRs) take technology have enabled just-in-time deliv- care of delivering laundry, transporting blood ery of services and equipment, while ensur- samples to labs and bringing medicines to ing coordination between all specialties and wards. Combining robotic technology and thousands of patients and staff. Our solu- artificial intelligence is part of the next step, Facts tions encompass supply logistics, clinical as artificial intelligence goes hand in hand A previous Healthcare DENMARK logistics, sterile goods and sample logistics. with logistics and planning. The right pa­ white paper was dedicated to a de- tient in the right bed, at the right time, giv­ tailed description of the Danish con- Danish hospitals continue to focus on or- en the right treatment – this is the essence cept of hospital logistics. ganizational and technological development, of the Danish healthcare system, which AI

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Optimizing capacity management with intelligent hospital planning

An innovative patient flow system ward and in all departments, across the time. We also experience enhanced coope­ gives clinicians a real-time over- entire region. With an overview of the re- ration and greater understanding across view of patients and beds in all gion’s total capacity, users can coordinate hospital wards.” - Karin Hedegaard, Head of hospitals in North Denmark Re- actions for patient flows in hospitals, within IT, Aalborg University Hospital. gion. clinical specialties, and even between hos- pitals, if necessary. This can take place via The solution currently offers occupancy lev- Difficulties tend to arise with reductions in el forecasts for seven days ahead, based on the number of hospital beds, and it can be “The system is easily acces- machine learning. The next step is to include a challenge to ensure the correct placing forecasts on each patient on the basis of of incoming acute patients. Furthermore, sible and can be adjusted their clinical data and on patients to be ad- when patients are transferred from one continuously with entries in mitted. ward to another, data loss and prolonged hospitalization are not uncommon occur- real time. We also experience This will help optimize patient flows during rences. enhanced cooperation and admittance, as the system can predict both length of stay and readmission risk. The Columna Patient Flow software suite is greater understanding across the result of an innovative project involving hospital wards.” clinicians from seven hospitals — headed Facts by Aalborg University Hospital, Aarhus Uni- • Optimizes capacity utilization versity and the Danish software company ten-minute capacity meetings in the morn- through improved planning Systematic. This innovative solution sup- ing through video conference calls, while in • Gives an overview of bottlenecks in ports the planning and capacity process in the afternoon, coordination is conducted the patient flow hospitals, and enables clinicians, coordina- via the system. • Enables a broader view of patient tors and administrators to see how the ca- progress, combined with forecasts pacity is related to the number of patients “The system is easily accessible and can be admitted and expected discharges on each adjusted continuously with entries in real

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Aalborg University Hospital improves sample quality with an intelligent sortation solution

Data-driven decisions, full trace- received when the hospital started to use ty of test material, as well as patient safety. ability and temperature monitor- the solution to less than 4% today. Ensuring correct sample temperature also ing have significantly increased helps to prevent the need for redraw of the quality of blood sampling and In the fully automated solution, blood sam- blood samples. workflows at North Denmark Re- ples are handled, unpacked and sorted, gion’s university hospital while retaining while traceability and monitoring of tempe­ ­ “We can now verify that the high quality we high patient safety. Higher patient safe- ra­ture conditions is ensured from the time believed we had did not actually exist. We ty and reduced redraw of blood samples the sample is collected at the general prac- thought our test material remained constant proves a solid business case. titioner’s until it is ready for analysis at the at 21 ± 1 degrees Celsius, but that was not laboratory. the case. So now we have full traceability By implementing an intelligent sample trace- and the true monitoring of our test material. ability, monitoring and sortation solution, As such, this solution allows for automated­ This quality boost is invaluable.” - Annebirthe Aalborg University Hospital has managed and data-driven quality control of sample Bo Hansen, Ph.D., Head of Clinical Biochemi- to reduce the number of temperature devi- materials, which reduces the number of er- cal Department, Aalborg University Hospital. ations registered from 100% of the samples rors in pre-analytics and increases the quali- The automated monitoring system has also helped improve workflows, while at the same time significantly improving the work- ing environment at the laboratory through the automation of unpacking. The proce- dure also prevents repetitive strain injuries from arising.

The innovative solution has been developed by the Danish company Intelligent Systems, in close collaboration with Aalborg University Hospital and the robotics company LT Auto- mation.

“We can now verify that the high quality we believed we had did not actually exist. We thought our test material remained constant at 21 ± 1 degrees Celsius, but that was not the case. So now we have full traceability and the true monitoring of our test material. This quality boost is invaluable.”

