Parnu Haigla raamat 2013

Page 1

! t s i v r Te


MISSIOON

MISSION

Pärnu haigla missioon on toetada inimeste tervist ja elukvaliteeti.

The mission of the Pärnu Hospital is to support the health and quality of life of people.

VISIOON

VISION

Pärnu haigla visioon on olla usaldusväärne, uuendusmeelne ja

The vision of the Pärnu Hospital is to be a reliable, innovative and caring centre of

hooliv arsti- ning õendusabi keskus Eesti tervishoiuvõrgus.

medical and nursing care in the Estonian health care system.

PÕHIVÄÄRTUSED

MAIN VALUES

• Eneseareng ja eneseteostamine – hindame professionaalset ja isiklikku arengut.

• Self-development and self-actualization – we value professional and personal development.

• Tunnustatus – meie tehtav töö on inimestele ja ühiskonnale vajalik.

• Recognition – our work is necessary for people and for the society.

• Partnerlus – teeme kollegiaalset tööd inimestega ja inimeste jaoks.

• Partnership –we work together with people and for people.

• Vastutustunne ja eetilisus – oleme sotsiaalselt vastutavad, pühendunud ja hoolivad.

• Responsibility and ethics – we are socially responsible, dedicated and caring.


! t s i v r e T


Tellinud: Koostanud: Toimetanud: Tõlkinud: Toimetuskolleegium:

Pärnu haigla Piret Hallik-Sass, Turundustugi Annika Poldre Meeli Kuura Urmas Sule, Veiko Vahula, Jaana Kikas, Ene Mironenkov, Eda Amur, Aldur Vunk

Materjalid: Kujundanud: Fotod:

Ada Kraak, Tiiu Pärnpuu Villem Hallik, Turundustugi Pärnu Muuseum, Pärnu haigla, Fotoarhiiv, erakogud, Olev Mihkelmaa, Ants Liigus, Ilmar Härg

Trükkinud: ISBN

Printon Trükikoda 978-9949-33-268-7 www.ph.ee


Ajas tagasi vaadates näeme, et Pärnu linn ja Pärnu haigla on eestvedajana ikka etendanud

Looking back in time we see that the Town of Pärnu and the Pärnu Hospital have always played an

olulist rolli nii Eesti riikluse kui ka meie tervishoiuvaldkonna arengutes. On avaldatud arvamust,

important leading role in the development of both the Estonian statehood and our health care field.

et siin võis sündida esimene tänapäevani tegutsev haigemaja Eestis.

According to certain historians the first hospital in Estonia which is operating until our times may have been born here.

Eesti haiglate ja Pärnu haigla jaoks on viimased paar aastakümmet olnud väga suurte muutuste aeg. Kui vanasti rääkisime arstiabist, siis nüüd aina rohkem tervisesüsteemidest. Varem oli jutuks

The last few decades have been the time of major changes for Estonian hospitals and for the Pärnu

haiguste ravi, tänapäeval kõneleme inimese elukvaliteedist ja personaalsest lähenemisest.

Hospital. While we talked about medical care earlier, we are now increasingly talking about health care systems. We discussed the treatment of diseases earlier but now we talk about the quality of life and

Kaasaegne haigla on spetsialistide organisatsioon, kus igal inimesel on oma unikaalne roll täita.

individual approach to people.

Kollektiivne tegutsemine keerulises valdkonnas eeldab selgelt mõistetavaid ühiseid eesmärke, jagatud väärtushinnanguid ja koos tegutsemise oskusi. Just lihtsate inimlike väärtuste

A modern hospital is an organisation of specialists in which every person has a unique role. Collective

kandmine ja edendamine aina uute teadmiste ning tehnoloogiate pealetungil ongi kaasaegse

activities in a complicated field presume clearly understandable common goals, shared values and

raviasutuse juhtimise suurimaks väljakutseks.

teamwork skills. Maintaining and promotion of basic human values in the situation of receiving increasingly new knowledge and technologies is the most important challenge in the management of a

Nüüdseks on meil õnnestunud kõige praktilisemal moel teoks teha haigla strateegilised

modern medical establishment.

eesmärgid. Ellu on viidud Pärnu haigla kahe terviselinnaku kontseptsioon – Ristiku tänaval tegutseb integreeritud aktiivravikompleks ja Ravi tänaval töötab moodne õendus-

By now we have managed to achieve in practice the strategic goals of our hospital. We have

hoolduskeskus.

implemented the concept of two groups of healthcare buildings of the Pärnu Hospital – the integrated acute care complex in Ristiku Street and the modern nursing care centre in Ravi Street.

Meie kollektiivne väljakutse on olla haiglana terve Pärnumaa nurgakivi. Our collective challenge as a hospital is to be the cornerstone for healthy Pärnumaa.

URMAS SULE

URMAS SULE

juhatuse esimees

Chairman of the Executive Board


HISTORY

u g u l a j A y r o t s i H 7


AJALUGU

HISTORY

ENNE HAIGLATE RAJAMIST

HOSPIDALID

BEFORE HOSPITALS WERE ESTABLISHED

Haiged olid perekonna hooldada ja abi otsiti nii

Mitmes keeles on haigla nimetus tulnud hospidalist.

saunast kui rahvameditsiinist. Siiski olid habeme-

Keskajal nimetati nii eeskätt kiriku või ordude poolt

Each family took care of their sick people and

long history. In the Middle Ages these were above

ajajad keskaja lõpus lisaks lihtsamale ilukirurgiale

rajatud palverändurite külalistemaju. Ka Pärnu oli

sought help from saunas and from folk medicine.

all inns established by the church or by orders for

omandanud ka lõikamise, aadrilaskmise ja muudki

keskajal palverändurite sihtpunkt. Hospidale, mida

However, by the end of the Middle Ages, barbers

pilgrims. Also Pärnu was a pilgrim destination in the

oskused ravitsemise alal, mistõttu neid nimetati nii

vaestekassa toel rajati vanade ja põdurate kodanike

had acquired cutting, bleeding and other skills of

Middle Ages. Hospitals established for the old and

barbier kui arste. 1509. aastast on esimene juhuslik

jaoks, nimetati ka seekideks või vaestemajadeks.

healing besides simpler skills of cosmetic surgery

feeble by charities were also called poorhouses or

teade Pärnus tegutsenud arstist. 1545. aastal lasi

Pärnus oli selleks Pühavaimu maja samanimelise

and were called both barbers and doctors. The first

almshouses. In Pärnu the Pühavaimu (Holy Ghost)

raad ehitada ühe toaga maja, et sinna saaks elama

kiriku juures.

incidental record of a doctor practising in Pärnu is

House was such a building attached to the church

from 1509. In 1545 the Town Government ordered

bearing the same name.

HOSPITALS The term “hospital” used in many languages has a

asuda habemeajaja-meister ja arst nimega Veltin. Selle ameti esindajaid vajati kogu aeg ja ka suure

Alamrahva ja linna talupoegade vaestemaja

the construction of a house with one room for a

garnisoni paigutamine Pärnusse kui kindluslinna

rajati 1549. aasta lõpus väljaspool linna asunud

barber-master and doctor Veltin to live in. Repre-

An almshouse for common people and peasants

ei muutnud juurdunud meditsiinisüsteemi. 1670.

Jaani kirikusse. Uut tüüpi avalik hospidal rajati

sentatives of that profession were always need-

of the town was established in the Jaani (St.

aastal oli linnakirurgi ja garnisoni velskrina ametis

Pärnusse 1660. aastal Rootsi kuninganna

ed and the established medical system was not

John’s) Church in 1549, outside the town bor-

habemeajaja sell Friedrich Dannehl.

