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In terms of hygiene, there are enormous differences between the hospitals of the world. Although there are differences between EU countries, compared to African standards there is still a huge quality gap in the handling of hygiene.
Most existing operating theatres in Germany do not correspond to the state of the art today. Many are around 30 years old. Investments in the future, out of place!
What is the always so elegantly and sloppily said standard saying of some surgeons about an operation?
"Two times 250 ml broad-spectrum antibiotics!"
The antibiotic is used as a precautionary measure to kill germs in the patient's
body that got into the wounds during surgery. The risk of infection for Surgical Site Infections (SSI) results, among other things, from the degree of bacterial colonization of the surgical site. This is measured in four Contamination classes:
and risk classes:
An example of the use of antibiotics in trauma surgery:
In accident surgery, a cephalosporin of the 2nd generation is used, with certain
shoulder prostheses additionally Clont because of special skin germs.
The medication is done i.e. and should be given 30 minutes before the incision so
that the effective level is available. If necessary, a repeat is administered after 3 hours and a longer operation time, but usually as a single shot.
In addition to increased morbidity and mortality, Surgical Site Infections lead to
an extended length of stay of about 7-8 days and about 1 million additional
hospital days per year. They are therefore not only a medical problem, but also
an economic one in view of the high follow-up costs.
This raises the question of whether this regular use of antibiotics and thus the
resulting length of time a patient spends in bed could be reduced if things
were cleaner in the operating theatre?
Every hospital should claim to have at least one clean room: The operation Theater. Unfortunately, the ideas differ from what is meant by cleanliness - however, microbiological air purity is primarily meant. The experts cannot agree on a European standard. A look at the technical standards in Germany provides clues. With DIN 1946-4 "Ventilation systems in buildings and rooms of the health
care system" there is a binding set of rules in which, after intensive discussions, VDI Guideline 2167 "Technical Building Equipment of Hospitals", which has since been withdrawn, has also been integrated.
For the air purity in the Operation Theater, the ventilation / type of ventilation
is of elementary importance. There are essentially three different concepts to
be distinguished here: TAV low turbulence displacement flow, TMV turbulent
mixing ventilation and layer or displacement ventilation. Through the
continuous supply of purified air, either a dilution (TMV Turbulent Mixing
Ventilation) of the concentration of the airborne particles or their
displacement (TAV from above or layer ventilation with a displacement from
below) can be achieved.
While absolute air purity is important for patients, for the Operation Theater team
the impurities generated in the Operation Theater area, such as the surgical
smoke that is generated when working with RF instruments, are also important.
For the qualification of the TMV (Turbulent Mixed Ventilation) as well as for
the layer ventilation, the so-called recovery time from short-term particle
contamination is the measure of things or the acceptance procedure defined in
the DIN standard. For its determination, the procedure according to DIN EN ISO
14644-3 "Clean rooms and associated clean room areas - Test methods"
Appendix B.12 "Testing of recovery time" is applied. This test serves to determine the plant's ability to remove airborne particles. The cleaning performance after particulate contamination is one of the most important capabilities of a turbulent mixing ventilation system. Purification performance is calculated from the 100:1 recovery time or purity recovery rate. The space is first homogeneously loaded with particles and after switching off the particle source the time is measured until 1 % of the initial concentration is reached.
The displacement, especially the TAV (low turbulence displacement flow) from above (designed as differential flow), is one of the most suitable ventilation
systems for the operating theatre. With this type of ventilation, the sterile
clean air floods the patient and the Operation Theater team from above, down
from the ceiling diffuser, and then reaches the return air diffusers arranged in
the corners of the room. This ventilation concept is often referred to as
"laminar flow". It prevents particles and germs from the environment
from reaching the critical area, i.e. the open wound of the patient, but also
the instrument table.
It should be noted that in contrast to a clean room in the pharmaceutical
industry, e.g. sterile filling, the most dangerous source of contamination is
the patient himself, followed by the surgical team, which can also be beached
as a large source of germs for possible infections.
The TAV ventilation ceiling, approx. 3.0 x 3.0 meters, is the only air supply to
the operating theatre. It sends around 9,000 m3/h of high-purity air to the
operating table. This air escapes at all four corners of the room near the
floor. With a standard room height of 3.0 meters and an air speed of around 0.3
m/s, the defined protection area (3 x 3 m) is 360 times the air exchange rate -
the air is exchanged approximately six times per minute in the critical area.
