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Erik Kreyberg Normann Smart Crowding

A finger on the pulse of hospital operations

«Logistics and technology have remained a key focus throughout my lengthy professional career,» says Erik Kreyberg Normann. He will join the board of Smart Crowding, a company that develops IT-solutions for hospital planning.

Erik K. Normann is a Norwegian hospital operations veteran with experience from the upper echelons of healthcare operations both nationally and internationally.

«I have always focused on technology and believe that many of the hospital improvement processes can and should be resolved digitally. Smart Crowding is an exciting digitalisation supplement,» is Normann's answer to the question of why he wants to become a member of the board.

«I have considerable operational experience from hospitals and have focused on logistics and organisation ever since the nineties. As part of my paediatrics education back then, I used the electronic health system Profdoc in my general practice. I convinced the head of services to implement Profdoc at the Outpatient Clinic for Children, as the very first outpatient clinic at Aker University Hospital. The deal was based on the assumption that the number of consultations would increase by 25 per cent, which we managed,» says Normann.

Unconventional solutions
Normann is currently serving as general manager at the deaconess foundation Stiftelsen Diakonissehuset Lovisenberg in Oslo. The CV of the physician and paediatrician extends all the way back to 1983 and is filled with general manager titles from Norwegian hospitals, national and international general secretary roles, president, director at the Norwegian Health Directorate, politician, committee member, district governor, advisor, consultant and board member of both unions and professional forums, as well as private healthcare companies.

His background is indicative of a professional and long-serving manager who has remained ever curious about which competencies private parties may provide for public healthcare services. His interest in technology led to some years of work for CapGemini Ernst & Young tackling the combination of healthcare and IT solutions. He has also contributed to several private start-up companies and has blazed untraditional paths as hospital director.

«When a new hospital was to be built in Drammen in 2002, I contacted hotel owner Petter Stordalen in order to get a fresh look at the logistics of the hospital's bed capacity. Hotels are the ultimate world champions in this field, so I considered it quite natural to ask him for advice. We wanted to make Drammen Hospital a combination of a hospital, hotel and conference centre and let the hotel operator manage all beds.»

"And how did it turn out?"

«Unfortunately, the ministry did not take an equally positive view towards this PPP (Public Private Partnership) solution at the time. It is, however, essential to think outside the box to solve the challenges of hospitals in terms of logistics, patient flow and safety,» he says.

The value is in the use
Erik Kreyberg Normann heard of Smart Crowding via a contact at «Klinikk for Alle», and both the problem addressed and the solution are key pieces of the puzzle for the technology-minded hospital director. He has always tried to optimise hospital logistics, but his extensive career has shown him that technology alone will not fix the challenges faced by healthcare services.

Smart Crowding.illustrasjon 4

«A tool fixes nothing. A tool is worth no more than the will to use it. The user is always the one who solves challenges, and in the end, human resources is the decisive factor. If Smart Crowding can help ensure that the right people will use the tool, the solution will stand out as both unique and special».

Smart Crowding was developed based on an idea by the physician Øystein Evjen Olsen, who once headed the emergency ward at Stavanger University Hospital (SUS). He realised there were great digital improvement opportunities in terms of what information could be made available to personnel having to make fast and resource-demanding decisions at hospitals. In short, since 2014, SUS has used Smart Crowding as its decision support system. Nearly 40 wards at SUS use this system, and the Norwegian Board of Health Supervision found no nonconformities during its 2019 audit. The Board was of the opinion that, to a large extent, this was due to good planning and the flexible use of resources at Smart Crowding.

A professional team has been established for the company, investors have been secured and the team is ready for the national, Nordic and international markets.

"Smart Crowding claims to save lives. Do you have the sense that overcrowding and stress are detrimental to patient safety?" No we don’t, we claim to ‘help’ save lives…

«The operational norm has been set at 85% of the capacity during planning of new hospitals due to safety concerns. If the norm is set higher, it will take less to upset the cart. In my opinion, the employees at our hospitals are world champions in improvisation. They must find solutions, and they do, once things come to a head due to unforeseen circumstances. But if the problems are too big or it happens too often, the risk of people making mistakes will increase. I believe Smart Crowding has the potential to reduce such peaks. Frequent updates of the current situation render the tool relevant for those who must act and adjust plans over the course of hectic hospital workdays,» he says.

Identify local needs
"When the tool can save lives, improve the workday for employees and patients and even save hospitals money due to better planning and decision support; why don't all Norwegian hospitals embrace this solution?"

«Smart Crowding is surely not the first company to knock on executives' doors with smart solutions. The product was developed at Stavanger University Hospital (SUS), and SUS probably feels a stronger sense of ownership. Smart Crowding must identify the needs at each individual hospital and prove that it has the answer to their diverse logistics challenges. It is no use offering a hammer when a saw is the tool needed.» I think this is dangerous, with the sense of ownership bit and this whole paragraph reads negatively, like that SC is potentially hard to implement.

"Smart Crowding writes that it can help healthcare workers have a better overview of the various wards and thus facilitate savings. What does this entail?"

«Savings is a close cousin to efficiency improvements. When I worked in Drammen, I always walked through every ward on Christmas Eve to wish the staff Merry Christmas. The staff in one ward, for example, could gather in the break room for a pleasant and relaxed chat, while the staff in an otherwise identical ward on the same floor would be rushing about like crazy. They would all be haggard and stressed. That is no way to run hospitals. Cooperation across wards is essential whenever possible and appropriate, for the sake of both people and finances. That is why we need tools like Smart Crowding, which provides decision-makers with real time resource overviews,» says Normann.

Into the world at large
"Based on your international experience, say something about the relevance of the Smart Crowding solution on a global level?"

«It is my experience after having met hospital managers from across the globe that they all face the exact same challenges. There is an insatiable need for treatments and services, resulting in logistical challenges. This can be solved in various different ways, but hospitals are basically logistical organisations requiring collaboration between several parties to ensure good treatment and safe flow. It makes no difference whether the tool that will solve this challenge was developed in the USA or Norway, Asia or Africa.»

"So where should they start?"

«It is always good to focus on the immediate environment. The company is in a phase where the focus should be to gain an understanding of the needs of the customers and refine the product. But there is an obvious scaling potential for Smart Crowding internationally.»

"Do you envision other business opportunities for Smart Crowding?"

«Of course, there are others; both aid organisations working in the field or other complex organisations, where good logistics are of the essence in terms of success, that are in need of decision support for logistics tools.»

"In this Year of Corona, we all have to deal with social restrictions, partly in order to prevent hospitals from losing control. Do you think that the current focus on hospital capacity has increased the appreciation of planning tools such as Smart Crowding, and that this could help save lives?"

«I have seen a demo from Smart Crowding where Covid is used as an example in terms of the local and national ventilator situation. This could be a good thing. There are probably some other parties with this level of control, but I would venture to say that it would be based on a fairly manual approach. Overviews in real time are probably not available. National resource management during a pandemic is an interesting field,» says Normann.

Text: Hilde Garlid, Validé