Hedvig Eleonora korraldusega.

changed even after the relocation of a large garrison

ders of that time. A public hospital of a new type

to Pärnu which was a fortress. In 1670, Friedrich

was established in Pärnu in 1660 with the order

Haigete eraldamisele tuli tähelepanu pöörata

Dannehl, an apprentice of a barber, was employed

of Hedvig Eleonora, the Queen of Sweden.

seoses nakkushaiguste levimisega. Keskajal raviti

as the town surgeon and medical assistant for the

haigeid saunades. Ühissauna teenindas saunasell,

garrison.

people had to be kept separate. In the Middle

kes pidi ühtlasi olema ka põetaja. 1675. aastal nõudis Pärnu komandant raelt sauna-laatsareti ehitamist linna. 18 aastat hiljem oli garnisonivelsker Johann Mackil haigete sõdurite põetamisel abiks saunasell, kes seal ilmselt juba töötas.

Apteegiuhmer ja kirurgi tööriistad keskajast

Mortar and surgeon’s instruments from the Middle Ages

Lisaks hospidalidele tegutsesid linnas ka apteegid.

Besides hospitals, also pharmacies were operating in

Apteekide asutamine sõltus turust. Pärnus on esimene

the town. Establishment of pharmacies depended on the

teade apteekrist 1595. aastast. Et apteegid tootsid ise

market. The first record of a pharmacist in Pärnu is from

enamuse ravimitest, kinnitab 1654. aastast pärit teade,

1595. The pharmacies made most of the drugs themselves

et Pärnu linnaapteeker Johannes Franckel on oma

which is confirmed by the record from 1654 that the

ravimtaimede aed.

Pärnu Town Pharmacist Johannes Franckel had his own garden of medicinal herbs.

8

Due to the spread of infectious diseases, sick Ages, sick people were treated in saunas. The sauna apprentice attending to the public sauna also had to take care of nursing people. In 1675 the Pärnu Commandant requested from the Town Government the construction of a sauna/infirmary in the town. 18 years later the medical attendant of the garrison Johann Mack was assisted in nursing the soldiers by the sauna apprentice who probably already worked there.

9


Rootsi kuningas Karl XI keelas saunameeste ja

1710. aastal evakueeriti ülikooli varad ja personal

habemeajajate ameti 1690. aastal. Linnaarstideks

sõja eest Rootsi ning Pärnu kapituleerus Vene

pidid edaspidi saama vaid ülikoolides meditsiini-

vägedele. 1721. aastal anti välja Vene impeeriumi

hariduse omandanud isikud. Meditsiiniteaduskond

senati ukaas, milles nõuti linnaarstidelt meditsiinilist

oli üks neljast täieliku ülikooli alustalast.

haridust. Pärnus jõuti uue linnaarsti valimiseni 1749. aastal. Sellele kohale kandideeris kaks

1632. aastal Tartus avatud protestantlik ülikool

meditsiinidoktorit: teist põlve kohalik apteeker

taasavati pärast mitmeid sulgemisi 1699.

Martin Johan Heno ja temast 34 aastat noorem

aastal Pärnus, kus see sai nimeks Academia

Johann David Wissel, kes ka valitud sai.

Pernaviensis. Ülikooli meditsiiniteaduskonda jõudmiseks tuli läbida filosoofiateaduskond ning omandada piisavad teadmised filosoofias, retoorikas, loodusteadustes ja matemaatikas, samuti joonistamis-, vehklemis- ja tantsuoskus. Varem põhiliselt filosoofiale tuginenud meditsiiniteooria hakkas vähehaaval lähenema praktilisele meditsiinile ja 1709. aastal viidi ülikooli

BEGINNING OF ACADEMIC MEDICINE Pärnu Elephant Barn where professors performed the first public autopsies

AKADEEMILISE MEDITSIINI ALGUS

HISTORY Pärnu Elevandiait, kus ülikooli professorid viisid läbi esimesed avalikud lahkamised

AJALUGU

juures läbi esimesed avalikud lahkamised. Ülikooli meditsiiniprofessor Laurentius Braun oli samal ajal ka Pärnu linnaarst.

In 1710 the assets and staff of the university were

sions of sauna attendants and barbers in 1690. Only

evacuated to Sweden due to the imminent war

persons who had acquired medical education at a

and Pärnu surrendered to Russian forces. In 1721

university could become town physicians from that

an ukase of the Senate of the Russian Empire was

time. The medical faculty was one of the four pillars

issued setting the requirement to town physicians

of a full-fledged university.

to have medical education. In Pärnu the new town physician was selected in 1749. Two doctors of

The protestant university opened in Tartu in 1632

medicine applied for that post: the local pharmacist

was reopened in Pärnu in 1699 under the name

Martin Johan Heno from a family of pharmacists

Academia Pernaviensis after it had been closed

and Johann David Wissel who was 34 years

for several times.

younger and was chosen for the post.

The students who wanted to enter the Medical Faculty of the University had to graduate from the Faculty of Philosophy first and acquire sufficient knowledge of philosophy, rhetoric, natural sciences and mathematics, also drawing, fencing and dancing skills. The theory of medicine which had been mainly based on philosophy earlier started to

Tolleaegsed kraadid saavutati teoreetilises meditsiinis,

The degrees were acquired in theoretical medicine at

become closer to practical medicine and in 1709

kõrgelt haritud meedikud praktiliste oskustega veel

that time; well-educated medical professionals could not

the first public autopsies were performed at the

hiilata ei saanud. Nii saatis 1751. aastal Pärnusse

yet boast of their practical skills. Thus the very expensive

university. The Professor of Medicine Laurentius

saabunud kuulsa professori ja imearsti Joseph Hillmeri

surgeries of the famous professor and miracle doctor

Braun at the university was at the same time also

ülikalleid operatsioone tegelikult ebaedu – üheksast kae

Joseph Hillmer who arrived in Pärnu in 1751 actually

the Pärnu Town Physician.

eemaldamise operatsioonist seitse ebaõnnestus täielikult.

failed – seven of the nine cataract removal surgeries failed completely.

10

The King of Sweden Karl XI prohibited the profes-

11


AJALUGU

HISTORY

KINDLUSLINNA LAATSARET

FORTRESS INFIRMARY

Pärast habemeajajate ameti kaotamist hakkas

1760. aastal rajati haigla kõrvale eraldi hospidal

After prohibition of the profession of barbers the

In 1760 a separate hospital was established next

kindluslinna komandant 1694. aastal kurtma haigla

süüfilisse jäänud talupoegadele. 1784. aasta

Commandant of the fortress started to complain

to the hospital, for peasants who had contracted

puudumise üle. Esimene linnaarst professor

aruande järgi olid linnas garnisoni laatsaret,

about the lack of a hospital in 1694. The first town

syphilis. According to the report from 1784 there

Laurentius Braun oli aastatel 1701–1705 sõjaväes.

talurahva laatsaret ja välirügemendi laatsaret.

physician professor Laurentius Braun was in

were the garrison infirmary, peasants’ infirmary and

the army in 1701–1705. When he returned from

the army field regiment infirmary in the town.

Kuramaalt tagasi tulnud, pidi ta hoolitsema Pärnus Garnisoni hospidal ja talupoegade laatsaret

ka laatsaret, millest aga andmed puuduvad.

asusid samas kohas, kuhu hilisem linnahaigla

H en no

Courland, he also had to organise the health care

Väli r üg e la a t m e n d i s ar e t

ka garnisoni tervishoiu eest. Ilmselt tegutses siis

jäi kuni 2005. aastani. 1750. aastal ametisse asunud linnaarst dr Johann David Wissel (1719–1775) asus samal ajal ka garnisoniarstina juhtima kindluslinna hospidali, millest

The garrison hospital and the peasants’

infirmary but there is no information about it.

infirmary were at the same place where the later municipal hospital remained until 2005.

