Since 2012, personalised surgery has been used in the hospital's Maxillofacial Surgery, Neurosurgery and Traumatology departments for the treatment of complex pathologies such as tumours and deformities. Our implementation of the 3D-LAB project offers a comprehensive service under a common framework based on personalised surgery that allows for more precise and safer surgeries with more predictable results. This improves resource management and fosters research and innovation.

Personalised surgery techniques enable more efficient and safer surgeries, through the use of surgical devices and prostheses that are tailored for each patient. They provide geometrically complex structural reconstructions, using computer design and manufacturing techniques and CAD/CAM technology, which improve surgical precision and the quality of reconstructions while reducing the amount of time employed.

A personalised, comprehensive and digital service

This comprehensive personalised surgery service is offered through the Office for Surgical Planning and 3D Design (3D-LAB) at the Vall d'Hebron University Hospital.

It is here that 3D prosthetics and implants are designed and the precision of the surgical technique used is evaluated. Only the 3D printing and production stage are outsourced.

To ensure an efficient, safe and high-quality implementation, the service combines new digital and 3-D printing technologies.

The next four years are expected to see this department treating some 660 patients, mostly for tumours, injuries, infections and congenital defects relating to the specialities of Maxillofacial Surgery and Neurosurgery as well as Traumatology and Orthopaedics, Spine Surgery and Rehabilitation, for patients requiring the amputation of a lower limb and subsequent distal load-bearing implants.

This project was launched in 2018 and will have been fully implemented by 2022.

As a leading hospital complex, we maintain a commitment to patients based on transparency, active risk management and a rapid response should an incident arise. 

In this context, the Safety Commission is working towards a Safety Model centred around patients and professionals, guaranteeing that it will:

• Propose and prioritise strategies in the area of safety of patients and professionals
• Promote improvement actions related to the safety of patients and professionals
• Be responsible for monitoring indicators of the safety of patients and professionals and evaluating the results

The patient is just as important as the professional caring for them. For this reason, we join forces in risk management throughout the whole healthcare process to maximise benefits and minimise injury. With this intention, we supervise and adapt care teams to detect risks during handovers (shift changes, duty changes). We bring together care teams to share patient information and encourage notices as a method of risk and incident communication.

Besides this, in order to learn from our mistakes, we monitor the results of safety issues through a series of indicators (both for patients and professionals) and apply proposed improvements according to the results. Treating professionals fairly implies, among other things, providing training on an ongoing basis. We therefore have a training programme to provide an adequate response individually and collectively.

Finally, looking to the future, we are preparing ourselves for the implementation of telematic notification of complaints and incidents detected by patients. Their opinion is essential to improve the organisational structure and the scope of the measures in our security model.

The Catalan Network of Oncology treats 60% of cancer patients in Catalonia. It is made up of the Catalan Health Institute (ICS) and the Catalan Oncology Institute (ICO). On the one hand, the ICS runs two large hospitals offering cancer care: Vall d’Hebron University Hospital and Arnau Vilanova University Hospital. The ICO, meanwhile, can be found in Hospitalet, with centres in Girona, Badalona, Camp de Tarragona and Terres de l’Ebre.

The Network was born from the desire to become a world benchmark against cancer. A benchmark for innovation, research and care in Europe and the world. The Catalonia Health Plan 2016-2020 defines cancer as one of the region’s health priorities. It establishes strategic alliances and resource concentration to strengthen networks between leading tertiary centres and hospitals in the territory.

The Catalan Network of Oncology care model works on the following lines:

• Frequent tertiary tumour programme: encompasses all care activity related to patients already diagnosed and the conventional therapeutic process.
• Rare tumour programme: therapeutic plan applied to patients with rare tumours
• Clinical research programme: includes all treatment within a clinical trial
• Palliative care: care aimed at improving the quality of life of people with cancer
• Associated Oncology Pharmacy Unit: improvement in the management capacity of the pharmacy, both in purchasing policies and in the management of service provision
• Hospital tumour register and information systems: integration of information from different centres with the aim of facilitating a shared information unit

This model is reflected in that of other world leaders in cancer treatment. It uses precision medicine, which allows for personalised treatment to be provided; and knowledge management, which facilitates data recording, the assessment of results and the transfer of information between professionals. 

The Surgical Block, opened in September 2016, represents a technological and quality breakthrough for both patients, focusing on reducing surgery and postoperative care times and for professionals, incorporating new surgical techniques and making their work more precise. In addition, the Surgical Block has a clear orientation towards sustainability and energy efficiency. The new facilities, the leading technology and the change of management through processes allow new surgical techniques to be carried out, improving patient security and the work of professionals.

Operating theatres incorporate neurosurgery navigation systems, 3D imaging systems, integrated ultrasound and the new Da Vinci Xi robot. With this incorporation, Vall d'Hebron University Hospital is the first in Spain to have two operating theatres equipped with Da Vinci® robotic technology for clinical use. In addition, it has two hybrid operating theatres. They incorporate X-ray surgical arches to be able to see surgery results directly, designed for vascular surgery and neurosurgery.

The design of operating rooms is optimised in space and time. Among other improvements, we can configure the operating room according to the type of surgery. In just a few seconds, it adjusts to the predetermined position. All the necessary devices and connection points hang from the ceiling through an electronic tower system, making the space more accessible and easier to prepare for the next operation. At the same time, it allows for a more sustainable energy management.

The General Hospital Surgical Block has a total of 700 professionals, with the aim of maintaining and improving the figure of almost 8,000 operations a year in this field alone.

To help achieve these goals, professionals have seen a series of improvements in work processes thanks to these new facilities and the incorporation of technology. For example, to facilitate the distribution of material, we use a 1,000 m2 robotic system which distributes all the material needed for each operation.

Aside from operating rooms, the Block includes two rooms for patient care before and after undergoing surgery. The Pre- and Post-Anaesthetic Recovery Unit (URPA) aims to optimise the use of the operating theatre, since previously patients would go to sleep and wake up in the operating room. In addition, anaesthesia and nursing staff work in the URPA, and the Unit is clearly orientated to better and safer patient care.

The new General Hospital Surgical Block, as well as its organisational management, has been developed with the participation of a multidisciplinary team made up of professionals from all fields. It is an example of participation and teamwork, in which voices have been collected to develop healthcare projects focused on innovation and the improvement of clinical management. This project required an investment of €21 million in construction and €16 million more in equipment.