 Loma Linda, CA - “Healthcare is broken.” That’s the very serious diagnosis that according to Dr. William Goral, MD was one of the catalysts for the founding of California Heart and Surgical Hospital (CHSH), due to open this Spring. “Things really don’t work very well these days,” explains Goral. “We wanted to create a new paradigm in medicine, to redesign the way care is delivered. In that regard, we wanted to develop a hospital that was physician, staff and patient friendly: to provide the best care that we could possibly deliver.”
Goral, an MD with 26 years experience, who serves as CHSH’s chief medical information officer, explains that one of the first major decisions when conceiving the hospital was to design it for optimal workflows. “We wanted it to be highly efficient and very safe for the patient,” he added. To that end, considerable effort has been spent selecting partners and technologies that would allow the hospital’s staff to deliver healthcare in a different way. Innovative leaders such as Cerner for IT systems and GE for high-end CT and MRI solutions were selected.
Through its partnership with Cirrus Health, a premier healthcare development and management company, CHSH’s team was introduced to TRUMPF Medical Systems. The Charleston, SC-based medical technology company offered knowledge and products consistent with the hospital’s objectives. “We were thoroughly impressed with TRUMPF’s insight into patient workflows: how to make things happen quickly and safely,” said Goral.
Specifically Goral made note of TRUMPF’s JUPITER System surgical tables that use interchangeable table tops and trolleys to streamline patient transport and reduce non-operative OR time. The team was also impressed with the iLED, TRUMPF’s industry leading LED surgical light, for the quality of light delivered. “The light is so even and comfortable to the eye and it enables a surgeon to see the operative field much more clearly then we are normally used to with multiple standard halogen” said Goral.
European Tour Shows Time-Saving Systems in Practice
Based on initial meetings, CHSH team members accepted an invitation to tour TRUMPF’s worldwide headquarters in Germany and hospitals in the area. “When we saw the equipment in live action in Munich and the surrounding regions we were blown away by how efficient and well designed it is,” said Goral. The transfer process using JUPITER System tables was observed in Austria and Germany.
 “We saw how efficiently that process goes: bringing the patient (and tabletop) in on the trolley, disconnecting from it, engaging on the pedestal and then reversing the process and bringing the patient to the recovery area after surgery,” said Goral. He estimated that the system could save at least 5 minutes on each process involved in moving the patient into and out of the OR. He categorized what the team saw as “impressive efficiency.”
Highly Engineered Technology
Goral also noted the quality of the products design and engineering. “One of the frustrations we surgeons experience frequently is poorly mounted, poorly designed lighting system. You swing the lights into position, you have everything where you want it and when you let the handle go it drifts away,” he said. Goral commented that this may be due to poor installation, but it is also likely to be due, in part, to poor design. During the facility walk-through in Europe, the CHSH team saw the superstructure used to suspend TRUMPF Equipment Management Systems and lights. “These devices are so over engineered it would just about take an atomic blast to knock them off plumb,” said Goral. “So just seeing how well those things were designed was truly impressive.”
Shadow Free Illumination
Another experience in Austria stayed with the CHSH team. “What we saw was remarkable,” said Goral. He recounted a mitral valve replacement procedure, during which the iLED 5 that the hospital was trialing was brought in on a mobile stand and substituted for the two halogen lights mounted in the room. Despite the potential for significant shadowing with the doctors working head-to-head and the light centered over the table, the surgeons performing the operation felt there was no shadowing and ample light for the procedure. They invited the visiting CHSH surgeons to take a closer look. “With three heads in the field and just a single iLED light, the illumination was so clean and so well distributed with essentially no bothersome shadows whatsoever,” said Goral. “The light going through the 1.5 centimeter valve opening illuminated the underside of the chamber perfectly well. It was just absolutely astonishing how even the light was and how well the system worked.”
Experience Results in Significant Change
Based on what the CHSH team saw in the US and Europe, the decision was made to change the equipment originally planned for the hospital. TRUMPF JUPITER System Tables, iLED Surgical Lights and Equipment Management Systems were specified. Although this was a significant change order, Goral explains the team felt it was necessary to select TRUMPF as their vendor due to the quality, efficiency and workflow expertise that was so consistent with CHSH’s founding principles and its commitment to delivering the best possible care.
According to CHSH’s CEO Randy Rolfe, since making that decision the hospital has had nothing but positive experiences working with TRUMPF. “Through the installation and readying the hospital to open, TRUMPF has performed very well in making sure that the delivery and installation went well,” said Rolfe.
Goral adds that TRUMPF team members Jason Keith and Alexis Scheffer have ridden shotgun over all aspects of re-engineering the original concept (when another vendor was specified) and made that process easy and headache free.” The TRUMPF team has also demonstrated flexibility. “We were looking for a different kind of side rail and found that Charly Dalbert, TRUMPF’s director, business development and professional services, was already working on a similar solution.” Goral said Dalbert was very open to moving that process forward. He added that Dalbert’s positive and enthusiastic attitude spoke to TRUMPF being accommodating and flexible.
Opening Spring 2008
When it opens, the 70,000 square foot, two-story California Heart and Surgical Hospital will house six surgical suites, two of which will be oversized to accommodate open-heart procedures; two cardiac cath labs; two procedure rooms for gastrointestinal endoscopy and pain treatments; 12 post anesthesia care beds; four intensive care unit beds; and 24 private patient rooms.
In Rolfe’s opinion, “California Heart will be a leader in technology and the integration of technology and IT solutions. The vision of the physicians who practice here is that the care provided is going to be care that reflects everyone’s commitment to the needs of the patient and service to the patient. Those two factors will equal a growing reputation for excellence in the immediate community and state-wide.” In considering the role TRUMPF has and will play at CHSH Rolfe adds, “We are looking forward to using their technology and continuing a great partnership with TRUMPF.”
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