This is a university hospital of a new kind, designed to meet the need of the next century. It is large, but its division into seven independent clinical centres will give it an intimate atmosphere. Its focus is on the well-being of the patient as an individual.

GIR NYE RIT ENGELSK SPRÅKDRAKT
Hun vokste opp i Sør-Afrika, i en by som heter Pietermaritzburg, på størrelse med Trondheim. I voksen alder har hun bodd hittil 14 år i trønderhovedstaden. Hennes daglige virke er oversettelser fra norsk til engelsk. Og for RIT 2000 kommer hun til å bli en ypperlig ambassadør ute i den ikke-norskspråklige verden på internett. Margaret Forbes lager den engelske versjonen av informasjonen på nettstedet til prosjektorganisasjonen: www.rit2000.no, snart på lufta.



Our Web site will present a broad view of:

BACKGROUND:
Ideology
Premises, costs and expected output
Integrating research and teaching
Historical background
Development plan
Relevant Internet links

DEVELOPMENT
Information Technology (IT)
Art
Enviromentally friendly demolition
Business development
Risk and vulnerability analyses

CONSTRUCTION OF CLINICAL CENTRES:
Neuro Centre
Women`s and Children`s Centre
Cardiology and Lung Centre
Psychiatry Centre
Environmental Centre
Mobility Centre
Abdominal and Emergency Centre

OTHER CONSTRUCTION:
Extension for Radiation Therapy
Laboratory Centre
Technical Centre
Patient Hotel
Administration Centre
Glass Bridges
RiT`s Kindergarten
Teaching and Service Centre


RIT 2000`s English Web site version is coming up in september.


