Service Redesign
The new Monklands facility will be equipped with an array of specialist departments that are crucial for a major acute hospital, comprising single en-suite bedrooms and facilities such as operating theatres, emergency department, endoscopy, infectious disease medicine, critical care, renal (kidney) care, radiotherapy, imaging and outpatient departments.
Clinical Model Plans
When we refer to ‘The Clinical Model’ we mean the framework that outlines how healthcare services will be delivered in the new hospital with the goal of optimising patient care and outcomes. It refers to the overall structure of care delivery and has driven departmental adjacency and the overall layout and design of the hospital.
What services will there be?
All of the acute services delivered within the existing University Hospital Monklands will move to the new hospital, however the design of the new hospital has allowed us to optimise the patient journey making it easier to navigate through the hospital. We have had the opportunity to ensure the correct adjacencies are in place to provide a streamlined patient journey through the hospital whether planned or unplanned.
There are a number of aspects to the clinical model which are detailed below:
Front Door Assessment
The redesigned hospital ‘front door’ model comprises the Emergency Department (ED), and an Assessment Village (AV) comprising 4 assessment wards for the management of patients presenting with potential medical and surgical conditions requiring rapid diagnosis and treatment as well a focus for the assessment of frail and elderly patients.
This unscheduled care service involves a number of assessment pathways including the Rapid Emergency Assessment Care Team (REACT); Same Day Emergency Care (SDEC); see and treat; and major treatment and resuscitation pathways. The key benefit of the proposed model is the ability to quickly assess all patients arriving at the hospital irrespective of their mode of arrival, in a bespoke centralised space that enables a multi-disciplinary team to operate in an efficient and integrated way.
The use of condition specific SDEC pathways to manage emergency presentations in an ambulatory care, non-bedded area has the potential to deliver more end-to-end care within the ED resulting in a more streamlined and effective pathway and an improved patient experience.
Operating Theatres &
Peri-Operative Care
In developing the new model of care for operating theatres and peri-operative care that will be implemented within the new hospital, the theatre and anaesthetic team at University Hospital Monklands have identified a new model of care centred on the use of “peri-op rooms.”
The central component of the concept concerns the use of a single room by patients for admission on day of surgery, pre-operative care and post-surgery recovery. This model is designed to deliver a more person-centred approach to care, improving privacy, dignity and confidentiality for patients as well as providing the opportunity for family and carers to remain with the patients until transfer to theatre and also attend at an appropriate time post-operatively.
Outpatients
Outpatient activity is provided within a number of different locations in the current hospital. The new hospital has afforded the ability to co-locate all outpatient activity within one ground floor footprint, which makes is easier for patients to navigate and supports workforce efficiency.
The new facility will enable more consultations and therapeutic treatments to be delivered in a single outpatient appointment; this will be facilitated by the implementation of an enhanced multi-disciplinary team approach. Specialties such as Urology, Dermatology, Gynaecology, ENT and Orthopaedics are increasingly adopting this ambulatory based, one stop approach to patient management.
Critical Care
The new hospital design provides the opportunity to manage the sickest patients in the hospital in the one place, reducing workforce pressures and improving management of patients, particularly in the out of hours period. In addition, clinical outcomes will improve through the consistent application of quality standards.
The co-location of complex services on the same floor of the new hospital will significantly improve patient pathways and flows, improve patient safety (particularly out-of-hours) and optimise the deployment and use of workforce. Importantly, it will ensure that bed capacity is used appropriately.
“The collaboration between service users and staff in the planning of the new hospital has transformed our clinical model and will help to reshape how we deliver healthcare across the county. It’s an exciting time for us all.”
Fiona Cowan
Clinical Lead – Nursing
Monklands Replacement Project