For the entire operating room, this still results in a 90-fold air exchange. In
order to be able to dissipate gaseous air pollution, part of the supply air is
with outside air. According to DIN 1946-4, this is typically 1,200 m3/h, which
results in a 12-fold fresh air change. The air flow divides the Operation Theater into work areas with varying degrees of purity. Due to the HEPA H14 air filtration system, ISO class 5 is safely located directly below the filter ceiling outlet. In the background of this protective area, however, an ISO clean room class 6 to 7 can still be expected in the operating room, depending on the particle emission of the Operation Theater team. Since according to ISO Standard 14644 "Clean rooms and associated clean room areas
- Part 1: Classification of air purity" the clean room classes are particulary defined, but in the operating theatre above all the air germ level is a measure of things for the avoidance of airborne wound infections, the definition of air quality in the operating theatre via the ISO clean room classes makes little sense.
The Operation Theater qualification procedure "Protection degree measurement" defined in DIN 1946-4 "Ventilation systems in buildings and health care rooms" is also carried out on a particulate basis. In this test procedure, however, the transmission path from the room background to the critical area or its avoidance is tested, i.e. the ability of the TAV to keep the germs emitted by the Operation Theater team away from the wound field is tested. At the same time, however, these germs should not sediment on the instruments, which are designed on the instrument tables, but be carried in the most direct way into the room exhaust air.
The most suitable concepts for patients and staff in the Operation Theater have proven to be differential flow ventilation rather than laminar flow concepts. In
contrast to pure Laminar flow ceilings, where the air flow is homogeneous
(direct current flow), i.e. flows at a uniform velocity, differential flow systems have different air velocities. In a ceiling field of 3.0 x 3.0 m, in the inner area of 2.0 x 1.0 m (core field) the pure air flows off at about 0.4 m/s, but in the remaining area of the air outlet only half as fast.
As proof of the effectiveness of a TAV ventilation concept from an air-hygienic
point of view (qualification of the ventilation system), the degree of protection was defined in DIN 1946-4 and SWKI 99-3 "Heating and ventilation systems in hospital buildings". This qualification method represents a direct quantitative proof of the displacement and/or dilution capability of the TAV ventilation concept. The method also enables the direct and quantitative determination of ventilation improvement measures or the determination of the influence of various devices that protrude into the protected area. For this reason, the degree of protection (SG) was also differentiated as a qualification criterion in the DIN standard: SG 4 without and SG 2 with operating lamp.
Rather than laboriously either ensuring a uniform degree of cleanliness over a large area or ignoring entire areas, it is much better to set up different degrees of
cleanliness by cleverly differentiating the zones. Highest cleanliness only
prevails where it really matters; without these critical areas being contaminated by other parts of the room. This "virtual" room-in-room concept significantly reduces costs and contributes greatly to stable flow conditions.
There are disturbance factors which swirl the controlled displacement air flow,
i.e. change the intended flow dynamics. Two triggers of uncontrolled air flows are
the heat from devices and lamps and movements of the personnel. In the planning phase, hospital operators should therefore examine exactly which type of flow, flow velocity and pressure gradient are suitable for the operating theatre and which thermal influences are present before construction begins. For hospital
rooms, the influences of the air flow in operating theatres are simulated,
analyzed and optimized by suitable service providers using special simulation
programs on the basis of the concrete planning data of the project (numerical
Even LED lamps become hot and swirl air due to this heat generation - despite an
apron in the supply air ceiling panel. One result of laboratory tests at the Lucerne University of Applied Sciences and Arts is that with well-chosen lamps, the design of the apron is not decisive.
Because the air flow carries particles with it, the workplaces of the employees who emit particles are ideally located downstream, i.e. not above the critical
areas. Now it is unavoidable during an operation to handle over the patient.
That is why protective clothing is mandatory. Unfortunately, the regulations are not particularly strict for this - especially since people are particle emitters of
the first order. In other clean rooms, for example in the pharmaceutical
industry, much stricter clothing regulations are practiced than in operating
theatres. There it would be unthinkable to step with street shoes. Not so in
the operating theatre. Here the doctors and medical assistants are by no means
completely covered. Rather, they usually wear an apron, sterile gloves,
headgear and a mouthguard through which they breathe in and out. In addition,
there are normal shoes and stockings. But what's wrong with the shoe doesn't
stick but can be whirled up. Tests at the Lucerne University of Applied Sciences and Arts show that clothing for operating theater staff should look better than that of colleagues in the pharmaceutical industry: Full body overall plus breathing air suction plus sterile boots. This corresponds to GMP class A. The number of microorganisms per cubic meter of air is drastically reduced thanks to this clothing. Because it is already very cool in operating theatres with 17°C to 18°C, there is no danger that surgeons will sweat much more in such clothing than before.