PURPOSE OF RIT 2000 DEVELOPMENT PLAN
In December 1991, Sør-Trøndelag Regional Council approved the preparation of an overall development plan for the organisation, operation and expansion of Trondheim Regional Hospital (RiT). In August 1993 the Norwegian government announced its backing for the preparation of this development plan.
Following the Regional Council's decision in August 1995 to base further work on the development plan on the prize-winning design entitled RiT-l'kkert, an in-depth appraisal and revision of the proposed new organisational and operational structure for RIT 2000 was carried out in association with groups of users at RiT and the Norwegian University of Science and Technology (NTNU). Similarly, the expansion concept contained in the prize-winning design was revised and refined in conjunction with the planning and environmental authorities at local, regional and national level.
The RIT 2000 development plan is:
 a reference document for the agreement between Sør-Trøndelag Regional Council and the government, to be appended to the agreement
 a reference document for use in assessing the project's progress and performance.
Under the agreement with the government, the RIT 2000 Development Plan is intended to provide Sør-Trøndelag Regional Council and the Norwegian parliament with a basis for:
 decisions on initiating and implementing the reorganisation and expansion of RIT 2000 as proposed in the development plan
 decisions on the budget and timescale for implementing the reorganisation and expansion of RIT 2000 as proposed in the development plan.
In the RIT 2000 Development Plan, the designation RIT 2000 is used both for the revised version of the prize-winning project RiT-l'kkert and for the RIT 2000 development project.
SUMMARY
 Part I describes RiT today and the background to the development plan, explains the need for modernisation of RiT, and sets out targets for the development of a patient-centred RIT 2000.
 Part II gives more specific details of the RIT 2000 development project.
 Part III considers the processing of patient flows and the number of students at RIT 2000 as a basis for the calculation of operational floor space and costs.
 Part IV considers the expediting and organisation of the project.
PART I:
BACKGROUND, PERSPECTIVES AND TARGETS
Background
Regional Hospital and University Hospital
Trondheim Regional Hospital (RiT) is the hospital for Mid Norway and functions as a general and local hospital for Sør-Trøndelag region. The Regional Hospital, the Sør-Trøndelag Psychiatric Hospital (STPS) and the Faculty of Medicine (DMF) together make up the Trondheim University Hospital.
RiT has several national and inter-regional specialities.
In addition to treating patients and providing specialist training for doctors, RiT supplies research and training services to DMF, Sør-Trøndelag College (HIST), the Norwegian University of Science and Technology (NTNU) and the Norwegian College of Physical Education.
In 1995, RiT had 958 regular beds, 111 of which were allocated to the rehabilitation units at Betania and Munkvoll rehabilitation centres and to the Røros Hospital unit. In addition there were 38 specialist beds.
That same year, RiT treated 40,330 patients, with 296,707 bed-days. The average occupancy rate over the year as a whole was 91.4%. The hospital operated for long periods at over 100% capacity, with a large number of trolley patients.
Out-patient services have expanded considerably in recent years. In 1995 RiT treated 234,890 out-patients. Because of space and staff shortages, the hospital was unable to meet the demand for out-patient treatment and day surgery in full.
The Faculty of Medicine (DMF)
When RiT started training medical students in 1975, it covered only the clinical aspects. Since 1993, a complete medical education has been available in Trond-heim. The initial intake was 40 students, but this has subsequently been increased to 90. The new University Hospital is intended to accommodate 120 students.
As well as training doctors, DMF accepts numerous students from other parts of the university, who work on their dissertations or theses within the faculty's departments. The faculty provides extensive postgraduate and advanced courses in association with the Norwegian Medical Association (Dnlf).
DMF currently rents about 7,000 m2 of premises within the hospital area and possesses about 7,700 m2 in the Medical Technology Centre, giving a net total of some 14,700 m2. These premises are used for both training and research purposes. In addition, students and staff use areas within the hospital. The size and location of the rented premises is not ideal in functional terms.
Buildings and facilities at RiT
The RiT buildings have a total gross area of 123,000 m2. The hospital currently presents a highly contrasting image. Repeated rebuilding and extension of buildings that in places are old and unsuitable has resulted in long and tortuous internal transport routes. Scarce financial resources have made it difficult to provide solutions with any scope for flexibility. Because of insufficient funds for maintenance, buildings and facilities are starting to fall into disrepair.
Extensive problems have been noted with the hospital's working environment, and the Labour Inspectorate has ordered various modifications and improvements.
The Regional Hospital in the city
The Regional Hospital is situated close to the city centre in a district with many residential properties and a significant number of education and research-related businesses employing many people.
Can RiT be expanded at Øya?
The design competition for RIT 2000 held in 1995 provided the regional council with a detailed picture of the opportunities and limitations posed by any total restructuring of the Regional Hospital at Øya. A key precondition was that the hospital must remain fully operational throughout the entire period. In its verdict on the RIT 2000 design competition as a whole, the judging panel said: "The competition has produced a winning design that convincingly proves that the present RiT can be developed into a top-class patient-centred teaching hospital on the basis of existing facilities at Øya".
The Trondheim local plan dated 1995 states: "From the point of view of transport policy and urban economic planning, it would be highly beneficial if the University Hospital remained in a central location, close to public transport services and main walking and cycling routes."
Perspectives and general trends
The following trends will heavily influence the planning of RIT 2000:
 demographic changes
 changes in the spectrum of diseases
 technological development
 demands for increased patient influence
 higher consumer expectations
 greater focus on control and management
 demands for fundamental organisational changes
 changes in duties and responsibilities
Together with molecular biology, medical technology is the field that has contributed most to the development of medicine over the past 30 years. The National Committee of Deans of Faculty and the University Council have recommended that Trondheim should become the centre for medical technology development in the Norwegian medical infrastructure.
The University Hospital needs to train more doctors than at present. There is a major shortage of both general practitioners and specialists, which is expected to increase over the coming years. Progress with medical technology is increasing the intensity of treatment during hospitalisation, and the need for doctors will therefore increase further.
Targets and principal tasks
The concept of putting the patient at the centre involves taking a comprehensive view of the patient's needs and a provider-led approach to the hospital's organisational structure. The organisation of services must be based on the needs of individual patients or groups of patients. The aim is that as many services as possible should be provided close to the patient and by members of staff with whom the patient has daily contact.
