The health platform was put into use in Trondheim in April and has since garnered a lot of criticism. Last week, it came to a head when over a hundred intensive care nurses at St. Olav asked that the record system not be introduced at the hospital. The board of St. Olav decided on Thursday that they are sticking to the plans to introduce the new system. In mid-November, the journal solution will be put into use. – This is a very important milestone. The solution now meets the requirements that have been set, and we are assured that there are no remaining errors that are critical for Go live on 12 November. Now we can focus all our attention on the final preparations, says chairman Ola Strand. Monica Engstrøm is a shop steward and senior physician at the surgical clinic at St. Olav. She has been asking for concrete plans to avoid patient injuries during the introduction period for a long time. Engstrøm reacts to the fact that the hospital still does not have such plans in place – only a month before the so-called “go live”. – We do not have good plans for the introduction of the Health Platform, she says. Fear of delayed treatment Engstrøm says she has on repeated occasions requested calculations for how many patients may be affected by reduced operations during the introduction. She has also asked for plans for how these are to be treated. She fears that a lack of plans will lead to patients receiving delayed diagnosis and treatment. – If the Health Platform is introduced and what we are afraid of happens, and the hospital has not planned for it, then it is a scandal, she says. The hospital expects that the introduction will lead to reduced operations for four weeks. Engstrøm believes that plans must be made for several scenarios, also for operations to be reduced for a longer period. It should be clearly stated how many percent reduced operations the management expects, in addition to over how long. – Such restrictions have not been made, and it is a clear weakness, she says. Monica Engstrøm is a trustee and reacts to the fact that the hospital does not have good plans for the patients if operations are reduced over time. Photo: Privat Optimistic plans The hospital has announced that it will work with extensive data support for error correction and increased staffing in the initial phase of the introduction. In addition, Helse Midt has announced that they have set aside NOK 100 million to reduce waiting lists. This will be done by sending patients to other hospitals and buying health services from private actors. Engstrøm believes this is a bad plan, because St. Olav is a university hospital. This means that the hospital carries out specialized treatment that cannot be carried out in private or other local hospitals. For example, private hospitals do not treat cancer or very seriously ill patients, says Engstrøm. She doubts that other university hospitals can accept the patients, as they themselves struggle with long waiting lists. – The health service is in a pressured situation and we have little to go on. That is why it is a problem in itself if you make plans for other hospitals to take over patients over a short period, says Vivi Bakkeheim, company representative for the Association of General Practitioners at St. Olav’s hospital. She assumes and expects that there are good plans in place to deal with reduced operations in the first four weeks after introduction. Bakkeheim believes that the most important thing is to avoid reduced operations beyond this period. Nevertheless, she questions the realism of the hospital’s plans for normal operation after four weeks. – It is very optimistic, she says. Vivi Bakkeheim is a company representative at St. Olav’s hospital. She believes it is optimistic to assume that the introduction of the Health Platform will only lead to reduced activity for four weeks. Photo: Privat Etterspurt Tobias Iveland is a company representative for Young Doctors’ Association. He confirms that union representatives have for a long time been asking for specific plans for how the hospital will handle waiting lists. – The work to prepare for the Health Platform has been challenging and affected by the pandemic and uncertainty related to the design of the solution and late deliveries. Nevertheless, we have requested such plans over time and are happy that there is now a major focus on ensuring good patient care for patients, says Iveland. – Helse Midt has said that they will spend 100 million on getting rid of waiting lists ahead of the introduction. Aren’t those good enough plans? – This is where we demand concretely where that money should be used. We understand that this is being worked on now, he says. Tobias Iveland is a company representative for Young Doctors’ Association. He says union representatives have been asking for long-term plans for the introduction for a long time. Photo: Privat More measures after introduction The hospital already has plans that apply to the hospital as a whole to ensure patient safety in the first four weeks. They consist, among other things, of: Extra staff Immediate help patients are sent to other hospitals where it is justifiable Reduction of planned operations in the first week after introduction by one third Medicine rooms have been mapped and some have been remodeled, to avoid queues This is clear from the case documents for the board meeting at St. Olav’s hospital on Thursday. The hospital plans to halve activity at outpatient clinics for two weeks after introduction. It is then planned that the activity will be doubled based on this in the last two weeks. Could become critical over four weeks If there is a sustained reduction in activity and increased waiting lists at the outpatient clinics beyond the planned four weeks after introduction, this will be critical for patient safety in certain specialist areas. Clinic-wise plans are still missing, and the hospital has therefore now asked the clinics to assess and discuss measures for three different scenarios. Some reduction in outpatient clinics for six months and twelve months must be discussed and sent to management this week. “… the managing director will then have an overall picture of risk down to the individual professional areas,” the board papers state. – I think it is terribly late, when I have been asking for it for a long time now, says Monica Engstrøm, shop steward for the superiors at St. Olav. The superintendent believes the hospital will not be able to make good crisis plans, even if calculations for how many patients could be affected become clear. This is because it is very difficult to obtain additional personnel. – When we work as much as we do, we can’t just hire personnel. I think the management needs to speak loudly about that, otherwise they trick people into thinking that we have better capacity than we do to make up for lost activity, says Engstrøm. Continuous risk assessments Grethe Aasved, managing director at St. Olav’s hospital, does not want to give an oral interview to news. She answers questions by email. “The most important measure we are taking now to ensure patient safety when introducing the Health Platform is to carry out the remaining training and practice in the solution so that everyone is ready by 12 November”. These are the questions news asked: 1. Does St. Olav want to respond to any of this criticism? 2. Is it true that the hospital does not have good enough plans to ensure patient safety after introduction? 3. This week, the hospital management collects information from the clinics about discussions for three different scenarios. Isn’t this a bit late? 4. The shop stewards have requested such plans for scenarios “over a long period of time”. Why haven’t you brought in this overview to make these plans until now? Furthermore, Aasved writes that St. Olav’s hospital has drawn up good action plans both before, during and after go live. “Scenarios with action plans down to specialist areas must, however, be based on the current operation and the waiting list situation close to go-live. These will show where the risk is highest if we are not up to full activity after four weeks, so that supplementary action plans can be established right down to the individual specialist area. Continuous support from the Health Platform after go live has been agreed for error correction and optimisation, in addition to Helse Midt-Norge having set aside close to NOK 100 million for measures to help reduce waiting lists, including private purchases where necessary. If there are significant activity challenges even after four weeks, plans are made for reinforced support and the purchase of external treatment capacity, also outside the region.” Grethe Aasved is managing director at St. Olav’s hospital. Photo: Bent Lindsetmo / news
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St. Olav lacks crisis plans a month before the introduction of the Health Platform – news Trøndelag
