New Zealand's Unique Mobile Surgery Service

An operating theatre on wheels is changing the face of day surgery in rural New Zealand.


The Mobile Health mobile surgical unit

The 20m-long and 4.2m-high Mobile Health bus, which is 2.5m wide when closed and 4.7m wide when open, was designed and manufactured in New Zealand as a fully-equipped operating theatre that can operate standalone or connected to a host site.

The mobile surgical bus travels to 23 rural towns on a five week cycle, with three weeks in the North Island and two weeks in the South Island, where District Health Boards decide on the surgeries to be completed during the unit's visit.

Mobile Health, which also runs a mobile lithotripter service and the NZ Telehealth Resource Centre, has had an ongoing contract with the Ministry of Health to provide the service, since the surgical unit first took to the roads.

Mobile Health general manager Mark Eager said the mobile theatre was first launched in 2002 when several rural hospitals were being rebuilt, and provides the only known service of its kind world-wide.

"There are other mobile operating theatres in the world however our service is unique," he said.

"We operate for one day, pack up at the end of the day, and move to the next town - same again next day, and so on."

The mobile surgical unit provides low-risk day surgery ranging from general surgery, such as lap hernias and haemorrhoids, gynaecology including ablations and tubal ligations, plastics such as grafts and carpal tunnel, through to orthopaedics.

It also provides general anaesthetic dental and colonoscopies - two growing areas that make up 35 per cent of the unit's operations.

The mobile unit's team features a clinical nurse leader and an anaesthetic technician, who travel with the bus for a week at a time, as well as three drivers.

Each day the bus has a different surgeon and anaesthetist while each rural town provides four local nurses to work in scrub, circulating, and recovery in first and second stage.

The mobile unit provides more than 1500 surgeries a year, and after visiting rural towns for 14 years has provided more than 20,000 surgeries.

Mr Eager said the surgical bus has become a part of the fabric of the nation's rural health care delivery.

"We are described by the towns as being 'our bus'. It is a big deal to the towns that we go to," he said.

"In the early days there was a lot of naysayers. That chatter has gone now. We have a low profile - few people outside of the rural towns would know that we exist."

Mr Eager said the unit also assists with the recruitment and retention of health professionals in rural areas, where practitioners can experience a variety of work and enhance their skills.

"We have a comprehensive training program for these teams. As they (practitioners at the host site) work one day every five weeks we need to ensure that they are confident and competent and well supervised when they come on," he said.

"We have had reports from rural nurses saying they get called out to rural accidents. They have been in situations where their skills working with an anaesthetist has assisted them in dealing with road accident patients, where they were assisting in putting in airways.

"We also get GPs to work on the unit with the surgeon and anaesthetist. It helps with building rapport and is a great learning opportunity.

"We have a flood of medical students wanting a five-week placement. They have a fantastic opportunity to see New Zealand and get to work alongside a surgeon."

Mr Eager said the demand for short-term surgery services in New Zealand is growing, and the organisation is examining ways to provide more surgical services.

"We are getting more pressure to bring the unit to large hospitals for assistance with capacity. We are exploring the option of having another unit to assist with this," he said.

"There are a number of portable theatre units around the world. We have been working very closely with a UK manufacture of these and are looking at this as being an option."


Source: HealthTimes



New Zealand's Unique Mobile Surgery Service

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The Operating Theatre Journal, OTJ, is published monthly and distributed to every hospital operating theatre department in the UK. The distribution includes both the National Health Service and the Private Sector.

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