Sahlgrenska University Hospital - Imaging and Intervention Centre

2. SAHLGRENSKA UNIVERSITY HOSPITAL Imaging and Intervention Centre Niclas Malmeling Representative for Västfastigheter Gunnar Linder WSP Sweden, Regional Director MEP, South West Sweden WSP Nordics representative for the WSP Global Healthcare Network

3. Sahlgrenska University Hospital A hospital with a history • Sahlgrenska Hospital o First patient admitted on 11th March 1782 o Founded by Director Nicolaus Sahlgren o Dr Pehr Dubb was the first hospital director o Located in the middle of the city of Gothenburg • Sahlgrenska University Hospital o Founded on 1st January 1997 • Sahlgrenska University Hospital in numbers (2015) o 10 000 new born o 360 transplantations o 200 000 emergency patients o 16 000 employees

4. 3 technical aspects Designing a rubust and flexible building that is aligned with the vision of the Imaging and Intervention Centre We will take a look at: • Its structure and foundations • How it is kept up to date • How it all fits

5. Structure and foundations Structure and foundations Requirements • Complex medical equipment o High loads supporting up to 12 tons (MRI) o Rigid structure to minimise vibrations o High additional load from lead and steel plates in walls and floor o Construction work carried out beside functional buildings and underground infrastructure • Flexibility o Building prepares to locate MRI in all surfaces along the façade o Slabs prepared for additional holes in case of reconstruction o Easy to mount equipment slab constructions Building • Foundations: solid steel piles anchored to rock • Basement: in situ cast concrete with moisture barrier • Slabs: in situ cast concrete without beams o Stiffness in two directions o Easier to locate (new) holes o High load bearing capacity • Top floors (technical floors): steel construction

6. Keeping it up to date • We are expecting one major change in the technical equipment every other month • To make that possible every OP-room is designed to ”stand alone” • Minimising impact on clinical operations Keeping it up to date

7. Keeping it up to date

8. Keeping it up to date

9. Keeping it up to date

10. Making it all fit • Careful planning • Unique combination of advanced medical equipment within close proximity • A team with in-depth knowledge of the technical equipment’s special requirements Making it all fit

11. Making it all fit

12. Making it all fitMaking it all fit

13. Making it all fit • Support to the design team and the contractors • Focus on the logistics • 400 patients were booked on the 1st day and everyone received the desired care Making it all fit

