Open solution for outpatient care


With the large-scale movement of outpatient care and day-care to new premises at Eugeniavägen 3, in Karolinska University Hospital's new hospital building, both personnel and patients will encounter a new environment that is adapted to a new way of working.

As soon as you walk through the entrance at Eugeniavägen 3, you are met by an atmosphere of openness and an environment that feels more like a modern hotel and conference facility than a hospital. It is light and airy, and particularly attractive, with different types of wood sourced from the Scandinavian region. Lining this space are a cash desk, reception and, on the same floor, a food court with a bar, a self-service food outlet and a restaurant with an open kitchen.

Visitors are also met by a large mural, "Stenbrottet" (the quarry) by the artist Andreas Eriksson. This 11 metre-high and 6.5 metre-wide painting is a natural visual point in the entrance hall and a kind of signature piece for the hospital as a whole.

"I see something new every time I look at it. It has elements that suggest hope and light, but there are also darker features. That's just what it is like for people coming into a hospital," says Annelie Liljegren, a consultant and expert who is responsible for transferring patients over to the new hospital buildings.

Annelie Liljegren, a consultant and expert who is responsible for transferring patients over to the new hospital buildings, thinks that the outpatient care section of the hospital will exceed expectations.

The big move on 23 April will, in principle, see all the outpatient departments moving into the new premises. D-day, which Annelie Liljegren has been anticipating since late 2008 when she joined planning of the New Karolinska in Solna. She has been involved in work on the project for ten years.

Naturally, there were innumerable trips and lots of discussions about every detail, but now that she can see the results and at the same time feel the frisson of anticipation prior to the opening, she says that it comes up to her expectations.

"It was even better than I had imagined, and my hope is that patients and their family members who come here experience the sense of calm that permeates this place. There are places here where you can go to switch off from nagging thoughts."

Prior to the move, most of the preparations were in place to ensure that the transition would go as smoothly as possible. In the period leading up to 22 April, equipment was gradually moved to the new premises. The departments reduced the number of appointments to make this possible and there was even a soft start on opening with about 1,500 patient visits, compared with the usual figure of about 2,000.

"Of course there will be some things that will not work, but the preparations have been extremely precise, as is also the case with the IT system, which was test-run a number of times," says Annelie Liljegren.

Visitors are met by a feeling of openness and light in the foyer to the outpatient departments. The mural "Stenbrottet" (the quarry) by the artist Andreas Eriksson occupies a central location, from where it prompts a range of feelings.

For the first few days there will be extra personnel on duty in the foyer to help visitors find their way. It may well be needed, because the signage is not what people are used to at hospitals. Instead of boards or signs saying cardiology outpatients, ears, endocrinology and such like, there are now combinations of letters and numbers that show the way. There is of course a thinking behind this. Outpatient care activities will pay as little attention to the old form of dividing care into various specialisms as at the new Karolinska site in Solna. Activities are now value-based and divided into different themes. The rooms in outpatient care will reflect this and, in order to achieve maximum flexibility, rooms will also change function as required. In principle, all outpatient departments in the premises are built to follow the same form.

So what will patients think of the change?
"It will be simpler and more comfortable," says Annelie Liljegren. A patient with prostate cancer who previously needed to see an oncologist in one place and a urologist at another outpatient department, now has these contacts gathered in the same place and on the same occasion. This doesn't just save time – it also leads to better quality care," says Annelie Liljegren.

The environment is also intended to promote research by exploiting the synergies resulting from contact between different disciplines. Here, there is also a lot of patient data that can be used in clinical research in order to produce better methods and medicines.

Just like previous moves into new premises, this has of course been discussed for a long time, prompting a lot of questions, and even criticism from the personnel.
"As I see it, it's not a question of black or white. Some people see the move as unnecessary and difficult, while others, particular younger people, consider the change being made to be in line with what they have learned during their training.
"But," she adds, "it will take time for everything to settle back down again. It's like moving into shared accommodation, where you have to share kitchen and bathroom duties with new people. I think it will be another five years before we can properly measure the effects of the change."

The hope with this new collective outpatient care is to increase outpatient care just a bit in order to reduce the need for beds.

"Looking further ahead, I think fewer patients will need to go to hospital in the first place, with some diagnostics and follow-up being possible via digital tools. This is a development that is being pushed by problems with resistance, as the risk of catching infections is greatest at hospitals," says Annelie Liljegren.


The transfer of outpatient care to Eugeniavägen 3 is the first of four relocation packages to the new hospital area in the course of 2018.
Relocation package 1, outpatient care in various specialisms and some inpatient care, is moving on 22 April.
Relocation package 2, parts of cancer activities, is moving on 13 May.
Relocation package 3 – neurology activities, in October
Relocation package 4 – the emergency department for adults, i.e. the new intensive care department, surgery, intensive care and the remaining care departments together with maternity, in October