Town Physician Dr Johann David Wissel (1719–

Kalam

kujunes ilmselt vanim järjepidevalt töötanud haigla

e he

1775) who was employed to the post in 1750 started to manage also the fortress hospital as the

mnt

garrison physician and this became the probably oldest hospital in Estonia which was operated without interruptions. Also pharmacies were

R ii a

Eestis. Linnaarstile allusid linnas ka apteegid.

of the garrison in Pärnu. There was probably also an

subordinated to the town physician.

Sillutise

Väike -

Veski

Garnisoni laatsaret

12

13


AJALUGU

HISTORY

HAIGLA KUURORTLINNAS

HOSPITAL IN THE HEALTH RESORT TOWN

1835. aasta lõpus alustati kindluslinna likvideerimist

In 1835 the liquidation of the fortress started and

In 1838 the first Pärnu health resort establish-

ning kõik kindlustused ja garnisoni hooned anti üle

1838. aastal rajati eraalgatusel esimene

all fortifications and garrison buildings were trans-

Pärnu linnale. Garnisoni haigla anti üle koos sisus-

Pärnu kuurordiasutus, järgnevatel aastatel

ferred to the Town of Pärnu. The garrison hospital

tuse ja varustusega.

kujunes linnas välja kuurort. 1889. aastal asus

was transferred together with the furnishings and

linnavalitsus kuurorti sihikindlalt arendama.

the equipment.

in the following few years. In 1889 the Town

ajastul sagenenud nakkushaiguste ravi polnud

The treatment of infectious diseases which had

the development of the health resort.

19. sajandi keskel veel välja töötatud, põhiliseks

become more common at the time of increasing

kaitsevahendiks nende vastu peeti tervise

population and relocation to towns had not been

tugevdamist vee- ja mudaprotseduuride ning

developed yet in mid-19th century and making

õhuvannidega.

one’s health stronger with water and mud proce-

Pärnu rand ja supelsillad

Pärnu Beach and bathing bridges

Rahvaarvu kasvamise ja linnadesse siirdumise

Pärnus kui kuurortlinnas oli populaarne tervise

Activities for strengthening one’s health were popular

tugevdamisele suunatud tegevus. Samuti oli esindatud

in Pärnu as a health resort town. Also the novel

uudne homöopaatiline ravi, millele keskendus ka

homeopathic therapy was represented and also C. A.

C. A. Knorre. Lisaks pakkusid teenuseid eeskätt

Knorre focused on these methods. In addition, offices of

kuurordikülastajatele orienteeritud eriarstikabinetid.

medical specialists provided services above all to visitors of the health resort.

14

ment was opened on private initiative and the health resort was developed in the town Government started systematic activities for

dures and fresh air baths was regarded as the main protection against them.

15


AJALUGU

HISTORY

1891. aastal toimusid haiglas suuremad ehitus1. jaanuarist 1857 sai linnahaigla iseseisva statuudi ja linnaarst dr Carl Adolph Knorre

In 1891 major construction work was performed

tööd – muudeti ruumijaotust, värviti üle seinad

From 1 January 1857 the Municipal Hospital

at the hospital – the allotment of space was

ja mööbel ning ehitati vannituba. Samas jõudsid

acquired its independent statutes and the Town

changed, walls and furniture were painted and

(1799–1870) nimetati haigla peaarstiks. Haigla

Pärnu linnavalitsusse arvamusavaldused, et mõistli-

Physician Dr Carl Adolph Knorre (1799–1870)

a bathroom was built. However, the Pärnu Town

juhtimine anti vastava komitee kätte, kuhu

kum oleks kohe uus, korralik haiglahoone ehitada,

was appointed as the Chief Physician of the

Government received information that according

mitte vana remontimisele raha ja aega kulutada.

Hospital. Management of the hospital was

to the opinion of citizens in town it would be

entrusted to the respective committee which

more reasonable to build a new proper hospital building instead of spending time and money on

kuulus nii rae liikmeid kui ka vaimulikke. Haiglas oli 40 voodikohta: 27 meestepalatis, 11

1907. aastal pakkus ehitusmeister Richard Fröhling

included both Town Council members and

naistepalatis ja 2 reservkohta. Haigla kõrval asus

ennast ehitama Pärnusse uut kivihaiglat. Plaanid

clergymen.

repairing the old building.

nakkushaigete hospidal.

seekord siiski tegelikkuseni ei jõudnud. Uus In 1907 the master builder Richard Fröhling

14. oktoobri öösel pääses teadmata põhjusel haigla

ward, 11 in the women’s ward and 2 in reserve.

offered his services for building a new brick

moel ja kui kiiresti jõuti uued hooned püstitada

vana puithoone teiselt korruselt velskri korterist

The hospital for infectious diseases was next to

hospital in Pärnu. These plans were not carried

the hospital.

through after all. Another accident happened

või säilinud rekonstrueerida, selle kohta andmed

tuli lahti ja hävitas mitte küll kõige ajakohasema,

puuduvad. Haiglat mainitakse oma ruumes tööta-

kuid siiski veel kasutamiskõlbliku hoone. 22 haiget

vat aga juba aasta pärast põlengut.

evakueeriti ja paigutati lähedalasuvasse kasarmusse Kalamehe tänaval.

1887. aastast pärinevad teated haiglahoone teisele korrusele nakkushaiguste ravikabineti ja velskrite korteri ehitamise kohta.

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Dr. C. A. Knorre, the first Chief Physician of the hospital; general’s Decree which ended the fortress status of Pärnu

There were 40 beds in the hospital: 27 in the men’s Haigla esimene peaarst dr C. A. Knorre; kindrali käskkiri, mis lõpetas Pärnu kindluslinna staatuse

õnnetus ei lasknud end kaua oodata: 1908. aasta 1878. aasta tõi kaasa haiglahoone põlengu. Mil

not much later: in the night of 14 October 1908 In 1878 a fire broke out at the hospital. There is no

fire broke out in the apartment of the medical

information about in what manner and how fast the

attendant on the second floor of the hospital for

new buildings were erected or the buildings that

some unknown reason and it destroyed the old

were preserved were restored. But the operation of

building which was not quite up-to-date but still

the hospital in the same premises was mentioned

useable. 22 patients were evacuated to a nearby

already a year after the fire.

barrack in Kalamehe Street.

Records from 1887 mention the construction of an office for the treatment of infectious diseases and an apartment for medical assistants to the second floor of the hospital building.

17


Sillutise tänava põlenud puithoone asemele otsustas linnavalitsus 1909. aastal rajada kivist

Novembris 1910 avati pidulikult uus haigla-

haiglahoone. Ehitamiseks vajati aga raha. Vajalikust

hoone, kus 50 koha asemel oli 116 voodikohta.

57 000 rublast kattis kindlustussumma vaid 16 650 rubla, 30 350 rubla eraldati linna tagavarakapitalist

Viimased ehitustööd lõpetati aga alles 1912. aasta

ning puuduva 10 000 rubla saamiseks otsustati

sügiseks, mil valmisid desinfektsioonikamber,

kasutada silmaarst dr Jossif von Reineri poolt

lahkamisruum ja haigla kabel. Uue haiglahoone

Pärnu linnale pärandatud raha, mille tingimuseks

avamisega seoses määras linn spetsiaalse

oli uue silmahaiguste ravi kabineti ehitamine.

haiglajuhataja koha, kelleks sai dr Julius Frey.