In Operation Theater optimized in this way, the probability that patients will
subsequently have to be treated with antibiotics decreases. In order to gain
certainty, the determination of the so-called bioburden would be a sensible
solution. How many germs did the patient get? This can be clarified by active
air germ count determination or surface copy tests. Such hygiene monitoring,
which is used to determine the number of microorganisms in products, has long
been common practice in drug production. This is rarely done on patients
because it is expensive. However, the decisive factor here is not what is measured behind the surgical team. All-falls is an influence of those germs that get into the wound (from the air or through instruments). However, this cannot be determined with generally standardized methods. So only the infection rate remains as a safe measure. This is (should) be collected continuously.
There is a study which says that with turbulent ventilation without antibiotic
prophylaxis an infectious rate of about 4% is to be expected with a hip
operation, with antibiotic prophylaxis still 0.8%. With antibiotic prophylaxis
and TAV ventilation, an infection rate of 0.7% can be expected. The difference
is in the range of statistical uncertainty. Thus, no compulsion for TAV
ventilation can be derived from this!
1 Hochschule Luzern, 2012, Gebäudetechnik im Gesundheitswesen, GiG II Projektabschlussbericht, Zentrum für Integrale Gebäudetechnik, Vortrag Dipl. Ing. Arnold Brunner auf den 7. Cleanroom Experts Days (siehe auch http://www.hslu.ch/download/t/Forschung_und_Entwicklung/t-zig- op_lueftung.pdf)
This overarching provocative presentation is currently causing a very lively and hot discussion among the experts as well as in the expert committees. The individual scientific statements of the parties involved are often so far apart
in their presentation and show an incomprehensible lack of acceptance of
further technological development and discussion.
But there are also many other good arguments for a TAV ceiling.
In addition to the various operating theatres, hospitals usually also house other
clean rooms: In in-house pharmacies, isolated clean room areas are set up for
the aseptic processing of active ingredients. Insulators, safety and laminar flow workbenches are frequently used here. Here, employees can deal comfortably with liquids containing, for example, cancer drugs -cythos - without fear, sometimes dressed only in low-dust textiles. Their only connection with these dangerous substances is the rubber sleeves and gloves of the insulators into which they put their arms. Protected in this way, they can handle inside the insulated area. In the three-sided or four-sided enclosed cabin, there is either a
horizontal or vertical laminar air flow to achieve the necessary cleanliness.
Once they have completed their work, the insulated work area is automatically cleaned and sterilized from the inside with hydrogen peroxide.
Every third hospital in Germany was making loss in 2011, reports the German Hospital Institute (DKI). The clinics are in a tough competition for patients. They can achieve competitive advantages through better hygiene on the one hand and lower energy costs on the other. There are plenty of starting points that are currently being discussed under the heading "Green Hospital". Because hospitals are large consumers of energy and water - and accordingly have a high savings potential that can be raised. Representatives of industrial companies promise hospitals operating cost reductions of up to 40 percent. An expert group of the German Society for Biomedical Engineering in the Association of Electrical, Electronic & Information Technologies (VDE) speaks of one third of the annual energy costs that German hospitals could save. They currently consume energy for around 2 billion euros per year. In view of these promises, the user should always ask himself: What does this cost in terms of investment - and when will it pay for itself?
A typical hospital consumes around 37 percent of its energy for lighting, 35
percent for ventilation and heating and 12 percent for hot water. A large hospital
emits about half as much carbon dioxide as a small town with 10,000 inhabitants.
Only with energy-saving options can such a complex building in operation around the clock be operated economically.
More than 30 German hospitals already bear the "Energy-saving Hospital"
seal of approval from BUND (Bund für Umwelt- und Naturschutz Deutschland). A
new hospital is currently being built in Lichtenfels, Bavaria - with an optimized building envelope, energy-saving lamps and the use of renewable energies. The project, which is funded with public funds, almost achieves passive house standards and is intended to serve as a reference for other clinics. In addition, the Free State of Bavaria has established the Green Hospital Initiative, a best- practice database as a planning aid. The Asclepios group is also working on this issue. Benchmarks of energy consumption provide reference values for the respective energy management systems in the Group's clinics. Energy-saving measures that pay for themselves in two to six years are implemented. This is the case with high-efficiency pumps in heating systems and combined heat and power plants. In 2011, 15 clinics in the Group reduced their CO2 emissions by a third simply converting to LED lamps. The list of individual options here is so complex and networked, you could say it's a never-ending story.