Assumptions regarding the scale of RIT 2000
The planning process is working on the assumption that RiT will largely perform the same functions as at present and maintain the current division of responsibilities in relation to other facilities within the health service and local government regions.
Patient base
The projected patient base in the year 2010 is, in the first instance, based on the same relative distribution of illness and treatment requirements as in the reference year, 1994. Some increase has been assumed for some types of illness.
Average admission period and occupancy rate
The average admission period in the year 2010 is assumed to be 6.0 days. The admission period is put at 24 hours for patients under observation and four days for the patient hotel. The occupancy rate for normal hospital beds (regular beds) is put at 85%.
Organisation of treatment
It is assumed that a systematic move away from in-patient treatment in favour of day treatment and the use of patient hotels will occur. Observation beds will be used to avoid unnecessary admissions, and the right conditions will be created for an improved professional and administrative partnership with local authority health services and specialists outside the hospital.
Training and research
Training in the Faculty of Medicine uses the concept of problem-based learning (PBL), which means that teaching is integrated with clinical activities and that students will spend time in clinical practice from their first term onwards.
With an annual intake of 120 students and the same use of the University Hospital by other NTNU faculties as at present, annual student numbers will be approximately 975. Sør-Trøndelag College (HIST) will have 272 students at RiT. The increase in student numbers will create more posts for researchers and technicians.
The hospital's in-house programme of postgraduate and advanced training includes specialist training for nurses.
Other assumptions and general conditions
It is assumed that the regional council will function as the owner and provider of hospital services, and that the current division of responsibilities and roles between central and regional government will be maintained in relation to the financing and provision of university facilities.
PART II:
RIT 2000 - A DEVELOPMENT PROJECT
New organisational structure
RiT is currently organised along departmental lines, largely according to established clinical specialities. Services to individual patients are broken down into many different subjects and specialities and in many cases are provided by units outside the patient's own department.
RIT 2000 is to have an organisational structure built around the clinical service delivery chain. This will offer the potential for substantial efficiency savings.
RIT 2000 must have all the hallmarks of a patient-centred hospital. The hospital will be organised into six clinical centres, each of which will incorporate in-patient, out-patient and day treatment units, operating theatres and associated functions.
The centres will have access to the resources of clinical support functions such as X-ray, anaesthetics and intensive care.
Clinical centres
RIT 2000 incorporates the following clinical centres:
 Gynaecology/Paediatrics Centre, covering gynaecology, obstetrics, paediatrics, child surgery and aspects of child and youth psychiatry.
 Neurological Centre, covering ENT, eyes, neurology, neurosurgery, maxillofacial surgery, nuclear medicine, geriatrics and stroke patients.
 Mobility Centre, centred on orthopaedic, rheumatology and plastic surgery patients.
 Abdominal Centre, bringing expertise in internal medicine and surgery under one roof for the treatment of gastroenterology and endocrinology patients. Associated fields such as urology, nephrology and vascular surgery are also based at the centre.
 Environmental Medicine Centre, with the oncology and haematology departments at its heart. Coupled with dermatology/venereology, epidemiology and occupational medicine, this gives the centre an environmental focus.
 Cardio-Respiratory Centre, covering cardiology, cardiac surgery, thoracic surgery and respiratory medicine.
Interdisciplinary functions
The concept incorporates six interdisciplinary centres: Accident and Emergency, Laboratory Services, Administration, Supplies, Training and Support and the patient hotel.
Accident and Emergency Centre
The Accident and Emergency (A&E) facility is centralised in a dedicated A&E Centre within the same building as the Abdominal Centre. The bulk of A&E patients will attend this centre, although large groups of patients will go direct to the appropriate centre (e.g. women giving birth). The A&E Centre will have a unit with beds for patients under observation, as well as access to operating theatres, X-ray, laboratory and intensive care facilities, either independently or jointly with the Abdominal Centre. The X-ray and anaesthetic departments and the central intensive care unit will be based close to the A&E Centre.
Laboratory Centre
The Laboratory Centre is a self-contained unit in both administrative and physical terms, gathering all paramedical functions under one roof, whether they are related to clinical activities or education/research. Samples will be taken locally within each clinical centre and automatically dispatched to the Laboratory Centre, where practically all analysis will take place.
Clinical support functions
The new organisational concept involves the coordination of diagnostic and treatment services close to the patient. A prerequisite for this is an operational structure with decentralised service delivery, but where central specialist units such as X-ray and anaesthetics are retained to guarantee coordination, development of expertise, in-service training etc. Decentralisation will primarily affect the X-ray, anaesthetic, intensive care, physiotherapy and occupational therapy departments.
Non-clinical support functions
In addition to a central Supplies Centre incorporating central stores, the non-clinical support functions comprise:
 administrative services
 central kitchens
 waste management and sorting centre
 decentralised portering services
 facilities for patients and staff
 childcare facilities
 technical services including IT
The Administration Centre will house the hospital management and administrative functions.
Development pattern
The central plank of the concept in urban planning terms is that RIT 2000 will be harmonised with the city environment at Øya. The major building programme has been broken down into smaller units to produce a coherent, decentralised facility with an open block structure to suit the urban surroundings.
The decentralised development pattern reflects the organisational structure of independent clinical centres and interdisciplinary centres, with basically one centre in each block. The development strategy will allow expansion in stages, with minimum inconvenience to patients and staff during the construction period.
The university function is closely integrated with the clinic buildings through the "academic districts" on the second floor of each centre, linked by walkways to form a coherent university area.
Buildings
The buildings are simple, versatile, general-purpose structures of relatively modest proportions.
Parking
The car parking requirement is estimated at 1,360 spaces, including 320 for visitors and students. 480 spaces are located in the underground car park beneath Olav Kyrres gate, close to the entrance from Elgeseter gate.
Helicopter landing pad
The helipad's location overlooking the river Nidelva means that pilots will approach it over the river, minimising the disturbance to the surrounding residential areas.