Linnavalitsus otsutas, et rajatakse kivihoone ning

1918. aastal loodud Eesti Vabariik ja novembri

haiglasse tuleb vähemalt 50 voodikohta, arstituba,

lõpus ametisse asunud eestlastest koosnev

vastuvõtutuba, operatsioonituba, silmakliinik,

linnavalitsus tegid muudatuse haigla senises

apteek, vannituba ja 2 tuba kinnipeetavatele.

juhatuses, valides dr W. von zur Mühleni asemel

Majja sooviti tsentraalset küttesüsteemi. Haigla

haigla juhatajaks dr Ernst Tumma.

projekteerimise ülesande sai linnaarhitekt Alfred Jung. Kolmekorruselise hoone projekt arutati läbi järgnevatel linnavalitsuse koosolekutel ning see

BRICK HOSPITAL BUILDING FOR SEVERAL CENTURIES Hospital in Sillutise Street. Sillutise Street got its name from a mistake made in the translation of the Plaster Street.

KIVIST HAIGLAHOONE MITMEKS SAJANDIKS

HISTORY

Sillutise tänava haigla. Rahvasuus sai Sillutise tänav nime Plaastri tänava tõlkimisel tehtud veast.

AJALUGU

sai ka linnaarst dr Alexander Kroegeri heakskiidu. Pärnu haigla oli algusest peale isemajandamisel, kuna

The Pärnu Hospital was a self-financing institution

linna toetusest jäi väheks. Haiglal oli linna piiril 42 ha

from the very beginning as the support from town was

suurune abimajand. 1931. aastast pärineb dokument,

insufficient. The hospital had a farm of 42 ha on the

kust selgub, et sel aastal oli haiglal 10 siga ja 48 kana

outskirts of the town. According to a document from 1931

ühes kukega. Seapidamine andis haiglale 1728 kg liha.

the hospital had 10 pigs and 48 hens with a cock that year.

Kanapidamisest saadi 5053 muna, tapeti 45 kana.

The hospital got 1,728 kg of pork from pig-farming. It got 5,053 eggs from the hen and killed 45 chicken.

18

The Town Government decided in 1909 to build a brick hospital building at the site of the burnt wood-

The opening ceremony of the new hospital

en building in Sillutise Street. But the construction

building was in November 1910, it had

needed financing. The insurance benefit covered

116 beds instead of 50.

only 16,650 roubles of the required amount of 57,000 roubles, 30,350 roubles were allocated from

The last building works were completed only in

the town reserve capital and the missing 10,000

autumn 1912, however, when the disinfection

roubles were covered from the funds bequeathed

chamber, autopsy room and the hospital chapel

to the Town of Pärnu by the oculist Dr Jossif von

were completed. With the opening of the new

Reiner on the condition that a new office for the

hospital building the town appointed a special

treatment of eye diseases would be built.

hospital manager – the town physician had been the chief physician of the hospital earlier. The first

The Town Government decided to have a brick

chief physician of the hospital was Dr Julius Frey.

building for the hospital which would have 50 beds as a minimum, a doctor’s office, reception

The Government of the new Republic of Estonia

room, surgery room, eye clinic, pharmacy, bath-

declared in 1918 and the Town Government consist-

room and 2 rooms for detained persons. A central

ing of Estonians which was appointed at the end

heating system was planned for the building. Town

of November changed the management board of

Architect Alfred Jung was entrusted the task of

the hospital, replacing Dr W. von zur Mühlen by

designing the hospital. The construction design

the new hospital manager Dr Ernst Tumma.

of the three-storied building was discussed at the subsequent meetings of the Town Government and was also approved by the Town Physician Dr Alexander Kroeger.

19


HISTORY

Haiglaolude paranemisele aitas kaasa 1919. aastal

1925. aastal soetati Pärnu haiglale ajakohane

The contract signed in 1919 between the town

In 1925 an up-to-date X-ray office was acquired for

linna- ja maakonnavalitsuse vahel sõlmitud leping,

röntgenikabinet koos diatermia ja kõrguspäikesega,

government and the county government helped

the Pärnu Hospital together with diathermy and

mille kohaselt kaeti haigla majanduslik puudujääk

rajati bakterioloogiakabinet (Munga 7) ning palgati

to improve the situation of the hospital as it was

quartz lamps, a bacteriology office was opened

ühesuurustes osades. Aastatel 1920–1940 oli Pärnu

bakterioloogia eriteadlane. Sel aastal registreeriti

agreed to cover the budget deficit of the hospital in

(Munga 7) and a specialist in bacteriology was

haigla Pärnu linnavalitsuse tervishoiuosakonna

hulgaliselt tuberkuloosihaigeid, mistõttu avati

equal parts. In 1920–1940 the Pärnu Hospital was

employed. That year a large number of patients

alluvuses, osakonnajuhatajaks ja linnaarstiks oli

Pärnumaa tiisikuse vastu võitlemise seltsi

subordinated to the Health Care Department of the

with tuberculosis were registered and therefore a

aastaid dr Jaan Kukk.

nõuandepunkt (Kuninga 7).

Pärnu Town Government, with dr Jaan Kukk as the

consultation office of the TB Prevention Society of

Head of the Department and the Town Physician for

Pärnumaa was opened (at Kuninga 7).

Pärnu haigla juhatajad-peaarstid:

kerkis taas päevakorda ruumipuudus ning haigla

1910–1913 dr Julius Frey

juurdeehituse vajalikkus. Projekt telliti linnaarhitekt

1914–1918 dr Wolfgang von Zur Mühlen

Olev Siinmaalt. Haigla juurdeehitus lahendas

1918–1933 dr Ernst Tumma

peamiselt sünnitusosakonna eraldi asetsemise ning

1933–1939 dr Theodor Brafmann

siseosakonna ruumipuuduse. Kuigi Olev Siinmaa

1939–1944 dr Leonhard Hantsoo

kavandas Pärnu haigla juurdeehituse mitmes etapis,

1944–1945 dr Leonid Volmer

õnnestus ellu viia vaid esimene etapp.

1948–1964 dr Karl Mõtus 1964–1969 dr Harry Brudel

Ehkki tööd edenesid jõudsalt, valmis haigla

1969–1977 dr Enn Värk

juurdeehitus lõplikult alles 1944. aastal. Hoone

1977–1992 dr Toomas Räppo

esimesel korrusel paiknesid siseosakonna palatid,

1992–1994 dr Maaja Voll

teisel korrusel sünnitusosakond.

1994–… dr Urmas Sule

20

Pärnu Hospital staff, Johannes Vares-Barbarus as the third physician from the right (1920)

1938. aastaks jõudis haigla koormus piirini, kus

Pärnu haigla personal, paremalt kolmas arst Johannes Vares-Barbarus (1920)

PÄRNU HAIGLA JUURDEEHITUS

Vaade Pärnu haiglale jõe poolt 19.–20. sajandivahetuse ajal.

1930. aastal võeti vastu Pärnu haigla uus põhikiri.

View of the Pärnu Hospital from the river at the turn of the 19th and the 20th centuries

AJALUGU

many years. In 1930 the new Statutes of the Pärnu Hospital were adopted.

EXTENSION TO THE PÄRNU HOSPITAL By 1938 the hospital was overcrowded to the

Managers/Chief Physicians of the

extent that lack of space and the need to build an

Pärnu Hospital:

extension were discussed again. The design was

1910–1913 Dr Julius Frey

ordered from the Town Architect Olev Siinmaa.

1914–1918 Dr Wolfgang von Zur Mühlen

The hospital extension solved mainly the separate

1918–1933 Dr Ernst Tumma

location of the Maternity Department and the lack

1933–1939 Dr Theodor Brafmann

of space in the Department of Internal Medicine.

1939–1944 Dr Leonhard Hantsoo

Although Olev Siinmaa planned the extension to

1944–1945 Dr Leonid Volmer

the Pärnu Hospital at several stages, only the first

1948–1964 Dr Karl Mõtus

stage could be implemented.

1964–1969 Dr Harry Brudel 1969–1977 Dr Enn Värk

Although the works progressed well, the extension

1977–1992 Dr Toomas Räppo

to the hospital was completed only in 1944. Wards

1992–1994 Dr Maaja Voll

of the Department of Internal Medicine were on

1994–… Dr Urmas Sule

the first floor and the Maternity Department on the second floor.

