The Vall d’Hebron University Hospital has started running the new Cystic Fibrosis Unit, counting with a designed infrastructure that will improve the efficiency of the attention to the patient, and it is pioneer in Europe. This project is possible thanks to the donation of Daniel Bravo Andreu Private Foundation, of 2’3 M euros.
The main novelty is that within the same space, one part will be exclusive for child visits and the other exclusive for the adult visits. The children will enter the unit from one side, reaching the side of the hall that gathers the offices for their visits. The adults will enter from the other side of the unit, reaching the medical offices for their own visits. This design with two halls, parallel but split by the area for the professionals, is the only one in Europe and will help on preventing the crossed infections between adult and pediatric patients. Moreover, another innovative aspect of this design is that the patient will not have to change from medical office to medical office to visit every specialist. The patient will remain in the same office, and the specialists will come by. The new Unit has the same location as the previous one, but triples the former space. The Cystic Fibrosis Catalan Association has supported the inauguration.
The Cystic Fibrosis is a genetic disease that affects lungs, digestive System and other organs, specially the cells that produce mucus, sweat and the digestive enzymes. The secretions of the organism that usually are not thick but fluid become then thicker. Instead of acting as a lubricant, the thick secretions create plugs, mainly in the lung and pancreas. The most frequent symptoms in children are the fat depositions, weight delay, bronchitis, and repetitive respiratory infections. With older children and adults, the symptoms can lead to sinusitis, diabetes, pancreatitis or fertility problems. It is a serious and chronic illness, which can risk the life of patients and reduce their quality of life.
Design and professional flow to reduce the infections risk
As Dr. Silvia Gartner explains, main coordinator for Children at the Cystic Fibrosis Unit, “the main morbiodity cause and mortality in adult and pediatric patients are the infections. By this means, the Unit is designed for the children and adults do not cross, do not share spaces. Their bacterias are different and very dangerous for each group. Especially in children that do not have a strong immune system yet”. At the middle of the unit, splitting both halls with the offices, there are the areas for the professional work, laboratories, meeting rooms and registration… Moreover, within the halls and the offices a pressure difference generating a flow or laminar current. This directs the air of the offices outdoors and renews it, reducing even more the risk of infections.
A unique design in Europe to prevent infections that reinforces itself with another innovative factor: the patient, being an adult or a child, arrives to the medical office and does not move anymore. The several specialists will move around the medical offices. This way, avoiding the crossing of patients in the hall. The visits with the different specialists are programmed throughout the same day, and, every 30 minutes, the professionals change to another medical office. “We adapt and adhere to the patients’ needs –remarks Dr. Antonio Álvarez, coordinator at the Adults Cystic Fibrosis Unit-. The patients are attended by pneuomologists, gastroenterologists, nutritionists, endocrinologists, otolaryngologists, physiotherapists and psychologists, specialists in children and adult, as it is a disease that affects several organs and systems”.
The patients carry out all the tests at the same medical office. Firstly, to diagnose if a person suffers from cystic fibrosis, a sweat- test is taken in a special room. This test evaluates the chlorine concentration in sweat, which is unusually high in patients with this pathology. “We set a bracelet that stimulates the sweat and analyze it”, explains Dr. Silvia Gartner. If the test results positive, the patient will start the Cystic Fibrosis Unit protocols in order to follow a personalized treatment and follow up. The tests run to the patients during the follow up are oxygen saturation, spirometries, culturing samples, blood tests, etc. One of the most important treatments for this pathology is the nebulization, which is the intake of drugs via aerosols so they inhale them. “We have a special room for adults and another one for children in order to carry out the treatment – explains Dr. Antonio Álvarez-. This treatment can make patients cough and expel their bacteria. The room is always sanitized after every treatment”.
Therefore, one of the main patients’ needs, to reduce the risk of infections, is conditioned by the design and working flow of the professionals. Even the door handles, walls, doors, and other surfaces that enter in contact with patients, have materials with antimicrobial properties that reduce the risk of infections.
A Cystic Fibrosis Unit of reference in Spain
Around 2800 patients in Spain suffer from cystic fibrosis. The Cystic Fibrosis Unit of Vall d’Hebron currently treats around 400 patients (adults on the 55% of cases), many of them from outside of Catalonia. Vall d’Hebron is a reference in this pathology, because of the amount of patients and because of its capacity to provide integral and multidisciplinary care. Moreover, it is the only State unit for cystic fibrosis that belongs to the European Cystic Fibrosis Society – Clincial Trials Network (ECFS – CTN). “Nowadays we have running 15 clinical trials for children and for adults”, adds Dr. Silvia Gartner.
New Pediatric testing cabinets
Additionally, the Daniel Bravo Andreu Private Foundation has also triggered the creation of new cabinets where the tests for cystic fibrosis pediatric patients and other pediatric patients, as children with ciliary dyskinesia, Crohn’s disease or cardiac malformations. A modern infrastructure, with last generation technological equipment, that count with a kind design to humanize the hospital to the patients. These cabinets will host bronchoscopies, colonoscopies, and esophagoscopies, besides other procedures that require the pediatric patients to be partially sedated.
With the new installations, Vall d’Hebron keeps going forward and investing on a more innovative treatment, hand in hand with increasingly friendly spaces.