17 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Artificial intelligence improves hospital robot traffic

Autonomous robots that run any- jects enter a narrow passage, the MiR robot “Robot technology will free up time for pa­ where and independently of floor will park on the side, waiting until the way is tient care and improve the working environ­ installations are increasingly be- clear. However, if a single person enters the ment. Porters’ jobs involve postures that ing implemented in Danish hospi- doorway, the robot will continue, as it knows strain their shoulders and legs, and repeti­ tals. At the Hospital of Southern there is room for both of them. The AI cam- tive movements are also a problem. I expect Jutland, an autonomous mobile robot eras thereby improve robot traffic, ensuring to see many more robots in hospitals, both with AI features improves robotic traf- collaborative and fully automated, to pull, lift fic and ensures internal logistics run as “I expect to see many more and push what’s needed.” - Tom Johansen, planned. Porter Manager, Hospital of Southern Jut- robots in hospitals, both land. An MiR100 robot from Mobile Industrial Ro- collaborative and fully auto- bots, based in Odense Municipality, wends its way among trash cans, trolleys, scooters, mated, to pull, lift and push porters pushing beds, groups of workers what’s needed.” and other logistics robots. Having delivered Facts its load of food, it returns the dishes to the Odense Municipality, in the Region kitchen four times a day in the Region of the smooth and efficient execution of the of Southern Denmark, is home to Southern Denmark’s Aabenraa hospital. hospital’s logistics. one of the world’s most successful robotics and automation industries. The robot’s AI feature avoids the problems of Automated internal transport provides ben- A strong national robotics cluster, robots meeting in narrow doorways, blocking efits to both management and employees. which includes more than 130 com- traffic by waiting for each other. AI cameras Whereas previously, kitchen staff had to walk panies, focuses on internationaliza- placed above doors are able to distinguish to hospital departments to pick up the used tion and provides an extensive net- between robots and other obstacles, such as service, a click on a tablet is now enough for work of global partners. people or other moving objects. If these ob- the robot to start collecting the dishes.

18 INNOVATING BETTER LIFE

Robots disinfect hospital with ultraviolet light

Twelve minutes are all a robot The UV disinfection robots combine innova- everything is ready, and then start the robot. needs to automatically disinfect tive mobile robotics technology with a UV-C Twelve minutes later, the disinfection pro- all surfaces in a room with ultra- light module. With robots a part of the clean- cess is completed. violet light. At Odense University ing cycle, bacterial counts are greatly re- Hospital in the Region of Southern duced before a new patient enters the ward. Rather than idling in the Department of He- Denmark, the innovative robotics solution This helps prevent the spread of bacteria matology, the robots are also put to work on enables cost efficient cleaning and reduc- and other harmful microorganisms, reducing disinfecting other areas of the hospital. At es risk of infection for patients and staff. hospital-acquired infections, which affect the beginning of 2021, after twelve months 50,000 patients in Denmark each year. trialing this procedure, the Department of Two UV disinfection robots from the Da­ Clinical Microbiology will evaluate the impact nish company UVD Robots in Odense Muni­ Having cleaned a room, the hospital staff of the UV disinfection robots on the number cipality are used in the Department of He- ensures that the furniture is optimally placed of hospital-acquired infections. matology, which is visited by some 29,000 for UV-C light illumination of surfaces. Us- outpatients and inpatients over a year. In ing a tablet device, the staff then instructs Recent testing in Taiwan has shown that sixty patient rooms, toilets, and bathrooms, the robot to leave its docking station, locate such robots, if used properly, result in bacte- these robots supplement the normal clean- and enter the room. The staff checks the ria counts being reduced by 77% in intensive ing procedure. robot on arrival in the room to ensure that care units and 83% in operating rooms.

19 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Automation of cleaning processes improves hygiene and ergonomics

At Viborg Regional Hospital in Cen- safety; further benefits include significant “Our new washing machine tral Denmark Region, hygiene and time savings and better ergonomics for ergonomics have gotten a boost hospital staff. from Semi Staal has had a with an automated cleaning ma- huge impact on both hygiene chine that provides much faster “Our new washing machine from Semi Staal and safer cleaning of beds. has had a huge impact on both hygiene and efficiency. It only takes and efficiency. It only takes a few minutes a few minutes from when a Manual cleaning of beds is a hassle – it takes from when a bed enters the machine until lots of time, reaching all the edges and cor- it comes out, spick and span, ready for use. bed enters the machine until ners is awkward, and the work environment And bacterial tests show extremely good re­ it comes out, spick and span, is poor. But automating the process can help sults.” - Hanne Louring, Service Consultant, overcome those challenges. Viborg Regional Hospital. ready for use. And bacterial tests show extremely good Viborg Regional Hospital obtained special The washing, disinfection, and drying pro- funds for a new automated bed and mat- cesses take place in a tunnel, so that con- results.” tress washing machine, which was installed tamination of the cleaned output is avoided in 2017, with a capacity to clean up to 25 by separating the reception bay for unclean beds per hour. On a daily basis, the hospital materials from the clean area. Depending uses the machine to clean about fifty beds, on the materials to be cleaned, the machine fectants are used for bed frames, aids, and mattresses and pillows, besides wheel- operates with different programs: mat- plastic crates. With these processes, good chairs and other assistive aids. The new tresses and pillows are cleaned by steam bacterial results of little as 2.5 CFU/cm2 are hygienic processes have improved patient and ultrasound, while hot water and disin­ ­ achieved.