21


AJALUGU

HISTORY

PÄRNU HAIGLA NÕUKOGUDE AJA ALGUSES

THE PÄRNU HOSPITAL AT THE BEGINNING OF THE SOVIET PERIOD

Nõukogude aeg viis Pärnu haigla linnalt ENSV

I JA III STATSIONAAR

In the Soviet period the Pärnu Hospital was

Tervishoiuministeeriumi süsteemi. Haigla allus

INPATIENT CLINICS I AND III

transferred from the town to the system of the Ministry of Health Care of the Estonian S.S.R.

Inpatient Clinic I – the Pärnu Town Hospital was

konnale. Ambulatoorseks teenindamiseks loodi

tänaval kolmes hoones. Peahoone oli kolmekorru-

The hospital was subordinated to the Healthcare

situated in three buildings in Sillutise Street. The

eraldi polikliinikud.

seline kivihoone, kus paiknesid siseosakond,

Department of the Executive Committee of the

main building was a three-storied brick building with

kirurgiaosakond, sünnitus- ja günekoloogia-

Council of People’s Deputies of the Town of Pärnu.

the Department of Internal Medicine, Department

Separate polyclinics were established for the

of Surgery, Maternity and Gynaecology Department

provision of outpatient services.

and the Pediatric Department, specialised offices

Pärnu linna haigla teenindas statsionaarselt Pärnu

osakond ning lasteosakond, erikabinetid ja

linna ja Pärnumaa elanikkonda. Polikliiniline osakond

toidublokk. Kahes puidust kõrvalhoones asus

teenindas Pärnu linna elanikke ambulatoorse ja

nakkusosakond. Haiglal oli kinnine apteek ühes

Pärnumaad konsultatiivse abiga. Polikliinikuga olid

vajaliku instrumentaariumi ja sisseseadega.

ühendatud samas asuv naiste nõuandla, onkopunkt,

Südamehaiguste paremaks diferentseerimiseks

kiirabijaam ja hambaproteeside labor. Polikliiniku

rakendati 1950ndatel aastatel tööle siseosakonnas

suurima puudusena nähti 1950ndatel aastatel

elektrokardiograaf ühes vastava kabineti

röntgeni puudumist. Vahemaa haigla ja polikliiniku

sisustamisega. Uusimatest ravimeetoditest

vahel oli umbes 2 kilomeetrit, mis oli tolleaegsete

rakendati kirurgiaosakonnas konserveeritud

ülevaadete järgi suureks takistuseks arstide tööle.

koe teraapiat ehk Filatovi meetodit. III statsionaar – Pärnu naha- ja suguhaiguste dispanser asus 1946. aastast aadressil Sääse 3 raviasutuseks ümber kohandatud 20. sajandi alguse puithoones. Hoone renoveeriti põhjalikult 1972. aastal ning 1986. aastal valmis juurdeehitus.

22

Pärnu Hospital surgeons L. Luht and K. Vainu performing surgeries in the operating room (1967)

I statsionaar – Pärnu linna haigla asus Sillutise

Pärnu haigla kirurgid L.Luht ja K.Vainu operatsioonisaalis opereerimas (1967)

Pärnu linna TSN Täitevkomitee tervishoiuosa-

and catering block. The Department of Infectious The Pärnu Town Hospital provided hospital

Diseases was in two small wooden buildings.

treatment services to the population of the Town

The hospital had an internal pharmacy with the

and County of Pärnu. The Polyclinic Department

required instrumentation and equipment. The

provided outpatient services to the population of

electrocardiography equipment was taken into use

the Town of Pärnu and consultation services to the

in the Department of Internal Medicine with the

population of the County of Pärnu. The Women’s

furnishing of the respective office in the 1950s for

Consultation Office, Oncology Office, Ambulance

the improved differentiation of cardiac diseases.

Station and Denture Laboratory Services were

Among the innovative therapeutic methods the

in the same building and linked to the Polyclinic.

preserved tissue therapy, i.e. the Filatov’s method

Lack of an X-ray office was seen as the main

was implemented in the Department of Surgery.

shortcoming of the Polyclinic in the 1950s. The distance between the hospital and the Polyclinic

Inpatient Clinic III – the Pärnu Skin and Venereal

was about 2 kilometres which was an important

Diseases Clinic was located at the address Sääse

obstacle in the work of physicians according to the

3 from 1946 in a wooden building dating from the

reports of that time.

beginning of the 20th century reconstructed into a medical establishment. The building was thoroughly renovated in 1972 and its extension was built in 1986.

23


AJALUGU Nõukogude aja muudatus, millega ambulatoorseks teenindamiseks loodi statsionaarist eraldi asuvad polikliinikud, jagas eriarstisüsteemi pooleks. 20. novembril 1940 loodi Pärnu polikliinik, mille juhatajaks määrati dr Schmuel Haitov. Pärnu polikliinik asus aadressil Lõuna 2. Polikliinikus töötas 12 arsti. Polikliiniku töömaht suurenes ja meedikute pere kasvas ning Lõuna tänava maja jäi kitsaks. 1955. aasta augustis kolis polikliinik Lõuna tänavalt aadressile Suur-Sepa 16, endise Pärnu Maavalitsuse hoonesse. Praegu tegutseb hoones linnavalitsus.

Aastail 1960–80 kujunes välja polikliiniku struktuur,

POLYCLINIC

kus peatähelepanu pöördus erialaarstide vastu-

was developed and the main attention was The changes made in the Soviet period with which

focused on visits to medical specialists. In 1961

uurimist. 1963. aastal avas polikliinikus uksed

polyclinics were created for outpatient services

the research into urological diseases started.

kardio-reumatoloogiakabinet, mis 1981. a jagunes

separately from inpatient departments divided the

In 1963 the Cardio-Rheumatology Office was

kaheks – reumatoloogia- ja kardioloogiakabinetiks.

medical specialist staff into two groups. On 20

opened at the Polyclinic and was divided into two

1964. aastal eraldati polikliiniku kirurgiakabinetist

November 1940 the Pärnu Polyclinic was created

offices in 1981 – the Rheumatology Office and the

traumatoloogia- ja ortopeediakabinetid. Tööd

with Dr Schmuel Haitov as the manager. The

Cardiology Office. In 1964 the Traumatology Office

alustasid nakkushaiguste, gastroenteroloogia

Pärnu Polyclinic situated at the address Lõuna 2.

and the Ortopaedics Office were separated from

ning noorukite kabinetid. Silmahaiguste, kurgu-

12 physicians worked at the polyclinic.

the Surgery Office of the Polyclinic. The Office of

nina-kõrvahaiguste ning neuroloogiakabinettidest

Infectious Diseases, Office of Gastroenterology

kujunesid osakonnad.

The work volume of the Polyclinic increased and

and Youth Office started operation. The Office of

the medical staff grew so the building at Lõuna

Ophthalmology, Office of Otorhinolaryngology and

Polikliiniku juhid:

Street became too small. In August 1955 the

Office of Neurology became departments.

1940–1941 dr Schmuel Haitov

Polyclinic moved from Lõuna Street to the address

1944–1948 dr Fjodor Janson

Suur-Sepa 16, the building of the former Pärnu

Managers of the Polyclinic:

County Government. The Town Government

1940–1941 Dr Schmuel Haitov

currently works in that building.