Of course, the planner has more possibilities in the new building than in the
existing one. When planning on the computer, care is taken to avoid rooms that
require air conditioning and ventilation. This is achieved by a sensible arrangement of the rooms, external sun protection and activation of the storage
mass of the building. If bedrooms are located along the façade, they can be
naturally ventilated through the windows. Only special functional areas such as
the operating theatre, sterile rooms and rooms with larger internal heat loads
are extra ventilated, cooled or air-conditioned. Economic efficiency calculations show that a decentralized arrangement of ventilation systems is much more cost-effective than a few centralized large-scale systems. This means that both investment and operating costs can be saved to a considerable extent. Internal WC cells in the care areas are efficiently ventilated by so-called small room ventilators. This reduces the total air volume and the need for heating energy.
9 DKI, 2012, Krankenhaus-Barometer, URL: https://www.dki.de/sites/default/files/publikationen/krankenhaus-barometer-2012.pdf 10 Asklepios Kliniken GmbH, 2012, Green Hospital Innovation, Nr. 1/2012
It is not just a question of healing, but also of how you heal and how the healing process proceeds. The psychological effect on the patient during an ongoing healing process is of the utmost importance for the overall recovery of the patient. The arrangement of all beds with a view of a park would thus speed up the healing process. Pediatrics has had great success here. It should also be tried to avoid the disadvantages of the usual two-bed room. In addition to the inequality of the bed places, this also includes the inability to get along in difficult disease situations. The atmosphere is much more relaxed if each patient is assigned his individual area with wet room and seat and if a separation is possible during a doctor's visit or when visiting relatives. In other words, the aim is to achieve single-bed quality in a double room. With an optimal floor plan arrangement, it is also possible to almost halve the length of paths within a ward for nursing staff. Although the RKI (Robert Koch Institute) abolished the separation of so-called "septic" and "aseptic" surgical units many years ago for hygienic reasons, this has still not arrived at some professional associations. Very often, under pressure from these institutions (they pay for these interventions), the surgical department must be divided into a septic and an aseptic area, equipped with its own adjoining rooms and sluices, against all logistical reason during the planning phase. These separating concepts are changed for the commissioning of almost all clinics, since this division requires a higher number of staff and thus substantial additional costs. The requirements for fire protection in hospitals are so high that investment costs in the tens of millions are usually incurred for ventilation systems alone. In order to save primary energy, heat recovery systems should be installed - where economical -, for example very simple rotary heat exchangers for the regenerative recovery of heat and moisture from the exhaust air. Exceptions are room areas in which recuperative systems with heat pipes or recirculating heat exchangers must be used for hygienic reasons (such as in the kitchen, laboratory diagnostics, pathology, etc.). The decisive factor in ensuring that all these measures bear fruit is consistent and highly qualified project planning and implementation. Only a competent and detailed planning allows an energy-efficient operation of a hospital - of course considering the hygienic general conditions
The conversion of the Operation Theater alone will not make it possible to turn a hospital into a virologically and bacteriologically experienced and safe hospital. What use is a sterile operation if germs subsequently reach the weakened patient via the food prepared in the hospital kitchen or via visitors? Not only each individual department, but also the hospital itself must see itself in the larger context. If drug addicts can find fentanyl adhesive plasters in hospital garbage cans from chronic pain sufferers to extract the remaining active ingredient by steaming or cooking, then inject it as a kind of heroin substitute and usually die immediately from it, then this is also a hygiene legend in the process chain. Such gaps, like energy guzzlers, can only be eliminated by thorough planning. But such thorough planning is often lacking. Again, and again it happens that newly established hospital departments must be rebuilt before they can be put into operation because they have hygienic deficiencies. In one clinic, for example, plasterboard panels were used in the operating theatre and painted with latex, or tiles were laid - which is not necessarily a bad thing - but grouted with normal cement. One can no longer speak of cleanability or hygiene here. You'd better call it a microbiological " Ultimate maximum credible accident ". If the medical board of a clinic doesn't like the wall paint after the reconstruction work is done, the newly installed operating theatres are removed again. It goes without saying that the costs will rise. That's the money of the others. The later in the planning process such change requests are expressed, the more expensive their implementation becomes. This often leads to differences of opinion in the construction and expansion of health facilities such as hospitals, small and medium-sized treatment centers or pharmacies. In 2012 alone, external experts drew up statements and expert opinions for judicial and extrajudicial disputes and settlements between 100 and 150 in which the operators of health care facilities on the one hand and planners and