20 INNOVATING BETTER LIFE

The hospital’s logistical heart is a fully automated buffer station with a capacity of 530 goods carts, serviceable from two sides by four multilevel cranes.

Automated service village improves hospital logistics

When the New Aalborg University waste disposal, the hospital’s logistical heart Three fully automated multichamber wash- Hospital in North Denmark Region will be a fully automated buffer station with ing lines for disinfection, manual pick-up opens in 2022, its highly auto­ma­ a capacity of 530 goods carts, serviceable locations at the waste yard and truck bays, ted 20,000 m2 service village will a 40-cart interlocked sterile buffer and a 60- ensure an efficient and energy sav- “Planning principles that ena- cart buffer for warehouse goods will also ing hospital operation for itself and other form parts of the system. hospitals in the region by optimizing flows ble automation and effective and processes. hospital logistics are impor- The project features a very high level of au- tomation, optimized flows and processes, Achieving a simple and effective logistics set- tant in all new hospital build- as well as flexibility and opportunity for fu- up was a driving factor in planning the new ing projects. Pneumatic tube ture expansion. The latest state-of-the art hospital: a key principle was a setup that would technology has been integrated to meet the allow hospital staff to focus on patient care systems and AGVs form part need for a unique solution. and other primary tasks, rather than worrying of the new technologies that about logistics. Partnering with the consultants “Planning principles that enable automation Rambøll Hospital Logistics for the construction enable more effective pro- and effective hospital logistics are important project, the starting point was to focus on pro- cesses in the new hospital.” in all new hospital building projects. Pneu­ cesses, hygiene, physical framework and inter- matic tube systems and AGVs form part faces between automation and people. of the new technologies that enable more from two sides by four multilevel cranes and effective processes in the new hospital.” - Rather than having central facilities for ware- connected with an automated guided vehi- Heine Overby, Office Manager for Logistics, housing, catering, sterilization, storage and cle system (AGV) servicing about 40 rooms. New Aalborg University Hospital.

21 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Hvidovre Hospital with solar panels on roofs.

Sustainable hospitals and environmental challenges

All over the world, countries are With hospitals typically using significantly energy and water costs. Major energy re- introducing goals to reduce their more resources, and producing more waste ductions can be achieved by means of inno- energy consumption. In Denmark, than commercial buildings of comparable vative solutions, such as efficient pumping hospitals are required to contrib- size, it is critical that resource management systems, district heating and cooling, natural ute to the green agenda, and there- is improved through effective environmental ventilation and lighting, integrated solar pan- fore new hospital projects are launching strategies. To meet the challenge of reduc- els and smart building technologies. eco-friendly initiatives and environmental- ing CO2 emissions and achieving positive ly friendly practices to the design, building long-term effects on operational costs, the Circular resource use and management of facilities, in order to design and construction of new hospital Circular approaches to the use of resources reduce their carbon footprint and improve buildings must be considered. While the are key to achieving sustainable hospital op- patient care. construction of Denmark’s new hospitals eration. By reducing, reusing and recycling must be made sustainable, renovation and the waste produced in hospitals, we can not Making future hospitals sustainable re- retrofitting will ensure decarbonization of only stabilize operational costs, but also re- quires solutions that are efficient and re- our existing hospital buildings. This includes duce the environmental footprint. Studying source-economical. With investment in 16 the use of renewable energy sources, such various cases of waste handling in hospitals new hospital projects, the opportunities for as solar panels and innovative cooling solu- has shown that waste need not be discard- green procurement in cooperation with pri- tions. As an example, Hvidovre Hospital in ed, but can actually become a valuable re- vate stakeholders are already being exploit- the Capital Region of Denmark has installed source that enables clean energy generation. ed. One such project is found at Aalborg solar panels on the roofs, supplying CO2-free This requires, however, behavioral changes University Hospital in North Denmark Re- electricity to the hospital. so that hospital staff are encouraged to gion, which has partnered with the private contribute their knowledge toward reduced company Aalborg Portland to use the wa- Efficient water and energy usage consumption, more sustainable solutions, ter left over from their concrete production Using energy and water efficiently is vital in and so on. Adjusting usage and workflows in the hospital’s cooling system. The new reducing CO2 footprints. The introduction of to ensure both the continuity and develop- facilities ensure the environmentally and new solutions, processes and designs lowers ment of high quality patient care can only financially sustainable future operation of environmental impact and operational costs come about when everyone is committed to the hospital. through increased efficiency and decreased the goal.