1944–1948 Dr Fjodor Janson

1948–1952 dr Jakob Flaks 1954–1959 dr Ellen Võlli 1959–1983 dr Valve Tölp 1983–1996 dr Jaan Lemendik

Pärnu linna haigla polikliiniku osakond (1959)

1952–1954 dr Muza Oja

24

In the years 1960–80 the structure of the Polyclinic

võttudele. 1961 alustati uroloogiliste haiguste

Polyclinic Department of the Pärnu Town Hospital (1959)

POLIKLIINIK

HISTORY

1948–1952 Dr Jakob Flaks 1952–1954 Dr Muza Oja 1954–1959 Dr Ellen Võlli 1959–1983 Dr Valve Tölp 1983–1996 Dr Jaan Lemendik

25


HISTORY

“UUS HAIGLA” – II STATSIONAAR

“THE NEW HOSPITAL” – INPATIENT CLINIC II

31. märtsil 1962. a avati Pärnu haigla uus ravikorpus

On 31 March 1962 the new inpatient care building

Inpatient Clinic II included the Neurology Depart-

of the Pärnu Hospital was opened at the address

ment, 2 Departments of Internal Medicine, one of

Suur-Kuke 72 (later Ravi 2), which became known

which was mainly for gastrointestinal diseases and

as “the new hospital”. The buildings of former

the other for pulmonary and cardiac diseases, and

barracks of the Soviet army were reconstructed

the Pediatric Department.

New hospital at the address Ravi 2, Pärnu (1962)

AJALUGU aadressil Suur-Kuke 72 (hilisem Ravi 2), mis rahva seas sai nime uus haigla. Maja kohandati haiglaks endistest Nõukogude armee kasarmutest. Pool majast oli staabihoone, pool kasarmu. Hooned jäid vabaks, kuna muutuste ajal (nn Hruštšovi sula) vähendati sõjaväe koosseise. Uus haigla oli viisaastaku suurim objekt. II statsionaaris asusid neuroloogiaosakond, 2 sise-

lasteosakond. Vabanenud kohtade arvel loodi senistes Sillutise tänava ruumides traumatoloogiaosakond ning laiendati sünnitus- ja günekoloogiaosakonda, onkoloogiaosakonda, nakkusosakonda ja kirurgiaosakonda. Moodustati mõlema statsionaari ja polikliiniku vastavaid alasid hõlmavad röntgeni, füsioteraapia, ravikehakultuuri, vereülekande, nina-, kõrva-, kurgu- ja silmahaiguste osakond

26

had remained vacant as during the changes (the

Department of Traumatology was created and

so-called Khrushchev Thaw) the army presence was

the Maternity and Gynecology Department,

reduced. The new hospital was the largest project

Oncology Department, Department of Infectious

during the 5-year period.

Diseases and Department of Surgery were expanded. The X-ray Department, Physiotherapy Department, Department of Therapeutic Exercises, of Otorhinolaryngology and Department of Ophthalmology and the Laboratory were created to cover the respective fields in the both inpatient clinics and in the Polyclinic. The Biochemical Laboratory of the inpatient clinics started operation. An independent Blood Transfusions Office was established.

Vasakult dr Tuul, Toots, Mitt, Haitov ja Soll

seeriti iseseisev vereülekandekabinet.

In the vacated rooms at Sillutise Street the

Department of Blood Transfusions, Department

ning laboratoorium. Tööle rakendati statsionaarse osakonna biokeemiline laboratoorium. Organi-

headquarters, the other half a barrack. The buildings

From the left: Drs Tuul, Toots, Mitt, Haitov and Soll

trakti, teine kopsu- ja südamehaiguste tarvis, ning

Uus haigla aadressil Ravi 2, Pärnu (1962)

haiguste osakonda, millest üks oli põhiliselt seede-

into a hospital. A half of the building had been

27


AJALUGU I STATSIONAARI JUURDEEHITUS

HISTORY

1979 ja 1980 avati reumatoloogiakabinet, gastro-

EXTENSION TO INPATIENT CLINIC I

enteroloogiakabinetis alustati panendoskoopiat.

In 1979 and 1980 the Rheumatology Office was opened and panendoscopy procedures were

1965. aastal töötas Pärnu haigla 410 voodiga

In 1965 the Pärnu Hospital was operated as an

started in the Gastroenterology Office.

statsionaarina. Siiski oli pidevalt järjekordi sise-,

1980ndatel aastatel töötas Pärnu haigla statsionaar

inpatient clinic with 410 beds. However, there were

närvi-, traumatoloogia-, onkoloogia- ja kirurgia-

endiselt 500 voodikohaga ning haigete mahuta-

constant queues to the Department of Internal

The Inpatient Clinic of the Pärnu Hospital still

osakonda, ülekoormatud oli ka sünnitusosakond.

misega oli suuri probleeme. Seetõttu kannatas

Medicine, Department of Neurology, Department

worked with 500 beds in the 1980s and there were

sanitaar-hügieeniline režiim ning sagedased olid

of Traumatology, Department of Oncology and

many problems with finding beds for patients.

Probleemi lahendamiseks ehitati 1966–67 välja

haiglasisesed infektsioonilevikud. Edusammudena

Department of Surgery, and also the Maternity

Therefore the sanitary and hygiene situation was

Sillutise tänava maja juurdeehituse III korrus, kus

rakendati 1980. aastal tööle veloergomeeter

Department was overcrowded.

not up to the standards and hospital-acquired

enne paiknes kirurgiaosakonna juhataja korter.

koormus-EKG-de tegemiseks, fonokardiograaf,

Sünnitusosakonnas paigutati eraldi patoloogilised

laboratooriumis ekspressdiagnostika, reumatoid-

The problem was solved with the reconstruction

achievements the following should be noted: taking

ja traumatiseeritud sünnitajad, vastsündinutele

faktori määramine. I siseosakonnas rakendati

of the third floor to the extension of the Sillutise

veloergometry into use in 1980 for exercise-ECG

rajati nõuetele vastavad palatid, välja ehitati

fraktsioneeritud kromaatilist duodenaal-

Street building in 1966–67 which used to be the

recording, phonocardiography, express diagnostics

sanitaarsõlm. 1966. aastal suurendati ka

sondeerimist.

apartment of the Head of the Department of

in the laboratory, determination of the rheumatoid

Surgery. In the Maternity Department the patients

factor. In the Department of Internal Diseases I

infections were often spreading. Among the

traumatoloogiliste haigete voodite arvu.

with pathologies and trauma patients were

the fractionated chromatic duodenal intubation

1975. aastal remonditi traumatoloogiaosakond,

separated, new wards were built to newborns

procedure was taken into use.

günekoloogiaosakond, onkoloogiaosakond, laste

according to the requirements, the hygiene rooms

osakond Ravi tänaval ja Sindi filiaalis ning mõlemad

were reconstructed. In 1966 also the number of

sisehaiguste osakonnad.

beds for patients with traumas was increased. In 1975 the Traumatology Department, Gynaecology Department, Oncology Department, Pediatric Department in Ravi Street and in the clinic at Sindi Blood transfusion

28

Vereülekanne

and both Departments of Internal Diseases were renovated.

29


AJALUGU LASTEPOLIKLIINIK

HISTORY

1979. a alustati lastepolikliiniku uue hoone ehita-

PEDIATRIC POLYCLINIC

mist, mis avati 15. märtsil 1982. Lastepolikliinikus 1968. aastal moodustati haigla struktuurse

In 1979 the construction of the new building of the Pediatric Polyclinic started and it was opened

oli 1984. aastal 100 töötajat, neist arste 32.

The Pärnu Pediatric Polyclinic was established as

on 15 March 1982. The Pediatric Polyclinic had 100

a subunit of the hospital in 1968. It had developed

employees in 1984, 32 of them doctors. Already

1940. aastal avatud emade ja laste nõuandlast.

