CASE STUDIES
The Norwegian Hospital Programme
In the testimonial section there is a translation of an article from the Norwegian Defence Journal. This case study sets out to examine why the Norwegians were so complimentary about the system.
Some time ago MSV had sold 2 so called Role One surgical units to the Norwegian Defence Logistics Organization (NDLO). This followed initial contact some years previously at an exhibition in Stockholm Sweden. Role One medical systems are small surgical and emergency treatment facilities, capable of easy transportation in military cargo aircraft and can thus be deployed in rough and difficult locations close to the front line fighting troops. The first lesson was that MSV invested the time and money in helping the NDLO get these systems into service in their time with no “sales” pressure.
These Role One units served the NDLO well and were deployed in a number of operational theatres where they provided medical aid to NATO and EU troops and civilians. They were a great boost to morale of Norwegian and other NATO forces because they knew that if things went wrong there was a dedicated medical facility with the most up to date surgical facilities nearby.
They were also available to treat local people injured in the fighting or who needed surgery due to normal life events, a critical capability in a counter insurgency situation. It helps win the battle to show the local population that these foreign soldiers are there to help. It wins the battle for "hearts and minds".
Throughout their service MSV’s customer support Team have helped the NDLO keep these 2 Role One Systems in service, and upgraded the capability as new systems came along. Their availability was impressive and their capability was improved as time went by. Quality built in from the start.
All the while the Norwegians and MSV were separately looking at the requirements for a Role 2 unit-a much bigger, much more capable facility, similar to a district hospital in the UK. The requirement was still the same-a rapidly deployable surgical facility but now with all the other facilities that one expects in one's local town.
Thus there was a requirement to include a full suite of mortuary, a pharmacy, pathology, medical gasses x-ray, CT scan, dentistry and be self sufficient in power and water and critically be fully protected against the ravages of CBRN. Thus no matter what mayhem was going on outside the doctors, nurses and other medical professionals could work inside without having to resort to cumbersome and inhibiting CBRN personal protection.
In essence what was required was a full NHS or Norwegian district hospital that could be delivered and start treating casualties within an hour and a half and be fully operational in a day and a half. Then it had to be capable of being taken to pieces, packed up, put on board the ubiquitous C-130 Hercules and arrive somewhere else and start work a few hours after getting there.
There are all sorts of issues that could go wrong in such a programme. For a start the design can become over elaborate and the hospital can grow in size so that it takes too many C-130 or other cargo aircraft to transport it. This is a time for the designers and engineers to earn their pay. They have to ensure that the customer understands not just the benefits but the penalty of every addition.
The only way to design such a facility is as a team with the users, designers, engineers and builders working together to come up with innovative effective solutions to every problem. Integrity realism and honesty have to prevail-"do we really need that capability and can it be built?" are questions that have to be asked several times a day before any design starts.
Then the programme managers have to take over. They have to understand the operational and financial pressures on the customer. This is especially so when the customer comes to them and says "you know the 18 months we had planned to deliver this system over, well for operational reasons it is now seven!!!"
The programme team were faced with this challenge just as the summer holidays started and delivery had to be made at Christmas. Effectively two months taken out of a seven month programme which in itself was reduced from 18. No pressure there then! However agility of though and deed were called for.
Suffice it to say it happened. The hospital was delivered on time and to cost. Why, how did this happen?
Firstly the hard design work paid off because every one knew the capability that was required and therefore what would be delivered. Secondly the programme could be broken down into definable more manageable chunks, each of which could be allocated its own programme manager. Thirdly the whole project team worked in the same project office with all the issues freely available and exposed across the whole team and discussed on a daily basis.
The programme leader has a saying "Programmes become late a day at a time" Thus if anything was delayed by even a day there was an immediate recovery plan to get the programme back on track. Fourthly the programme manager and his team of project managers had responsibility devolved to them. They knew they had the trust, support and back up of senior management but equally they knew they could call on them for advice and help or corporate muscle if required. Finally there were daily briefing and meetings at all levels where the openness and honesty coupled with problem exposure and solution discussion were openly visible-no secrets, from anyone.
Result on time, on cost delivery thanks to Quality Agility and Integrity. Result Happy customers. Result more capable Norwegian Defence Forces higher morale. The second role two hospital is now halfway through its build stage.