22 INNOVATING BETTER LIFE

District cooling of New Aalborg University Hospital

In a collaboration with the city util- In principle, district cooling is a reversal of troduction of biogas-powered buses, reduc- ity company, Aalborg Forsyning, the district heating process, with cold rath- tions in resource consumption and waste the New Aalborg University Hos- er than hot water being supplied. From the volumes and intensified recycling measures. pital will be cooled by water from lake, water at 8–12 degrees Celsius will be a nearby lake. This system, which piped to the hospital, where it will cool pa- is the first of its kind in Denmark, will con- tient rooms, staff and clinical facilities and tribute to a substantial reduction in annual medical equipment. CO2 emissions. Facts Only the pumps will generate CO2 here, and • Local public–private collaboration In the first system of its kind in Denmark, the annual carbon dioxide savings to the between the North Denmark Re- cooling will be provided for the North Den- new university hospital will be 500–700 tons. gion, Aalborg Forsyning and Aal- mark Region’s 170,000 m2 university hos- This supports North Denmark Region’s ambi- borg Portland pital using water from a 30-meter deep tious “Climate Region” measures to reduce • Contract value of approximately chalk pit, located some 3.5 km north of emissions, thereby contributing to achieving EUR 36.2 million, with a maturity the new hospital in the Aalborg Portland Denmark’s climate goals. Other sustainable of twenty years facility. initiatives taken by the Region include the in-

23 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Solar cell park at New Odense University Hospital

The Region of Southern Denmark Solar energy is an obvious candidate for Jensen, Project Director, New Odense Univer- is currently building its largest sustainable measures in the construc- sity Hospital. hospital, which will cover 296,000 tion of Denmark’s future hospitals. The m2. Solar panels and other sus- New Odense University Hospital in southern The solar power plant is being supplied by tainable initiatives were key ele- Denmark will be powered by a large solar the company Better Energy Solutions. ments of the design phase to supply CO2- power plant close to the hospital. Already free electricity to both the construction supplying power to the building site, the site and hospital operation. plant’s capa­city will have surplus capac- ity for other buildings when completed in Facts 2022. “This is a frontrunner proj­ • Air quality will benefit from the large energy savings ect. No other hospital in the The output of the solar power plant will be • The plant will provide over 45% of equivalent to the electricity consumption country has similar capacity: the hospital’s summer power con- of 1,100 households, more than enough to sumption (yearly average 20%) in fact, the total electricity meet the needs of the large university hos- • 35% of construction site’s electri­ ­ pital. production from all other hos- city consumption will be covered • There will be an estimated green- pitals in the region is about “This is a frontrunner project. No other hos­ house gas reduction of 1.3 tons pital in the country has similar capacity: in one sixth of the future capac- per year fact, the total electricity production from all • The panels generate 4,650,780 ity at New Odense University other hospitals in the region is about one kWh annually sixth of the future capacity at New Odense Hospital.” University Hospital.” - Torben Hedegaard

24 INNOVATING BETTER LIFE

Plastic recycling at hospital provides both environmental and economic benefits

Central Denmark Region’s efforts It is much more attractive to lower the to- changing the cover and the easier handling toward circular economy show tal amount of waste by 20%, which would of the slightly thinner bags has also saved that reducing plastic waste has by achieve a 1.5 ton reduction in CO2 emis- time by being quicker to pull over the carts. far the greatest effect, both eco- sions, with almost ten-fold savings of more nomically and environmentally. By than EUR 134,200. The decision to focus on In addition to the reduced plastic consump- changing procedures at the region’s hospi- waste reduction was thus a foregone con- tion, the laundry now avoids mixing plastics tal laundry, a significant reduction in plas- clusion in the hospital’s work on sustainable materials of different colors, in order to tic consumption is achieved. solutions for the future. improve the sorting of used materials. This means that, rather than paying for the col- An analysis conducted at Aarhus University The region’s own Nordic Swan eco-labe- lection of used covers, the plastic can now Hospital in November 2016 indicates that led hospital laundry, MidtVask, has thus be recycled. only about 37% of the sorted plastic is tech- changed its procedures. One example is the nically recyclable. Even if it were possible to plastic covers used on linen carts during Overall, the reduction in plastic consumption locate market players to recycle this plastic transport. Reducing their thickness from 35 and the increase in recycling have saved 26– waste, CO2 emissions would be reduced by microns to 25 microns has saved 4.5 tons 34 tons of CO2 equivalents. only 1.2 tons and the cost by EUR 13,285 of plastic and reduced costs by 10%–12%. compared to waste incineration. The greater roll capacity saves time spent on

25 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Zealand University Hospital Køge in September 2019 seen from above. Forming part of the future University Hospital Køge, the majority of the exist- ing buildings will be covered by the ESCO project