Juba varem, 1972. aasta 1. augustil liideti Pärnu

from the Mother and Child Consultancy opened

earlier, on 1 August 1972, the Sindi Hospital had

1945. aastal loodi eraldi laste ja naiste nõuandlad.

haiglaga Sindi haigla, mis muudeti lastehaiguste

in 1940. In 1945 separate consultancies had been

been subordinated to the Pärnu Hospital and

Lastenõuandla esimeseks juhataks sai dr Abraham

osakonna filiaaliks ja mis toimis põhiliselt järelravi

created for children and women. The first manager

became a subunit of the Pediatric Department

Levin. Alates 1950. aastast olid Pärnu lastenõuandla

osakonnana.

of the Pediatric Consultancy was Dr Abraham Levin.

which was mainly used for rehabilitation treatment.

allüksusena Pärnu lastepolikliinik. See arenes välja

patsiendid kõik Pärnu linna ja maakonna kuni 15aastased lapsed.

Since 1950 all children up to the age of 15 years in the Town and County of Pärnu were patients of the

KIIRABI

AMBULANCE SERVICE

Pärnu Pediatric Consultancy. Lastenõuandla/polikliiniku juhid:

1972. aastal moodustati linna ja rajooni hõlmav

1945–1953 dr Abraham Levin

tsentraliseeritud kiirabiteenistus. Kui varem asus

Managers of the

In 1972 the centralised Ambulance Service was set up to cover both the town and the county. While

1953–1958 dr August Ilves

kiirabiteenistus polikliinikuga samas majas, siis

Pediatric Consultancy/Polyclinic:

the earlier Ambulance Service was in the same

1958–1960 dr E. Meermann

ruumipuuduse lahendusena alustas alates

1945–1953 Dr Abraham Levin

building with the Polyclinic, from 16 May 1984 due

1962–1968 dr Rosa Sokolova

16. maist 1984 haigla kiirabiosakond tööd eraldi

1953–1958 Dr August Ilves

to the lack of space the Ambulance Department of

1968–1996 dr Uno Mirme

majas aadressil Kanali tänav 10.

1958–1960 Dr E. Meermann

the Hospital started operation in a separate building

1962–1968 Dr Rosa Sokolova

at the address Kanali Street 10.

1957. aastal jäi lastenõuandla pärast mitmekordset

1968–1996 Dr Uno Mirme

kolimist pidama Pärnu polikliiniku õuepoolsesse majja, ent ruumikitsikuse tõttu tuli peagi hakata

In 1957, after moving for several times, the Pediatric

otsima võimalusi suurema pinna leidmiseks.

Consultancy remained in the building which was in

allüksusena Pärnu lastepolikliinik.

30

Kiirabibrigaad (1971)

1968. aastal moodustati haigla struktuurse

Ambulance Brigade (1971)

the yard of the Pärnu Polyclinic but due to the lack of space it soon had to look for opportunities for finding larger premises. In 1968 the Pärnu Pediatric Polyclinic was established as a hospital subunit.

31


AJALUGU

HISTORY

POLIKLIINIKU JUURDEEHITUS

UUE HAIGLAHOONE KAVANDAMINE

EXTENSION TO THE POLYCLINIC

PLANNING OF THE NEW HOSPITAL BUILDING

1985. aastal alustati polikliinikule juurdeehituse

Nõukogude ajal ehitati maakonnakeskustesse uued

In 1985 the construction of an extension to

New central hospitals were built in county centres

rajamist. 1987. aastal valminud polikliinikuhoone

keskhaiglad. Pärnu haigla uue hoone planeerimine

the Polyclinic was started. The new part of the

during the Soviet period. Planning of the new

koosnes kahest korpusest, millest üks kohan-

(Ristiku 1) algas 1985. aastal ja ehitus 1988. aastal.

Polyclinic completed in 1987 consisted of two

building of the Pärnu Hospital (Ristiku 1) started

dati 1930. aastate lõpul ehitatud hoonest ning

1990. aastal ehitus aga seiskus ning Pärnumaa

buildings, one of which was reconstructed from

in 1985 and the construction started in 1988. In

teine ehitati spetsiaalselt polikliinikuks. Polikliini-

oli ainuke maakond, kuhu nõukogude võim ei

a building completed at the end of 1930s and the

1990 the construction was stopped, however, and

kus paiknesid registratuur, arstide ambulatoorse

jõudnudki haiglat ehitada.

other was built specifically for the Polyclinic. The

Pärnumaa was the only county where the Soviet

Polyclinic included the registration desk, doctor’s

power was not able to build a hospital after all.

vastuvõtu kabinetid, protseduuride toad, röntgenikabinetid, sonograafiakabinet, endoskoopiakabinet,

13. juulil 1990 nimetati Pärnu haigla ümber Pärnu

offices for outpatient visits, rooms for procedures,

funktsionaaldiagnostika kabinet, füsiaatriakabinetid,

keskhaiglaks. Sama aasta 1. septembril eraldati

X-ray offices, ultrasound office, endoscopy office,

On 13 July 1990 the Pärnu Hospital was renamed

operatsiooniplokk koos autoklaaviga ja stomato-

keskhaiglast Sindi haigla koos ambulatooriumiga,

office of functional diagnostics, physiatry offices,

into the Pärnu Central Hospital. On 1 September in

loogiakabinetid koos oma registratuuriga.

mille tõttu vähenes voodite arv 25 koha võrra.

surgery block with an autoclave and stomatology

the same year the Sindi Hospital together with the

offices with their own registration desk.

Outpatient Clinic was separated from the Central Hospital, which reduced the number of beds by 25.

1988. loodi samas röntgensonograafia osakond In 1988 the X-ray/Sonography Department was

komplekteeriti funktsionaalse diagnostika kabinet.

kasutusele fiibergastroduodenoskoop, kardioloogiaosakonnale eraldati fonokardiograaf, defibrillaator ja portatiivsed EKG aparaadid. Uusi ravimeetodeid võeti kasutusele paljudes osakondades.

32

Haiglahoone seisis pikka aega varemetes

Polikliiniku gastroenteroloogiakabinetis võeti

The hospital building remained in ruins for a long time.

ning laiendati stomatoloogiaosakonda. Samuti

created there and the Stomatology Department was expanded. Also the Office of Functional Diagnostics was set up. A fibre-optic gastroduodenoscope was taken into use in the Gastroenterology Office of the Polyclinic, and the Cardiology Department received a phonocardiograph, a defibrillator and portative ECG equipment. New treatment methods were adopted in many departments.

33


AJALUGU

HISTORY

PÄRNU HAIGLA EESTI TAASISESEISVUMISE AJAL

PÄRNU HOSPITAL AFTER REGAINING OF INDEPENDENCE OF ESTONIA

Suuremad arengud teenuste osutamisel: Pärast Eesti taasiseseisvumist 1992. aastal munitsipaliseeriti Eesti tervishoiuasutused

• Endoskoopia areng, mis säästab patsienti

ning riik andis kohalikele omavalitsustele üle

lõikustest, uuringud viiakse läbi sondi abil (kõrva-

raviasutuste hooned.

nina-kurgu, kopsu- mao- ja sooleuuringud). • Funktsionaaldiagnostika areng ja digitaalne EKG,

Selle protsessi käigus tekkisid üksustest

kus andmed on võrreldavad ja järeltöödeldavad

eraldiseisvad eri suunitlusega asutused ning

(südame rütmihäired, kopsu-uuringud,

haiglale jäid statsionaarid ja laborid. Selline

spirograafia, funktsionaaldiagnostika).

jagunemine aga ei võimaldanud otstarbekalt täita

• Kardioloogia areng ja ultraheli diagnostika.

raviasutuse eesmärki – teenindada abivajajaid.

• Armeenia päritolu ehhokardiograaf, kus

aparaadiga.

uue arenguplaani. Samal aastal alustati Pärnus

• Üldsonograafia areng.

tervishoiureformi, mille eesmärgiks oli korrastada

• Röntgendiagnostika areng. Varem kasutatud

killustunud raviasutuste süsteemi.

pimikufotod on asendatud täisdigitaalse lahendusega, mida hoitakse pildipangas. Nii on võimalik arstidel üle maailma pilte vaadata ja konsulteerida. Tavalisele röntgenile lisandus kompuutertomograafia. Kui algselt kasutati üherealist aparaati, siis tänaseks on kasutusel juba 40-realine aparaat, millega saab uurida veresooni.

