At the new Karolinska has to sterilisation of instruments, as previously provided by each of the activities at Karolinska, has been centralized to a common sterilcentral. From the centre to disposable and sterilised operationsmaterial delivered according to a so-called just-in-time approach where the instruments are transported to the operating theatres with robots.
Sterilcentralen is a part of the concept, with the new Karolinska where the activity is to work quickly and efficiently in the planned flows, in line with the new organization put in place with the help of consultants. But it would provide economies of scale with a common sterilcentral for all surgical services have proven to be anything but effective.
the move into the new hospital in the autumn of 2016 had major problems with growing operationsköer. At the moment waiting around 8,000 patients in the surgery. It has been explained by the lack of care. But now it turns out that the problem with sterilcentralen also delays operationsverksamheten significantly.Since the move into the new hospital, Karolinska has had major problems with growing operationsköer. Photo: Alexander Mahmoud
Materialförsörjningsproblemen in the new hospital was described as ”huge”.
It feels as if sterilcentralen affects almost everything we do. Sterilcentralen have neither the right skills or capacity.
" It feels as if sterilcentralen affects almost everything we do. Sterilcentralen have neither the right skills or capacity, " says a doctor in the therapeutic practice.
the beginning of the move into the New Karolinska had great inkörsproblem. The business was undersized and could not manage to deliver the appropriate instruments in time for the operations.
the Summer of 2018 built in the new sterilcentralen out of the 11 million to increase the capacity. Then worked the business during a period, the better, according to the hospital management, but DN's sources state that the problems with sterilcentralen now is worse than ever. The wrong instrument delivered to the operations – or so delivered not at all, which means that operations are delayed significantly and that the subsequent operations to be deleted.
" It has been a very large turnover of staff, and it will be very wrong or no deliveries at all. We have even got the bloody instrument sent to us, " says the doctor who testifies that the problems have escalated in recent times.
– It has at times not had any instruments at all. The staff is distraught and crying in the hallway.
vårdplatssituationen, Karolinska have big problems to get operationsverksamheten to work inside the new hospital building. Sources testify about how the entire operationslag is finished, but that the operation will not started due to wrong instrument delivered to the halls.
It has at times not had any instruments at all. The staff is distraught and crying in the hallway.
– As a consequence is then also the patient sedated for too long and it gives an increased risk of wound infection. The next patient may be deleted. It leads to anger and irritation, and in the long run personalflykt, according to a source with the transparency of the DN.
as the plan of operations says that account must be taken of the availability of instruments in the planning of operations is made. Against the background of the logistical problems in the state of the art hospital building and to improve the efficiency of the operations are also carried out operations in the old Karolinska, where the whole operationslag leased in. But it has not been purchased more instruments.
" We must take into account that ”ok, we do this operation on the new, then it's not on the old”, for when enough instruments are not to. I am so angry at the consultants that are thought out to streamline, it has never been so ineffective, " says the nurse.
the operations are planned, set the big sterilcentralen to manage the cleaning and sterilization of all instruments with the problem. In the old hospital have the various activities been responsible for the sterilisation of their instruments.
– It is also about responsibility. When we all had our own instruments, so you feel a responsibility for them. Now, when we need our instruments, so we are told that ”we do not have the time”. They go well down to a mammoth-sterilcentral where you do not feel the responsibility and it is too large, " continues the nurse.
been problems with the transport between the sterilcentralen and operating theatres. The problems are exacerbated by the fact that there are stores next to or in the halls for back-up equipment and if something is missing or goes wrong during the operation. Several managers tells us that the surgeons or operationssjuksköterskor may run to the sterilcentralen to download the instruments made. Operationssjuksköterskor has also literally helped on the spot to ensure that the right instrument will operationsgallret.
"It has been chaos, with piles of sterilized instruments that have been ungraded on the sterilcentralen," says a doctor.Annika Tibell, associate hospital director at the New Karolinska. Photo: Magnus Hallgren
master kai fa Annika Tibell confirms that at the New Karolinska have logistical problems in sterilflödet – it is also about to set about from small units to a large central sterilenhet.
NKS has a lot of problems to get the new working methods to work, and it is true that sterilcentralen is one of the units had a problem with it.
– the Design of the NKS means that we need to work in new ways and it is true that sterilcentralen is one of the devices which we are not completely ahead of the game with it. We have also had some problems with logistics and supplies, and we are working very intensively, " says Annika Tibell.
In the hospital's business plan for the years 2019, describes lead to problems with sterilcentralen likely to pull down the hospital's provision of care during the year.
" This is a significant impact. Operationsstarter may be delayed. We take it into account when we book the day's program, and they become less tightly booked than we would do if we had full capacity. It's all about the work at the central station as the logistics from the central station, " says Annika Tibell, and says that in some flows affected the capacity as much as 20 per cent compared with the normal mode because of the problems with sterilcentralen.
the Hospital has also, according to Tibell, had contact with other hospitals to try to find solutions.
" We have been in contact with both the hospital and the university hospital in Linköping, which also has operated large central sterilization centres, who have described how they are working and it has taken time to get the flows working even there.
the Hospital announced on Thursday evening that after several emergency meetings will increase sterilcentralens manning and to open a new sterilteknisk title, to get to grips with the situation, which the Aftonbladet newspaper was first to report.