Energy services project improves energy efficiency at new university hospital

Sustainability will be a premium ments in 2019 on the implementation of a grated in the new hospital. They include re- feature in the construction of Uni- number of energy-saving projects. This gives placement of lighting fixtures, renovation of versity Hospital Køge in Region the region a comprehensive overview of the ventilation and control systems, installation Zealand. To provide energy sav- potential for savings based on uniform as- of one-handle mixers on utility water, and ings, an Energy Service Companies sessment criteria. installation of solar panels. The Køge ESCO (ESCO) project has been established to en- project is expected to provide savings of 1.2 sure operating and energy optimization of At the same time, it is an opportunity to GWh in electricity, 0.5 GWh in heating, and the existing buildings. pool many small projects in a large tender. 2,900 m3 of water. This helps us optimize projects with short- Region Zealand has long focused on sustain- term effects with projects that provide sub- “The ESCO project will optimize our hospi­ ability and energy savings. All construction stantial long-term benefits. tal’s operating and energy expenditure. Fi­ projects exceeding EUR 13.4 million must nancing the project through energy savings be certified by the German Green Building After Region Zealand called for tenders for has opened up new possibilities.” - Mads K. Council (DGNB), while smaller-scale projects seven hospitals, contracts for approximately Kristoffersen, Technical Manager, University are energy screened according to regional EUR 26.8 million were signed, with an ex- Hospital Køge. guidelines. pected payback period of 15–20 years. Of this amount, some EUR 5.2 million cover The first projects went ahead in January The region has concurrently worked on ener- proj­ects at University Hospital Køge. 2020, with completion expected by the end gy optimization of the existing building stock of 2021. with many years of service ahead. Most re- The thirteen projects at the future Universi- cently, an ESCO process was initiated which, ty Hospital Køge concern only those parts following intense analysis, has led to agree- of the existing buildings that will be inte-

26 INNOVATING BETTER LIFE

State-of-the-art wastewater treatment plant at Herlev Hospital

In the Capital Region, the purifi- New sustainable methods have been de- A report based on 18 months of opera- cation and reuse of wastewater veloped to extract medicine residues, en- tion has shown a 99.9% reduction in drug in the new sustainable waste- docrine disruptors and antibiotic-resistant substance loads, making the water pure water treatment plant at Herlev bacteria from the sludge. The cleaned water enough for reuse in the hospital’s cooling Hospital represents a double gain is so pure that it can be sent directly back system. for the environment and the hospital’s fi- to nature, saving the cost of treatment at a nances. central plant.

The mixture of water and pharmaceutical The hospital plant has a daily capacity agents, pathogens and antibiotic-resistant of 600 m3, corresponding to the amount bacteria carried by hospital wastewater can- of wastewater discharged by 3,000 people. not be treated by conventional means. To To ensure a high standard of water quali- meet this challenge, Herlev Hospital in the ty, a variety of biological purification pro- Facts Copenhagen area began directing all waste- cesses and membrane filtration are used, Apart from the Capital Region, Her- water through a brand new treatment plant followed by activated carbon and ozone lev Hospital, Grundfos Biobooster, in the summer of 2014. polishing. the collaboration behind the plant included the companies DHI, Ul- The world’s largest and most modern of its The plant also cleans the air emitted during traaqua and Neutralox. Support was kind, the plant was established as part of the cleaning process, removing both odors obtained from the Danish Business a public–private collaboration between the and harmful pathogens in its closed and Authority’s Market Development Capital Region, Herlev Hospital, Grundfos Bi- noiseless system. Fund and others. obooster and others.

27 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Unique setting for public-private collaboration at Health Innovation Centre of Southern Denmark. User-driven design and innovation

Basing innovation and ideas for safe and innovative solutions developed as and experiences are essential in the develop- new solutions on strong collabo- part of collaborations between end-users ment of new innovative solutions. ration between hospitals, univer- and companies known as user-driven innova- sities and private companies has tion projects. This concept plays a key role in The Danish experience with involving users earned Denmark international achieving successful outcomes for the ben- at a very early stage of the design and de- recognition for its user-driven innovation efit of patients, the healthcare system and velopment processes helps to ensure the culture. Public–private partnerships with society as a whole. successful implementation and use of the high levels of stakeholder involvement solutions in the new hospitals. Pilot testing are defined by a uniquely Danish concept User-driven innovation projects typically orig- of future operating rooms at Odense Uni- which is playing a key role in the new hos- inate with a hospital, a municipal author- versity Hospital in the Region of Southern pital construction projects. ity, a primary care organization, or another Denmark provides an example of a success- healthcare organization that has identified ful user-driven innovation project. In coop- In Denmark, we cherish our proud tradition a problem to be solved through innovative eration with the Health Innovation Center of cooperation between the public and pri- concepts and solutions. In many cases, uni- of Southern Denmark, patients, relatives vate sectors — in particular in the healthcare versities or cluster organizations also play a and healthcare professionals from across sector. The many new hospital construction role in motivating healthcare organizations departments, academia and management projects provide unique opportunities for en- to bring strategic or daily operation problems contributed their insights to the construc- tering into various forms of public–private forward. tion of the new operating rooms. Thanks to partnership. Not only does this apply to the a full-scale mockup of an operating room, actual construction process — partnership User-driven innovation leads to successful users could participate in simulation tests to also characterizes the development of the implementation uncover issues in a realistic set-up. Clinical innovative solutions to be used when the A high level of user involvement is required staff were thus able to test specific operat- hospitals begin operations. to ensure that our current and future needs ing scenarios within all medical specialties are identified, so that the proposed solutions before implementation, leading to the in- The new hospital landscape — involving the will work in practice. Users may include pa- troduction of new concepts and designs for reorganization of hospitals and increasing tients, families, healthcare professionals and improved patient safety. the individualization of treatment — requires hospital staff, as their varied perspectives

