Saving lives at the Silesian Centre for Heart Diseases
The Silesian Centre for Heart Diseases (SCCS) in Zabrze has been setting the standards for modern cardiology and cardiac surgery in Poland for more than 30 years. Since its inception, SCCS has worked with the Silesian Medical University to educate generation after generation of specialists. It was at the SCCS in 1985 that the first heart surgery and the first successful heart transplant took place in Poland.
During an expansion and modernisation programme, the focus of the SCCS was to update AV systems to distribute audio, video and control signals efficiently, use the latest signal transmission technologies and create a reliable network. The most important strategic goal for the institution was to enable hands-on education for students, without disrupting complex, often risky operations.
The challenge for any AV company was to combine world-class education with patient safety and physician comfort. After winning a tender process, Polish AV company A+V was tasked with the design and installation of AV systems at SCCS. “The client required a flexible, scalable and reliable AV solution, together with high quality images and audio with a minimal delay in transmission,” explains Marcin Bogaczyk, AV system designer (AV design team manager) for A+V. Bogaczyk and his team were responsible for the full scope of the project in the design and build mode, which encompasses AV, management and control systems, integration with the lighting systems, BMS, CCTV, recording and transmission online and for social media platforms, and an IT infrastructure based on Cisco with a core switch on a skeleton structure.
The scope of the project included treatment rooms, server room, seminar rooms in Building A, and an auditorium, training department hall and operation theatres in Building B, as well as upgrading the AV system in Building C. The client brief focused on providing an appropriate system offering AV signal transmission from the operational theatres and treatment rooms to the seminar and training rooms,” says Andrzej Galecki, project manager for A+V. “This solution was to enable teaching on the highest level whilst maintaining a sterile environment for the operation and preserving patients’ privacy.”
The backbone of the AV is a signal transmission and multimedia management system based on Crestron AVoIP products, chosen because it offers flexibility, is easy to service, and is capable of expanding in the future, if the needs arise explains Galecki. “This has given us virtually unlimited possibilities for expanding the system’s reach over the years to come. A single signal distribution ecosystem and management system based on Crestron products guarantees native communication of all components. This, in turn, has its direct impact on the reliability and high responsiveness of the entire system.”
The AV systems are equipped with the ability to wirelessly transmit images and audio using the Crestron Digital Media NVX platform. In addition, the Crestron AirMedia system allows the ability to connect up to 32 devices at once using AirPlay and Miracast technology, which removes the need for users and guests to log in to the corporate Wi-Fi network, which can cause IT security frailties. The Building A section of this project is in a newly built hospital. Each of the six hemodynamics (the study of how blood flows through blood vessels) and electrophysiology treatment rooms are equipped with standardised AV kit says Bogaczyk.
Each treatment room is equipped with a 10-in wall touch panel to manage the AV in the room, ceiling speakers (used to broadcast intercom messages between rooms, the lecture hall and technicians), and a set of eight wireless microphones connected to a common antenna. The mics can be freely assigned by the technician to the treatment room. Video from the treatment rooms is fed through a set of NVX transmitters into the AV LAN network. A DSP has been installed in a cabinet, supporting AEC (echo cancellation) and audio using the Dante/AES67 protocol, which communicates with other elements of the system (seminar rooms, AV system in the Hall, Pavilion B).
The DSP also serves as an interface for analogue signals between wireless microphone receivers and a multi-channel audio amplifier that powers the speakers in treatment rooms using 70V/100V technology. In addition, in the corridors, next to each treatment room, there is a PEL connection, allowing users to connect a mobile trolley with the technician's AV devices.
The trolley has been equipped with Crestron 10-in wired touchpanels for managing AV signals, BenQ preview monitors for displaying video from treatment rooms and images from CCTV cameras in seminar rooms, as well as audio or video via Logitech webcams in seminar rooms. Each of the five seminar rooms has been equipped to provide multimedia presentations from locally connected sources of AV signals to the media ports in the tables. It is also possible to conduct AV transmissions from the treatment rooms, along with two-way voice communication.
