WEST MIDDLESEX UNIVERSITY HOSPITAL LONDON

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WEST MIDDLESEX UNIVERSITY HOSPITAL LONDON

How to Survive Big Bang
Tom Naunton Morgan MB FRCS FRCR
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The Plan
To have PACS in AE for 6 months before moving to
the new hospital
This was so that we could have some sort of
database
Six months PACS training for everyone
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The Reality
Due to the amazing bureaucracy in the NHS,
funding was not available for the PACS.
Latest plan was that we had to join with some
other hospital in our area !
Our closest historical link was Teddington
Hospital
This was not in our health authority so we had
to find someone else
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The Reality
So we found somebody else. Ealing
We spent many months going around Europe and the
UK
Eventually we made our choice only to find that
Ealing did NOT have any money so it was a
complete waste of their time!!
We now did not have a partner with six months to
go
What now?
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The Reality
The builders, were on schedule, when not being
shipped back to Sangatte
The hospital was going to open in six months with
no PACS
Since the hospital was built by the French it was
quite small, and there was NO room for
conventional processing
We coined the phrase-
NO PACS NO HOSPITAL
This sent shivers down the spines of senior
management
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The Reality
The CEO had to go to the health authority and
explain that the hospital could not open without
PACS
The health authority HAD to agree to fund the PACS
Phew, and six months to go
The stress levels were high, but luckily
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The Reality
We had to move from this -
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The Reality
To this -
Over the weekend, to go live on Monday!!!
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The Reality

To crown it all, some bright spark decided that
we were to move 2 weeks early !!!!
We were moving to -
New Agfa PACS
New Agfa CR System
New Xograph DR System
New Toshiba 16 slice CT
New Siemens Screening Room
New GE Digital mammography Suite
New Building with security passes
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The Reality
We still had-
Our original Siemens Polystar

Our four Phillips 5000 SonoCT Ultrasound
machines
Our Amersham/Torex Radiology Information System
Our old Tosh CT
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The New Plan
Close AE to ambulances from Midnight until
9.00pm Monday
Keep the old Department going until 9.00am Monday
Keep the old AE radiology going just in case
Keep the old CT going as no one knew how to work
the new one
Print hard copies for 6 weeks alongside PACS.
Very expensive 40k
Train the Whole hospital to use PACS in 6 weeks
!!!!!!!!!
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The New Plan
9.00 am Monday Go live with patients still
piling through the doors. Walking wounded, normal
clinics and reduced GP patients
Start using DR / CR and PACS
All CT scans had to go across the site to the old
department Using the internal ambulance
9.00 pm Monday A/E opens to ambulances
Continue the Consultant on-call service
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How did it all go?
8.00 am Monday Continue unpacking.
Find the kettle
Try and look at some films. Agfa people were
everywhere
Walk to the old hospital to report CT. CT Not on
PACS
Try and look busy in our small un air-conditioned
offices
Comfort the radiographers to stop them crying
Continue the Consultant on-call service with
heightened security
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How did it all go?
By the Wednesday we were getting the hang of the
PACS
The Boys from Agfa were fantastic and nice with it
All a bit tired especially Annette, our
multitasking manager, as she slept in the
department
We would not have survived without her
We were getting used to our offices but there
was nowhere to swing a cat
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How did it all go?
Not many of the staff had been trained to view
the web
There were not enough working PCs around the
hospital and those that did work, had not had the
web browser loaded
It was time to dig my own grave !
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How did it all go?
Day by day and week by week all the problems
seemed to get Sorted out
Then the digital dictation people arrived so
another steep learning curve
This was soon mastered and we are now learning
how to use Voice Activated Dictation
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How did we do it?
We could have ended up with this
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How did we do it?
But we ended up with this.
Absolute perfection
Because
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How did we do it?
WE had -
to kick
A Project Manager
State of the art equipment so we knew that it
would work
A totally dedicated Department who gave their ALL
and that bit EXTRA
Unprecedented team spirit which managed to cope
even though we were given two weeks notice that
the opening had been put forward by two weeks
!!!!
Training one junior Doctor to train the rest !!
VERY Successful. He gave out the passwords
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How did we do it?
WE had -
Dan, our own PACS/IT guy. His office was in
Clinical Imaging so that he couldnt get away !!!
He was appointed and paid by us, but we invited
Agfa to the interview as he would have to work
very closely with both teams
Dan
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How did we do it?
Lunch time meetings with FREE food.
Its amazing where all the punters came from!!
Oligoneuronia caused some difficulties with
Consultants
Extended working days reduced the waiting times
before the move
Have a good working relationship with senior
management when their plans were daft ie move to
new A/E without PACS
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How did we do it?
And finally we had this guy
Dr Mark Owen Ex Imperial College
You may think that he is completely bonkers but
hes NOT
He designed the department so as to fit in the
patient flows and all the high technology
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The Finale
Toms new friend Gordon Brown who opened the new
hospital