Timeline – main events in the decision-making process regarding the organization of vascular treatments at Oslo University Hospital from 2009–2019
| Year | Event | Participants | Decisions/actions | Consequences |
|---|---|---|---|---|
| 2009 | The merger of Rikshospitalet, Ullevål and Aker Hospitals into Oslo University Hospital | The new hospital board, the temporary CEO | Coordinate the activity of the merged entity | Initiates restructuring processes |
| The first attempts to colocate the vascular treatments at Oslo University Hospital | Participants in the “P-5”-project | Transfer hospitalized vascular patients from Aker hospital to Rikshospitalet and perform the surgical procedures at its Intervention Centre | Initiates numerous meetings concerning locations for vascular patients and expansion of the Intervention Centre | |
| 2010 | Possible new facilities for Oslo University Hospital are investigated | The board at Oslo University Hospital | Close down Aker Hospital and use money from sale to build new facilities | Local resistance manages to reverse decision to close Aker hospital. Situation affects and derails vascular surgical decision-making process |
| 2011 | Large budget overruns at Oslo University Hospital | The CEO, the board and managers at Oslo University Hospital | Impose major budget reductions on all the divisions; stop expansion of the Intervention Centre | The reorganization of vascular services becomes part of internal political issues at Oslo University Hospital |
| The board and CEO disagree about economic plans | The hospital board, the CEO | CEO resigns | The board assigns temporary and later permanent CEO | |
| Long-term plans from important stakeholders in the vascular surgical decision-making process completed (O+, Kar+) | The Department of Cardiothoracic surgery, The Department of Vascular Diseases | The plans display deviating views on how to organize the provision of vascular services | Decision-making process becomes more and more diffuse and many-faceted. Makes it difficult for hospital management to pursue a centralizing policy | |
| Emergency preparedness for vascular services at Aker Hospital is economically challenging for the Division of Emergency and Critical Care | The hospital board, The Division of Emergency and Critical Care, The Department of Vascular Diseases | Transfer patients with ruptured abdominal aortic aneurysms from Aker Hospital to Rikshospitalet | Decision disturbs the larger decision-making landscape. The vascular surgeons from Aker Hospital are obliged to work at a third treatment site | |
| 2012 | Summary about relocation plans concerning vascular services is presented. Vascular community is divided | The hospital CEO | Transfer vascular surgical patients according to previous plans, make new relocation plan | Decision-making process is prolonged and becomes even more complicated |
| 2013 | New remodeling/construction projects initiated to coordinate reception/treatment of vascular surgical patients at Rikshospitalet | Several surgical units | Other departments than the vascular achieve additional space | No transfer of vascular patients is initiated |
| 2014–2015 | Decision-making process fades | |||
| 2016 | The Intervention Centre receives external funding and price reduction on MRI | The Research Council of Norway, Siemens, The Intervention Centre | The Intervention Centre displays ambitions beyond restructuring vascular care | Oslo University Hospital is pushed to finalize expansion with large investments |
| 2018 | The Intervention Centre is finally expanded with a new MR, CT and two advanced surgical suites | Oslo University Hospital, The Research Council, The Intervention Centre, Siemens | Several different departments and professionals use the expertise and the new hybrid rooms at this location | The Intervention Centre becomes an important regional/national provider of R&D and treatment |
| The decision-making process concerning the organizing of vascular services resumes | The management at Oslo University Hospital | Assign steering group, project group and working group | Different locations and treatment cites for vascular surgical hospitalized patients are investigated | |
| 2019 | Area/local patients with ruptured abdominal aortic aneurysm are transferred from Rikshospitalet to Ullevål hospital | The management at Oslo University Hospital | Transfer hospitalized vascular surgical patients from Aker to Ullevål hospital in 2020. Day surgery and outpatients remain at Aker and national/regional patients at Rikshospitalet | Planning work initiated |
| Year | Event | Participants | Decisions/actions | Consequences |
|---|---|---|---|---|
| 2009 | The merger of Rikshospitalet, Ullevål and Aker Hospitals into Oslo University Hospital | The new hospital board, the temporary CEO | Coordinate the activity of the merged entity | Initiates restructuring processes |
| The first attempts to colocate the vascular treatments at Oslo University Hospital | Participants in the “P-5”-project | Transfer hospitalized vascular patients from Aker hospital to Rikshospitalet and perform the surgical procedures at its Intervention Centre | Initiates numerous meetings concerning locations for vascular patients and expansion of the Intervention Centre | |
| 2010 | Possible new facilities for Oslo University Hospital are investigated | The board at Oslo University Hospital | Close down Aker Hospital and use money from sale to build new facilities | Local resistance manages to reverse decision to close Aker hospital. Situation affects and derails vascular surgical decision-making process |
| 2011 | Large budget overruns at Oslo University Hospital | The CEO, the board and managers at Oslo University Hospital | Impose major budget reductions on all the divisions; stop expansion of the Intervention Centre | The reorganization of vascular services becomes part of internal political issues at Oslo University Hospital |
| The board and CEO disagree about economic plans | The hospital board, the CEO | CEO resigns | The board assigns temporary and later permanent CEO | |
| Long-term plans from important stakeholders in the vascular surgical decision-making process completed (O+, Kar+) | The Department of Cardiothoracic surgery, The Department of Vascular Diseases | The plans display deviating views on how to organize the provision of vascular services | Decision-making process becomes more and more diffuse and many-faceted. Makes it difficult for hospital management to pursue a centralizing policy | |
| Emergency preparedness for vascular services at Aker Hospital is economically challenging for the Division of Emergency and Critical Care | The hospital board, The Division of Emergency and Critical Care, The Department of Vascular Diseases | Transfer patients with ruptured abdominal aortic aneurysms from Aker Hospital to Rikshospitalet | Decision disturbs the larger decision-making landscape. The vascular surgeons from Aker Hospital are obliged to work at a third treatment site | |
| 2012 | Summary about relocation plans concerning vascular services is presented. Vascular community is divided | The hospital CEO | Transfer vascular surgical patients according to previous plans, make new relocation plan | Decision-making process is prolonged and becomes even more complicated |
| 2013 | New remodeling/construction projects initiated to coordinate reception/treatment of vascular surgical patients at Rikshospitalet | Several surgical units | Other departments than the vascular achieve additional space | No transfer of vascular patients is initiated |
| 2014–2015 | Decision-making process fades | |||
| 2016 | The Intervention Centre receives external funding and price reduction on MRI | The Research Council of Norway, Siemens, The Intervention Centre | The Intervention Centre displays ambitions beyond restructuring vascular care | Oslo University Hospital is pushed to finalize expansion with large investments |
| 2018 | The Intervention Centre is finally expanded with a new MR, CT and two advanced surgical suites | Oslo University Hospital, The Research Council, The Intervention Centre, Siemens | Several different departments and professionals use the expertise and the new hybrid rooms at this location | The Intervention Centre becomes an important regional/national provider of R&D and treatment |
| The decision-making process concerning the organizing of vascular services resumes | The management at Oslo University Hospital | Assign steering group, project group and working group | Different locations and treatment cites for vascular surgical hospitalized patients are investigated | |
| 2019 | Area/local patients with ruptured abdominal aortic aneurysm are transferred from Rikshospitalet to Ullevål hospital | The management at Oslo University Hospital | Transfer hospitalized vascular surgical patients from Aker to Ullevål hospital in 2020. Day surgery and outpatients remain at Aker and national/regional patients at Rikshospitalet | Planning work initiated |
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