28 INNOVATING BETTER LIFE

Promoting collaboration and innovation through physical integration

The New Aalborg University Hos- The hospital and faculty buildings will open tered entrepreneurship among innovative pital in North Denmark Region is their doors in 2022. Their physical inte­ clinicians and students. being erected next to the prem- gration will enable the sharing of auditori- ises of Aalborg University’s Fac- ums, lecture rooms and so on, to create The merger of the two organizations will ulty of Medicine. The physical synergy between these two strategic part- thus lead to new and innovative ways of integration of the two organizations will ners. The features of the buildings and sharing facilities and staff, helping to better strengthen their already well-established their shared areas will ensure easy move- coordinate and utilize resources. knowledge exchange and collaboration on ment of staff and students from one to the innovation. other.

Aalborg University Hospital and the Faculty The faculty’s broad range of healthcare pro- of Medicine at Aalborg University (AAU) have grams, including healthcare engineering and a shared vision of providing healthcare-relat- molecular biology, will be served by the new ed education, research and innovation. Their teaching facilities. The medical students’ focus on innovation and close collaboration master’s program will be taught entirely in involves staff and patients in translating the hospital’s facilities to strengthen the ideas into new procedures and products to already established pathways between fac- improve treatment and care. ulty and university, ties that have long fos-

The physical integration and shared areas will ensure easy movement of staff and students from one building to the other.

29 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Prototype of the new psychiatric bed.

Users design their own psychiatric bed

By involving users in a public-pri- is a cordless, battery-powered, easy-to-clean “The goal was to develop a bed that con­ vate innovation partnership, a new bed that goes a long way in implementing tributes to the values underlying psychiat­ type of bed has been designed for patients’ ideas while ensuring a safe and ric nursing in both design and functionality. psychiatric patients’ rooms. Both convenient work environment for the staff. During the development process, there was patients and staff have welcomed the a great focus on both staff and patient per­ initia­tive and as a result, the new bed in- spectives in their interactions with the bed. creases patients’ well-being and improves “During the development The result is a completely new type of bed, work environment for staff. process, there was a great fo- one designed for and by the users.” - Ole Ryt- tov, Director of Specialist Nursing in Psychia- In a successful collaboration between the cus on both staff and patient try, Region of Southern Denmark. Region of Southern Denmark and the Capital perspectives in their interac- Region, the new bed was developed for use The bed has improved the work environment in psychiatric wards. After a two-year design tions with the bed. The result for staff, as it is designed for use both in phase, the so-called Resilience Human Life is a completely new type of normal day-to-day use and in stressful acute Carebed was introduced in the Region of situations. Southern Denmark in autumn 2015. It was bed, one designed for and by later introduced to psychiatric wards in the the users.” North Denmark Region and the Central Den- mark Region, both of which contributed to Facts the design. The bed has proven effective in preventing A multi-functional comfort cushion psychiatric patients from self-harming be- called SenceCirle, allows the bed The bed is manufactured by the compa- havior, while the patients say they now sleep to be transformed into a sofa or a ny Agitek, who involved patients and staff better and feel more comfortable during ad- “comfort zone”. in its development from day one. The result mission.