All seminar and training rooms, as well as the auditorium, have been additionally equipped with image processors, that allow several video streams to be shown simultaneously. This means a presenter can show content from a laptop or phone and display the broadcast of the medical procedure taking place in the treatment room at the same time. The lecturer can describe the surgical procedure ‘live’ to students, and they can ask questions about the operation being performed. The seminar rooms have been equipped with 75-in Sony Bravia 4K displays with touchpads connected to a PC that support interactive programs, e.g. a whiteboard. A webcam has been connected to a PC allowing users to run videoconferencing platforms such as Zoom. The PC is also connected to the Dante/AES67 network via a USB/Dante audio interface, allowing the video conferencing to be integrated with the room's sound system (Extron ceiling speakers, Sennheiser handheld mics). A 9.7-in wireless Crestron touch panel installed in a docking station in the wall is used to manage the room equipment, it can be removed from the wall but only after entering the correct PIN code.
The Building B part of this project is in an existing hospital which has seen A+V upgrade previous AV systems. “The AV system in the auditorium of Pavilion B is key to the hospital’s entire global system, as it is from here that the system in buildings A, and B and C can be remotely managed, in terms of selecting video sources and establishing two-way voice communication with operation theatres and treatment rooms,” explains Bogaczyk. The auditorium is also a key venue due to the training sessions, lectures, internal meetings and press conferences held there, dedicated connections for journalists have been provided especially for these events. The auditorium includes two 75-in Sony 4K displays installed on the side walls of the auditorium, a 4K projector, 4K BenQ preview monitor for speakers at the conference table, a touch preview monitor built into the lectern and a preview monitor for the technician. In the auditorium control room, a PC with software for recording video signals has been installed and is equipped with an independent NVX video signal receiver, which will allow it to record any available video signal in the LAN AV network. The audio system in the auditorium has also been modernised.
The main element managing audio signals is a multi-tasking DSP equipped with support for echo cancellation (AEC), acoustic jitter reduction and support for transmission of Dante or AES67 digital audio signals. The auditorium has been equipped with a ceiling sound system divided into zones, used to reproduce speech signals, and wall speaker sets next to the screen, reproducing sound in stereo format from multimedia presentations. All loudspeaker devices are powered by a multichannel Lab.gruppen amplifier, which divides the power between the channels in pairs.
The Training Department Hall was upgraded by adjusting its existing multimedia equipment to be compatible with the AV system found elsewhere in the entire SCCS complex. “We equipped it with classic conference room systems, such as a Sony laser projector and audio, together with a control system managing all devices in the room. Just like all spaces in the complex, this one has also been integrated with the central AV system, which has allowed signals to be transmitted to and from the room in any way, along with verbal communication through the sound system. For trainees, this is an experience of great value and an opportunity to learn practical skills, in a safe environment,” says Galecki.
The two operation theatres have been upgraded with AV signal distribution, allowing the room equipment to be connected to a central AV system. This allows for audio to be passed between the classrooms and operating rooms used for training or consultations for future medical professionals.
In Building C, A+V upgraded the existing AV systems in five operation theatres, in line with the agreed standard for the whole complex. To echo other spaces in the project, these rooms have also been integrated with the central AV system. The audio element of this project, which manages the audio signal distribution is a QSC DSP Core 110f network audio processor.
What were the most difficult parts of the installation for A+V? “The worst element of the job was the fact that we were working on a ‘living organism’ which was a fully operating hospital and education unit. We had to adjust our working patterns and schedules to the hospital rhythm. We were doing a lot of night shifts working in the operation theatres but still, even agreed time slots for installations were sometimes cancelled due to an emergency operation,” says Galecki. Luckily for A+V it didn’t have to wait till the other trades had finished before it could do its own work, “Because we were responsible for multi-disciplinary coordination, we were given access to the site early in the project and we had a chance to do a site visit in areas locked away from the general public,” says Bogaczyk.
With regards to the technology chosen for this project, how did A+V come to make its decisions? “We had freedom to choose whatever technology we felt was the most suitable for this client and this specific project, the client trusted us with our recommendation,” says Bogaczyk. Some of the kit went through preliminary tests in A+V’s technical lab in its Wroclaw office, with more tests conducted onsite. The final commissioning stage took place with the full involvement of the client and there was also a fourweek-training period organised for the client and various staff members.
With such important work going on inside the SCCS, and with such a high profile client, it was vital the systems A+V implemented would work now and, in the future, but also allow SCCS to meet its educational goals while meeting safety standards and other required procedures too. “SCCS is a place where the fate of human life is at stake, as well as a centre for training future doctors,” concludes Bogaczyk. “That is why it is so important that it has the best technological solutions, implemented in a thoughtful and consistent manner. Hence we designed an AV system that allows teaching at the level of the best centres around the world: with video and audio transmission capabilities. Thanks to this project, students are able to tangibly learn the principles of performing procedures.”