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wwH-c GmbH - Operating theatre of the future “Made in Tübingen”

The company wwH-c GmbH optimises surgical wards from a holistic perspective, improving their equipment, design, technology and all operating theatre-related processes, taking into account the requirements of patients and surgical staff. This optimisation covers the activities of all personnel, including those who work in preparation and post-anaesthetic recovery rooms. The ample experimental rooms designed by wwH-c GmbH are also used for training purposes.

In 2006, the experimental operating room (OR) was no more than a concept: a small team of wwH-c GmbH staff led by the company’s managing director, Dr. med. Ulrich Matern, were planning to establish an experimental operating room at the University Hospital of Tübingen (UKT), which would enable the company to deliver better surgical conditions for patients. Matern, who is himself a surgeon, has first hand experience of many of the problems that arise. He therefore empathised when surgical teams complained about the needlessly long paths they have to take from point A to point B, unnecessary manoeuvres and uncomfortable postures needed to use certain pieces of equipment and devices used in operating theatres. Matern was hoping to find ways to achieve improved ergonomic design and improved work processes in an optimised work environment, without impeding the normal operation of an operating room at a clinic.

Since 2006, the prerequisites for these projects have been put in place and considerably expanded. In Tübingen-Derendingen, a 1,000-square-metre fully functional OR centre was created. This globally unique centre is equipped with state-of-the-art technology, and houses a training room, meeting rooms and a show room. However, no real surgical interventions are carried out in this experimental OR, which is neither designed nor approved for such processes.

The concept wins over industry and university

Education and further training are offered in the experimental operating theatre under realistic conditions. © wwH-c GmbH

The establishment of the OR centre cost a lot of money and was only possible with the financial support of industry. Matern explains: "88 companies were involved in establishing the experimental OR, we have received many gifts and loans, without which this would not have been possible." Matern and Martin Scherrer (an engineer) are the owners and managing directors of wwH-c GmbH.

Although the University of Tübingen and the University Hospital do not have a holding in wwH-c GmbH, there are close connections between the two. "We have signed a cooperation agreement that enables medical students from the University of Tübingen, and surgical and anaesthesia assistants to be trained in the experimental OR," explains Matern. An innovative product resulting from this cooperation is the "OR licence", which is a professional training concept for future physicians and personnel who work in an OR. wwH-c carries out the training in its rooms and awards a certificate to successful participants. "All medical students at the University of Tübingen are required to do the OR licence in the 4th semester. This is a quality feature of the medical training at the University of Tübingen as well as a unique selling point of the Tübingen Medical School," emphasised Matern.

A one-day OR licence course is also offered to company employees who need to be present in operating theatres for professional reasons - in particular medical device consultants, service technicians and development engineers. The OR licence is recommended by the German Society of Surgery (DGCH) as a quality assurance measure related to patient safety. All successful participants receive a certificate with a DGCH stamp. Paul Hartmann AG was one of the first companies to integrate this course into its staff training.

Testing of humans and machines for OR suitability

Building and air-conditioning technology are important components of the experimental OR facility © wwH-c GmbH

The experimental OR is at the heart of wwH-c GmbH's concept, and, just like a real heart, it can only function correctly if the general conditions are right and reflect those in real hospitals. This means that supply, maintenance and waste disposal have to be in place. "We have invested more than a million euros in the air conditioning and control and communication systems. Our own research is focused on the optimisation of air conditioning systems. One of our colleagues, Dirk Büchel, developed a standardised usability process during his doctorate, which enables the testing of practical suitability of medical devices according to international standards. The tested devices are assessed and marked with a computer system," explains Matern.

wwH-c is very much focused on the usability of devices and equipment in hospitals and in operating theatres in  particular. The company plans to work with the TÜV (Technical Inspection Agency) to develop a quality seal for the usability of medical devices and instruments. In common with the company's other projects, this project also assesses criteria such as recycling, process integration, hygiene and ergonomics. "If everything goes to plan, we might be able to launch the seal in 2010," said Matern. wwH-c also works with industrial partners on the development of user-defined, usable devices and systems. The cooperation partners' products can be presented in the show room and - when integrated into the experimental OR - become an integral part of training carried out by partner companies for their staff and clients in the wwH-c rooms.

The OR centre as holistic system

Researching, training and providing advice – all these individual services are part of a wider vision: wwH-c regards the OR centre as a complete system and has plans to develop a testable general concept. Companies planning and constructing hospitals worldwide are extremely interested in these systems. “The plan includes the establishment of a “just-in-time-concept” of the entire OR process, from the initial preparation to when the patient wakes up and onwards to aftercare. We analyse the workflow for patients, devices, instruments and consumables,” said Matern highlighting that this remains a challenging goal because “there is still room to improve on the cooperation between building engineering and medical engineering,” said Matern diplomatically.

Devices are not the company’s only focus. wwH-c has also begun working with the Albstadt-Sigmaringen University of Applied Sciences on a textile engineering project with the idea of developing and optimising OR clothing. The company is also working on the optimal design of dressing rooms for surgical teams, which includes the assessment of equipment such as door handles for their suitability in OR wards. “We have to take all aspects into consideration in order to come to a holistic solution,” said Matern. The global holistic concept is already integrated into the company name: “wwh” stands for worldwide hospital, and the “c” stands for consulting, and also for construction, communication and creativity.

wwH-c’s most recent and very ambitious initiative is the “innovative hospital” project, a network of companies and academic and institutional partners that join forces in order to plan, build, certify and potentially also operate hospitals. The initiative will be presented to a broad expert audience on the Baden-Württemberg booth during the upcoming Arab Health 2010 tradeshow in Dubai. "The network is supported by the Baden-Württemberg government,” said Matern.

Further information:

wwH-c GmbH
Dr. med. Ulrich Matern
Dipl.-Ing. Martin Scherrer
Ernst-Simon-Straße 16
72072 Tübingen
Tel.: +49 (0)7071 97732-0
E-mail: info(at)wwh-c.com
Website address: https://www.gesundheitsindustrie-bw.de/en/article/news/wwh-c-gmbh-operating-theatre-of-the-future-made-in-tuebingen