30 INNOVATING BETTER LIFE

Innovative sensory concept at new mother–child department

A new sensory delivery room con- “Our focus is on improving patient outcomes The concept was developed by a close pub- cept creates a relaxed and homely and care with patient-centered innovation. lic–private innovation partnership (PPP) atmosphere, with an overall sooth- We embrace the opportunities offered by between North Zealand Hospital in the ing effect on both women giving new technology and knowledge. It was there­ Capital Region of Denmark, Wavecare and birth and hospital staff. fore a given that we would provide sensory Philips. Continuous refinement and optimi- delivery rooms for the entire maternity ward zation has brought the concept from an in- With the same key facilities as an ordinary at our newly built hospital.” - Niels Georg novative experimental project to a scalable delivery room, the sensory delivery room is Reichstein Larsen, Chief Director, Slagelse solution. furthermore equipped with ambient light Hospital. and specially designed audiovisual programs with a user-friendly interface. Providing a stress-reducing ambience in the delivery ward and supporting birthing women, the sensory delivery rooms also ensure a better Findings from a study of 476 births in ordinary delivery rooms, compared with working environment for the midwives dur- 313 births in sensory delivery rooms (same period, North Zealand Hospital)* ing their night watches. 6.4% were acute cesareans in the sensory delivery rooms 10.7% were acute cesareans in the ordinary delivery rooms Slagelse Hospital in Region Zealand is the * Published in the international science journal Nature in 2019 first in Denmark to implement the Danish company Wavecare’s innovative sensory Findings from a satisfaction study of women giving birth in sensory delivery concept in every delivery room to give all rooms birthing women the opportunity to benefit 93% of women reported a very positive impact on their total experience from its positive effects. 74% of women reported a very positive impact on their experience of pain

31 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Ergonomic hospital lighting improves minimally invasive surgery

Denmark strives to replace in-pa- A warm and soothing light welcomes patients on a customized white light. For cleaning and tient procedures with outpatient as they enter the room. During procedures, preparation before the next procedure, a spe- treatment. In order to help increase cially developed white light highlights dirt and invasive surgery procedures, ergo- “The new light makes me less blood strains and boosts the daylight. nomic lighting has been installed in Aarhus University Hospital’s 100+ op- tired and reduces the strain Close collaboration between the staff and eration rooms — a sign of the high priority on my eyes. It makes a huge lighting experts has ensured customized de- given to the work environment and patient signs of light settings and user interfaces for safety in Central Denmark Region. difference and gives me the each room and speciality. The lighting solu- energy to cope better. The tion was developed in 2006 by Danish lighting The specially calibrated colored lighting has specialist Chromaviso. Today, well over one improved work conditions during minimally green and red lights provide hundred hospitals across Scandinavia have invasive surgery, benefiting the well-being of for very clear and pleasant implemented the solution as a standard. both staff and patients. contrasts.” “We are in operations for many hours, so light and high-quality screen imagery are the operation room is divided into different Facts extremely important. The new light makes lighting zones that each support specialized Developed by leading surgeons me less tired and reduces the strain on my work tasks. A combination of green and red and lighting specialists, the evi- eyes. It makes a huge difference and gives light ensures a high image quality, minimizes dence-based Ergonomic Lighting me the energy to cope better. The green and reflection and relaxes the eyes. During X-ray- solution is customized for room red lights provide for very clear and pleasant ing, the red light enhances the grey-scale conditions, workflow and specialist contrasts.” - Mikkel Seyer-Hansen, Surgeon, image. To reduce glare from the operation applications. Aarhus University Hospital. lamp during open surgery, the staff can turn

32 INNOVATING BETTER LIFE

The robot is being tested for use at University Hospital Køge

Taking patient handling and rehabilitation to the next level

At University Hospital Køge in Re- continuous evaluation, to ensure optimal fea- “It’s very important for us gion Zealand, a robot developed as tures in the robot. The simple and intuitive part of a public–private innovation user interface ensures that anyone can use it that our needs are under- project ensures safe and flexible for safe and flexible patient transfers. stood and met by our com- patient transfer, for the benefit of patients and staff. Feedback and input were also sought from mercial partners. The close broader groups of hospital staff. Close col- and successful partnership Conventional patient transfer procedures are laboration with hygiene experts, technical burdened by limitations and heavy work ex- staff and IT/communication staff assured with PTR Robots meant that penditure. This led University Hospital Køge definition and early implementation of the we were listened to in the to look for robotic solutions for a more flexi- requirements and interactions with the ro- ble patient transfer system. bot. This public–private innovation project process of developing the has enabled the hospital to create better new robot.” The innovation project involving the hospital patient transfer options, not only for the pa- and Blue Ocean Robotics led to the develop­ tient, but also for the caregiver. ment of the PTR Robot, manufactured by the company PTR Robots, based in Odense “It’s very important for us that our needs Facts Municipality. The R&D process began by map- are understood and met by our commercial The PTR Robot has been developed ping all patient transfer situations and inter- partners. The close and successful partner­ in a local public-private partnership viewing several hundred representatives of ship with PTR Robots meant that we were including a diverse group of profes- relevant caregiver groups. The valuable field listened to in the process of developing the sionals from Project University Hos- and user tests that resulted from the close new robot.” - Frank Hansen, Chief Project pital Køge, Blue Ocean Robotics and collaboration between the development team Manager, IT & Equipment, University Hospital PTR Robots. and the healthcare professionals en­abled Køge.