14. Thanks! wsp.com

Editor's Notes

My name is Gunnar Linder and I´m with WSP Sweden, I am an Regional Manager for the MEP services in South West of Sweden. I´m also the Nordic countrys representative in WSPs Global Healthcare Network. I´m going to present a project from my home town, the city of Gothenburg, called Imiging and Intervention Center. To help me with this presentation I have Niclas Malmeling who is representing Västfastigheter, the landlord and our client in this project.
I would like to star with a bitt of a history to give you that perspective on the project. Sahlgrenska Hospital was founded in 1782 (seventeen) and Sahlgrenska University Hospital in 1997. Sahlgrenska University hospital is the combination of Sahlgrenska Hospital, Mölndal Hospital and Östra Hospital and some other sites around Gothenburg and its Northern Europe's largest University hospital. It´s the main hospital for the region of Västra Götaland with 1,7 miljon citizens. Sahlgrenska University Hospital has 7 different national healthcare assignments, which is the highest number in Sweden. National healthcare means that certain highly specialised services are centralised at one or two centres in the country. The aim is to promote greater quality of care and better utilisation of resources. The Sahlgrenska Hospital is located in the middle of the city of Gothenburg.
As you can imagine there were a lot of challenges for the Architects and Engineers to make a robust and flexible building that would fulfil the visions of the Imaging and Intervention Centre. We also had to make it future proof, to make it a hospital building for tomorrow. There are off course a lot of technical aspects on a project like this one, I have chosen to give you a glimpse on 3 aspects which I think are key for the Imaging and Intervention Centre.
One of the keys to a robust and flexible building is the structure design. We have chosen to use an in situ construction for most parts to be able to meet the requirements for heavy loads, the ability to take new holes and to mount new equipment. The in situ construction lengthens the time table of the project and you carefully need to take care of the moist issue that comes with it but in this project we valued the better quality of the final building over the time aspect. We faced a rather complicated building-site when it comes to the foundation. There was an existing infrastructure of culverts and the bedrock was in a steep angle, in one part we needed to remove the bedrock to make room for the basement and in the other part of the building we needed piles 30 meters down to the bedrock. To meet the requirements for vibrations we used solid steel piles that are anchored to the rock.
New techniques are pushing the limits of society today. Digitalization is here and is effecting our everyday life more and more. But the fact is that we are never going to be affected as little as we are today by the technical revolution and digitalization ever again, it will only increase. And this goes for the Healthcare sector as well. New and better versions of the medical technical equipment is introduced every day and we need to design our hospitals of tomorrow in a way that they are easily transformed to new conditions. At Imaging and Intervention Centre we are expecting one major change in the technical equipment every other month. Whether it´s software or hardware, it will have a major effect on the clinical operations. To minimize the effect of these on clinical operations we have had this aspect in mind throughout the project and it has effected the design in many ways.
In the background of this Operation theatre you can see some pretty large windows. They are of course letting the daylight in but they are also designed to be easily removed in large sections. That gives us the opportunity to transport large equipment directly into the room through the facade.
Here you can see an MRI-camera being transported into an operating theater on the 4th floor. The camera is loaded in a container, the container is lifted in position and you can then roll the camera right in to the room.
All the systems are designed in a ”stand alone” fashion. Which means we can seal of an area or a room and make adjustments, or even rebuild a whole room and managing that from the outside through the facade and with minimum effect on the clinical operations in the rest of the house.
At Imaging and Intervention Centre the density of the medical technical Equipment is very high. To make this all work we allocated a special team that focused on the technical equipment. The team’s assignment and focus changed through out the project. At first it was of course taking care of the requirements for the clinical operations, discussions with the distributors of technical equipment, carrying out studies on how different equipment work together and how they affect each other. We have created some rather unique equipment combinations with the help of mobile applications and advanced shielding's between different areas. As an example we have an angiography and an MRI-camera in close proximity in the hybrid-OR on the 4th floor.
Here you can se a 3D study from an early phase in the project. It's like VR for the Flintstones but these paper models really help us finding the right way.
These pictures are from 10 years ago, it´s 3D disorder study and are made with a combination of 2D-cad drawings and Scetchup and was produced by Tyrens Architects. This helped us to find the right places for the equipment on the floor, but also in between different floors. We also hade to calculate with elevators and other moving metallic objects, electrical shafts and so on to get everything to work together.
When the project started the design phase, the equipment team changed focus and became more of a support team to the design team. Giving them the right information on the equipment that is supposed to be in a specific location; how big, how heavy, which connections and fittings required and where. This is always a tricky part, when we start the planning phase of a hospital project the equipment that is going to be in the finished hospital has not even been develop yet. To make this work we have to have a steady process and manage the information to the design team in a way so they can keep a good flow in the design and not being forced to make unnecessary changes. When the construction phase began the equipment team became a support team for the contractor in the same way as for the design team earlier. They also focused more on the logistics, getting the right equipment in to the right room in the right time. The time plan for Imaging and Intervention Centre has been successful and on the opening day there were 400 patients booked, which is almost full capacity, and everyone got the care they desired.
This is my first day of four in London. The first two days we are spending here at “European Healthcare Design” and then two days at WSP´s London Office and have a meeting with our Global Healthcare Team. This is our way of making ourselves accountable for our part of the development of tomorrows healthcare. And it is our way to take our global experience and expertise to our local businesses, our local projects for our clients around the globe. We are at exhibition stand number 14 if you’d like to come and talk to us. Thanks for listening!

Sahlgrenska University Hospital - Imaging and Intervention Centre

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Sahlgrenska University Hospital - Imaging and Intervention Centre

Editor's Notes