construction service providers on the other, faced each other. Sometimes the guarantee was not given, sometimes it was about money. The clients were often confronted with far higher costs than originally expected. Many felt that they had been taken for a ride. A recurring pattern: Suppliers, for example, promise a clean room for the manufacture of cytostatic products for 200T€ to 300T€, without pointing out that several other costs are incurred which are essential for operation. The additives can then add up to three to four times or more at once. One conclusion from this is: High-quality planning takes time! As with any plant and process planning, it is important to find the best combination of effort and benefit. But when it comes to planning such complex processes as those in hospitals or pharmacies, many customers obviously expect witchcraft. There is an expectation that everything can happen very quickly. This is a mistake. An entire hospital needs two to three years of intensive planning. Those who demand or promise less time are miscalculated and the statement: "This is all standard with us" is only to be found in the fairy tale book. But how can it be that here in particular highly paid managers throw all good resolutions overboard and believe in the fairy and the sorcerer's apprentice in fairyland again, who promise that all this cost nothing and is more or less free. Is this decision-maker going to the market with his savings in such a way in his private life and deciding in ignorance at the green table about being and not being?...
The first step towards serious planning is taken by the user. Hospital operators
must specify their requirements precisely before obtaining planning and cost
estimates. Based on this URS (User Requirement Specification) and the
specifications, planners can assess, for example, whether the internal apo
counter requires expensive insulators or whether cheaper safety cabinets or LF
cabinets are enough.
Due to time pressure, hospital operators usually do not capture all details. This
is a big mistake. If you don't specify everything in advance, you will find much more than necessary (and as ordered) on your service provider's invoice later. A project must be divided into different project phases, which are processed one after the other. When selecting a partner, the client should pay attention to the independence of all parties involved in the planning. Otherwise the cheapest equipment will be sold to them at the most expensive price.
An interdisciplinary approach is crucial for planning. In a hospital, one is connected to the other, the individual subsystems are closely interlinked. Therefore, subsequent corrections made in one place do not have nom consequences for the other areas (rule 10). Many experts are therefore involved in the planning process. These include clinic administration, planning coordinator,
general planner, health department, building authorities, state ministries,
urban planning and civil engineering office, organizational office (occupational safety department), TÜV and fire brigade. It makes sense for the clinic administration to form and involve working groups from the very beginning, for example in a nursing and intensive care group, an operating theatre group and a pediatric group. Each room, its purpose and use, as well as its furnishing, is discussed with them.
The parties involved often lack a control instrument which they can use to check
and change their ideas. Floor plan, section and view represent the boundaries
of the space, but they say little about what is in between, namely the space
itself. A model simulation captures space from the user's point of view. It
simulates an image of the later reality and allows an examination of one's own
ideas at the design stage. Animation software can be used to create realistic
representations of, for example, the operating theatre, the nurses' station or
other facilities. Working models are relatively easy to create. Exactly built
models require more effort but are sometimes unavoidable. (Just think of the
"modern aircraft construction".)
The decisions in the planning phases are made in two regular discussion groups. In the planning discussion with building owners, users and all planners, the
draft, ground plan and detailed planning is coordinated. The technical
discussions serve to detail all technical problems. From the start of the
construction phase, there are also construction coordination, schedule control
and company coordination meetings as well as individual coordination.
An important criterion for satisfactory project execution can be derived from
experience. Nearly all successfully completed projects that met the cost and
deadline limits can be traced back to the fact that a competent department was
created that was responsible for schedule and cost control across the board and
exclusively committed to the economic success of the project. A unit in the
project team that introduces methods, thought patterns, instructions and rules,
provides IT-supported tools for project management, adapts them to the specific
project conditions and monitors their use. An office which is integrated into the daily project events and which shows the connection between the status of deadlines, costs and performance and ensures that the decision-making bodies
have access to the connection between planning and completion of construction,
between target and actual figures in the decision-making process. Anyone who points out undesirable developments in good time and thus makes it possible to set the course at an early stage. Where these planning principles are disregarded in major projects, deadlines cannot be met and cost explosions are programmed - whether in the construction of airports, philharmonic concert halls or hospitals.