33 SUSTAINABLE HOSPITALS Future Hospitals in Denmark

Danish hospital construction for the future

In Denmark, new highly specialized hospitals are quality treatment and active involvement in their own course being built, taking into account the changing role of treatment. With longer life expectancy and an increase in of hospitals in our future healthcare system. Re- the number of patients with chronic diseases, new thinking lying more on outpatient treatment, coherence is required from the healthcare system. and primary care, architectural aspects of hospi- tal construction and technological support systems place Transformation and changes to our healthcare system will increasingly high demands on innovation. continue at an accelerating pace. Future perspectives include:

The increasing focus on hospitals’ relations with patients • Smartphone and wearable solutions are being developed and the desire to empower and strengthen their indepen­ to support individualized health provision and will become dence call for new ways of collaborating with patients, with increasingly important in future diagnostics and treat- the primary sector and with hospitals. ment.

This white paper has given an introduction to many of the • The national telemedicine solutions being implemented in transformations in the Danish healthcare system, with co- Denmark will allow patients to take a more independent herent healthcare offering treatment in new ways, shaped and participatory role. by new demands on hospitals’ roles. • A personalized medicine strategy is being implemented Healing architecture is one of the new initiatives in hospital to ensure better and more targeted treatment. design aimed at helping patients to faster recovery, support- ed by innovative solutions that optimize the patient flow and Subsequent white papers will keep you updated on these shorten patients’ length of stay. developments and the impact on our future hospitals. In our previous publications, you can find a comprehensive over- Digitalization and automation ensure efficient operation of view of innovative Danish solutions in relation to current core services in hospitals, with new work methods, technolo- themes in health provision. gies, and organization. This frees up resources for treatment and care, while also providing better health and safety con- To learn more about the new Danish hospital constructions, ditions for staff. feel free to contact Healthcare DENMARK. If you want to visit Denmark to study its innovative solutions in detail, you This is only the beginning. The role of Danish hospitals will can request a delegation visit through the Healthcare DEN- continue to change, with patients expecting ever higher MARK website.

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About Healthcare DENMARK

Healthcare DENMARK is the inter- national gateway to Danish health- care expertise and innovation. Our aim as a non-profit public-private partnership is to internationally benchmark Danish best practices within healthcare.

The goal of Healthcare DENMARK is not to HRH The Crown Princess of Denmark sell or promote any specific products or solu- patron of Healthcare DENMARK tions, but to communicate the strongholds of Danish health- Healthcare DENMARK has a national and po- care. We do litical mandate to provide this service to pol- this by attract- iticians, relevant top and management level ing health pol- professionals, and journalists working with iticians, deci- healthcare. sion-makers, and journalists Backing this public-private initiative is a part- to experience ner group of both public and private key actors Danish health- within Danish healthcare, including the Min- care solutions istry of Health, Ministry of Industry, Business in practice and Financial Affairs, Ministry of Foreign Af- and meet the fairs of Denmark, Danish Regions, Region of people behind. Southern Denmark, North Denmark Region,

Hans Erik Henriksen Our network is Aalborg Municipality, University of Southern Chief Executive Officer an extensive Denmark, Aalborg University, the Confedera- pool of public tion of Danish Industry, the Danish Chamber of sector, private Commerce, Danish Export Association, Danish companies, and other actors in the area of Care, Falck, Systematic, Intelligent Systems, healthcare – all dedicated to providing excel- Leba Innovation, Mobile Industrial Robots, lent and efficient healthcare as well as shar- UVD Robots, OpenTeleHealth, KMD, Lyngsoe ing best practices across borders and profes- Systems, Wavecare, Icura, Corporate Health, sions. Pressalit and UCL.

’’In Denmark our focus on putting the patient Her Royal Highness The Crown Princess of first – combined with efforts to improve effi- Denmark is patron of Healthcare DENMARK. ciency and quality – has resulted in a wide array of innovative solutions. I sincerely believe Da­ Visit www.healthcaredenmark.dk to learn more nish solutions and expertise can have a positive about some of the world’s best and most inno- impact on global health.” - Her Royal Highness vative healthcare providers and companies or The Crown Princess of Denmark to request meetings with the stakeholders who are future-proofing healthcare sectors around If you would like to learn more about our the world. world-renowned healthcare, we can assist you with tailoring a visiting program, setting up meetings, and arranging access to otherwise Stay updated with off-limits areas and people within both the our newsletter Visit our website public and private sectors, as well as assist healthcaredenmark.dk you with local accommodation and transpor- and sign up! tation.

35 Healthcare DENMARK SUSTAINABLE HOSPITALS Forskerparken 10G Phone: +45 23 84 00 56 INNOVATING BETTER LIFE Future Hospitals in Denmark DK-5230 Odense M [email protected]