Healthcare | One man created through the most terrible accidents in recent history – Now he is going down for the last time

“No one has there is no danger to life,” said a familiar calm man in May.

In Tapiola, the pedestrian bridge collapsed from under the schoolchildren, but this too would be resolved.

The speaker was trusted because he was just as direct and matter-of-fact Eero Hirvensalo has spoken after all the major accidents affecting the capital region in this millennium.

For years, Hirvensalo has been the medical manager of Husi's preparedness center, i.e. responsible when something extraordinary happens. The Myyrmann explosion, the tsunami, the Jokela school shooting, the pandemic.

Now Hirvensalo, who has retired, wants to highlight the slowly progressing crisis.

It threatens the functionality of healthcare every day.

“I don't accept that our core mission of patient care has to be saved, while the administration functions normally.”

In the current world political situation, it is necessary to discuss prioritization, i.e. for example, which operations should be left undone if, for example, there is a shortage of essential surgical supplies.

Hirvensalo is upset that the same prioritization will soon have to be considered for budgetary reasons in the normal everyday life of the hospital, when the administration at the same time has swelled.

Hirvensalon The most important hospital in a long career is the recently closed Töölö. There he specialized as a surgeon and orthopedist, became enthusiastic as a researcher and advanced to management positions.

Despite the progress, he has always wanted to work with patients. He believes that a leader should act that way, even though it is no longer fashionable.

Töölö, founded by the Finnish Red Cross, was for years unofficially the hospital in Finland where special preparations were made for emergency situations. For a long time, the hospital had such a title as disaster manager.

So it wasn't Hirvensalo's title, but when Hus was founded in 2000, he became a bit like that on the scale of the entire hospital district. He led the preparation for everything.

“When something extraordinary happens, it makes sense for hospitals to work together, in a networked manner,” explains Hirvensalo.

So there needs to be an overall picture of where in Hus's twenty or so hospitals there is space right now, where there is congestion or a shortage of staff. Similarly, you need to know the situation of the cities' (or nowadays Helsinki and welfare regions) own hospitals.

For a couple of years, a situation center has been on duty at Husi's preparedness center for this situation. With the health and safety reform, an even wider Southern Finland preparedness center is under development.

Exception situation can be anything that burdens hospitals. From the hospital's point of view, it's not a traffic accident involving a large group of people, which you get over with bruises. Instead, even just five burn patients in need of demanding treatment can already affect the normal operation of the hospital.

In a major accident, planned measures often have to be postponed in order to be able to treat patients who need urgent treatment. The right amount of professionals must be alerted to work.

“When Tosipäikka comes, the professionals' desire to help is strong. Even with the current staff shortage, enough employees are available in an emergency.”

However, the person leading the crisis must be able to anticipate it. It is not worth alerting a huge number of people to twiddle their thumbs at the very beginning and then be surprised when there is no one to alert for the next shift. Surgery for major accident victims can take days or even weeks.

The manager must have up-to-date information and the ability to make decisions calmly at the right time.

“It doesn't work for the manager to panic,” says Hirvensalo. But panic has reportedly not been close, because even in the most serious moments, he has had faith that we can handle this too.

Hirvensalo also considers information to be essential. That is, of course, internal, so that everything goes as it has been rehearsed. But also external, because in exceptional circumstances, public healthcare must share the right information quickly and not leave everything up to social media or the media.

Corona pandemic it was a special exception that it just dragged on and on.

“And also because the decisions were made on strong political grounds and not just on medical grounds,” he says.

For example, Helsinki-Vantaa's corona tests for tourists were continued for a month after they had already proved useless, because it was more likely to get infected inside Finland than from a tourist.

“We survived tolerably at least, the places in the intensive care units did not run out. We are better prepared for the next pandemic,” says Hirvensalo.

For example, he estimates that for the second time in Finland, one would hardly wake up until the last minute to notice that there are too few protective clothing and masks for professionals.

But the pandemic's decision-making had the same thing that worries Hirvensaloa in the whole of healthcare. Medicine and expertise do not always decide.

Then when Hirvensalo himself specialized in operating rooms, one doctor had time to do more.

Operating theaters were not kept closed all the time because there was a shortage of nursing staff. Not so much working time was spent messing around with information technology. At the university hospital, you could do the kind of research that allowed you to practically develop the ways of working in your specialty.

The administration of the clinic meant, in practice, the chief physician in charge of his specialty, together with his secretaries. Over the decades, many more layers of administration have been added to the hospitals, and after the social security reform, the situation worsened.

In Uusimaa, the politicians of Helsinki and the welfare regions decide which slice of the funding from the state will be given to Hus. Funding is no longer as strongly tied to patient care periods.

According to Hirvensalo, it is necessary to choose whose treatment society can afford.

“Decisions should be made closer to the patient. It is also cost-effective. When the teams are allowed to develop their own work without over-directing by the administration and high-quality work is appreciated, we are also proud of our own work and have fun at work.”

Effective healthcare is also prevention. It means a person's own responsibility for their own health, but in Hirvensalo's opinion, smarter ways of sharing information are needed. That is, for example, stronger school health care and wider use of modern technology for this.

Although Hirvensalo has now retired from his main job, he is still working at Hus in special positions with the aim of improving patient safety.

In healthcare, there are well-established ways of reporting, investigating and compensating patient injuries according to the Patient Care Act, but the process can take years.

“There should immediately be a way to deal with mistakes in the work community so that we learn together how not to repeat them.”

Read more: What connects the Myyrmann explosion and the treatment of the corona pandemic? Disaster expert Eero Hirvensalo tells how crises have been overcome