Today, many hygiene-critical industries work in accordance with the guidelines of the EC Guide to Good Manufacturing Practice (EC-c'GMP). This is derived from the American GMP guidelines (Good Manufacturing Practice). Companies commit
themselves in detail to quality assurance of procedures and process environments in the production of active ingredients, pharmaceuticals and
Hospitals have minimal experience with GMP. As recommendable as GMP compliance would be, it is rarely carried out. There is no such thing as continuous hospital GMP. For the hospitals to focus more on hygiene and quality control, it would make sense for hospitals to deal with GMP in order to use it as an aid in the daily operating routine. Not always, but more and more often, those responsible for quality in hospitals, are now looking for partnership support to install their own type of GMP in their facilities. However, this procedure requires TIME, time that is only rarely available or made available, because time means MONEY.
There's no point in simply providing yourself with a GMP consultant (What is that? does he really exist?). This procedure cannot be underestimated financially and
usually leaves the clinics with only a lot of paper and potential for dispute. The decisive factor is the implementation of the measures associated with GMP
by the interdisciplinary network of departments, possibly through a higher-level quality management. With an increased effort in quality assurance, many of the daily problems in the critical subject areas can be controlled, improved or even solved. GMP-compliance is good and makes many things easier, but it is in no way a panacea with which all problems can be solved as if by magic.
Special attention should be paid to the systematic behavior of the staff. According to the Federal Statistical Office, 1.1 million people work in German clinics.
Infection-preventive hygiene measures must be applied consistently. Hand
disinfection is the easiest way to avoid hospital infections.
Regular GMP checks would make the quality of service providers more visible. It would be noticeable that pharmacists in hospitals tend to be more negligent than
external pharmacists. The latter are audited more strictly. The dispute between
pharmacists, logisticians and users is often inevitable. The Berufsgenossenschaft
für Gesundheitsdienst und Wohlfahrtspflege (BGW) (Employer's Liability
Insurance Association for Health Services and Welfare Care) recommends that
finished infusions should be delivered by pharmacies instead of being prepared
on the ward. Studies such as the BGW's "MEWIP" research project, in
which 130 pharmacies that produce cytostatic drugs participated, show that
there is a need for improvement in the pharmacy sector.
The GMP-related audit examines all these processes and identifies weaknesses, the elimination of them will provide efficiency benefits for the hospital. So far,
the response of managers to the pressure of improving efficiency has usually
been different. They are launching cost reduction programs based on
conventional organizational structures and process chains. These usually lead
to short-term success, if at all, and are often at the expense of quality. What
is needed here are new organizational structures and processes.
The hospital of the future is no longer departmental, but process oriented. The
integrated admission of patients (emergency admission, central occupancy
management - ZBM, central patient admission - ZPA) leads to central service
centers. These are the central OR and the functional diagnostics. These are
followed by the various forms of inpatient care - from intensive care units to
nursing wards and day clinics.
Today, many of these functions can still be found in every department and thus several times under one roof.
There are neither coincidences nor "magic" in the technological nor in the
hygienic areas of a hospital, so there is nothing else to do but talk to each
other in the entirety of the faculties involved. Unfortunately, many cannot or
do not even try to do so. The reason for this is a very simple and very often human nature:
You are no longer in the center of a positive event and the hymns of praise, which
you would very much like to write down on yourself, you have to share.
11BGW, 2008, Monitoring-Effekt-Studie für
Wischproben in Apotheken, URL: http://www.bgwonline.de/internet/generator/Inhalt/OnlineInhalt/Medientypen/Fachartikel/MEWIP- Schrift,property=download.pdf
The start with the topic Green Hospital and Hygiene shows very clearly after a short time that the world of doctors and engineers needs a superior association. The "world" in a hospital is no longer dominated by medicine alone, but the success of a hospital is increasingly dominated by technology. The current situation in medicine makes it clear that the physician also needs engineering knowledge and, conversely, the engineers need medical engineering knowledge. Here, the newly established study courses "Medical Technology" point in the right direction! Bench marketing is not everything, because it requires a lot more.
As Einstein already said: „Imagination is more important than knowledge “.
It is time to overcome the traditional class thinking (the gods in white and the rest of the world) and approach each other. Interdisciplinarity is the buzzword of the hour. We do not wage wars against each other, because wars have no winner - everyone loses -, we wage a fight together, a fight for human life, which we should try to win together. Only the safeguarding and preservation of human life can be the winner of this common struggle. One for all and all for one.
Prof. Dr. Gernod Dittel