34

pulmonary examinations, spirography, functional diagnostics).

institutions to local governments.

As a result of this process, the subunits became

Development of cardiology and ultrasound The echocardiograph manufactured in Armenia

separate specialised institutions and only inpatient

which showed the cardiac atrial function with

clinics and the laboratories remained with the

a green jumping speckle has been replaced by

hospital. Such division did not, however, allow

Hospital work soon after Estonia regained independence

Vabariigi sotsiaalministeeriumi ja Maailmapangaga

and processable data (cardiac arrhythmia,

transferred to municipal ownership and the

diagnostics.

Töö Sillutise haiglahoone vastrenoveeritud operatsioonitoas

täpike, on tänaseks asendunud täisdigitaalse

and digital ECG, which yields comparable

1992 the Estonian health care institutions were state transferred the buildings of health care

südameklappide tööd näitas roheline hüppav 1994. aastal koostas Pärnu haigla koostöös Eesti

Development of functional diagnostics

After regaining of independence by Estonia in

now with fully digital equipment.

the medical establishment to serve its purpose –

Development of general sonography.

provide services to the population.

Development of X-ray diagnostics. The darkroom images used earlier have been

In 1994 the Pärnu Hospital prepared a new

replaced by now with fully digital images

development plan in cooperation with the Ministry

stored in an image bank. Thus physicians from

of Social Affairs of the Republic of Estonia and

all over the world can view the images and

the World Bank. In the same year the health

consult each other. Computed tomography was

care reform was started in Pärnu to regulate the

added to the conventional X-ray examination.

fragmented system of medical establishments.

While single-line equipment was used at first, by now already 40-line equipment is used for

Main developments in the provision of services: •

also vascular examinations.

Development of endoscopy which eliminates the need for surgeries, examinations are performed through intubation (otorhinolaryngological, pulmonary, gastric and intestinal examinations).

35


HISTORY

m r o f e r u i o h s Tervi m r o f e r e r a c h Healt 37


90ndate aastate alguseks oli kõigis arenenud

1994. aastal otsiti Pärnus aktiivselt võimalusi

riikides jõutud arusaamisele, et tervishoiukorraldust

uue tervishoiukorralduse mudeli loomiseks.

ootavad ees suured muutused. Eestis oli see veelgi

Maailmapraktika pakkus näiteid seinast seina, kuid

enesestmõistetavam, kuna taasiseseisvumise

poliitilised otsused riigi tasemel olid veel kompivad

järel oli ka nõukogudeaegne süsteem lagunenud.

ja mitmeid arenguvõimalusi pakkuvad. Selgeks

Olukord sarnanes sajandialguse filmitööstusega,

sai teadmine, et Pärnul rahvusvahelise kuurordina

kus mustvalgeid filme enam ei toodetud ja

puudub perspektiiv ilma usaldusväärse haiglata.

värvifilme veel ei toodetud. Oli üks väga oluline

Vastata tuli aga veel täna lihtsana näivale, kuid

mõõde, millega Pärnu haigla pidi arvestama.

samas väga põhimõttelisele küsimusele: kas Pärnu

Kui üleilmseid arengutrende suunas soov ohjata

vajab ühte tugevat või mitut haiglat?

paisunud tervishoiukulutusi olukorras, kus elanikkond vananeb ja elukvaliteeti parandavate uute tehnoloogiate ning ravimite pealetung aina kasvab, siis Eestis olid tervishoiukulutused väga

Chairman of the Management Board of the Hospital Urmas Sule, County Governor Toomas Kivimägi and Head of the Department of Education and Social Affairs of the Pärnu County Government Epp Klooster at the construction site of the hospital

TERVISHOIUREFORM JA SELLELE JÄRGNEV ARENG 1994–2000

Haigla juhatuse esimees dr Urmas Sule, Pärnu maavanem Toomas Kivimägi ja Pärnu Maavalitsuse haridus- ja sotsiaalosakonna juhataja Epp Klooster haigla ehituse objektil

REFORM

tagasihoidlikud. Sellises olukorras oli äärmiselt

HEALTHCARE REFORM AND SUBSEQUENT DEVELOPMENT 1994–2000 By the beginning of the 1990s all developed countries had reached the understanding that major changes would be required in the healthcare systems. In Estonia it was even more self-evident as the system that had been in place during the Soviet period had also fallen apart after regaining independence. The situation was similar to the movie industry at the beginning of the century when black-and-white movies were no longer produced and no colour films either yet. The Pärnu Hospital had to take into account one very important dimension. While the global development

In 1994 opportunities were actively sought in Pärnu for the creation of a new model for the reorganisation of the healthcare system. The global practice offered all kinds of examples but the political decisions on the national scale were still tentative and open to several development opportunities. It became clear that Pärnu would have no prospects as an international health resort without a reliable hospital. However, a very fundamental question had to be answered which would seem easy to answer today: would Pärnu need one strong hospital or several hospitals?

trend was to cut the increasing healthcare expenditures in the situation where the population

tähtis teha tarku otsuseid. Nõukogude ajal ei olnud perearstisüsteemi. Rajooni keskhaigla oli Pärnu haigla, kõik allüksused – polikliinikud, dispanserid, maakonnahaiglad kuulusid keskhaigla alla. Kui Eesti taasiseseisvus, toimus omandireform. Asutused iseseisvusid hoonete põhjal ja süsteem ei lähtunud teenuste sisust. Reformi mõte oli tekitada kahetasandiline süsteem – ühelt poolt eriarstiabi, teisalt jaoskonna pediaatritest perearstid.

There was no family physician system in the Soviet

is aging and new technologies and medicaments to

period. The Pärnu Hospital was the central hospital of the

improve the quality of life are increasingly offered,

county and all subunits – polyclinics, dispensaries, county

the health care expenditures in Estonia were very

hospitals were subordinated to the central hospital. After

modest. It was extremely important to adopt wise

Estonia regained independence, the ownership reform

decisions in such a situation.

was carried out. Institutions became independent based on the buildings, and the system did not proceed from the essence of the services. The idea of the reform was to create a two-level system – specialised medical services on the one hand and pediatricians as family physicians of different districts on the other hand.

38

REFORM

39


TWO SCENARIOS

Pärnu haigla ruumipuudus ja hoonete mittevastavus

Pärnu haigla ajalooraamatu uue peatüki avas Pärnu

kaasaja nõuetele olid endiselt lahenduseta.

volikogu otsus (15.06.1995) kinnitada tulevase

Kasutusesolevad hooned polnud perspektiivselt

haiglahoone asukohaks Ristiku tänava krunt. See

haiglana kasutatavad ja nõukogude ajal alustatud

otsus võimaldas uue haigla arenguvisiooniga

ravikompleksi ehitus oli päeva pealt seiskunud.

edasi minna. Nüüd tuli võtta suund, kas saada

Arutluse all oli kaks stsenaariumi – Sillutise tänava

regionaalse tähtsusega õpetavaks aktiivravi

juurdeehitus või Ristiku tänava poolelijäänud

haiglaks või orienteeruda peamiselt pikaravi- ja

ehitise jätkamine. Arengukava lähteülesande

hooldusteenustele. Lisaks tuli poliitiliselt otsustada

koostamisel tehtud esialgsed arvutused näitasid,

perearstisüsteemile üleminek ja olemasolevate

et Ristiku tänava hoone lõpuni ehitamine on

tervishoiuasutuste reformi kava.

odavam kui Sillutise tänava juurdeehituse rajamine. Juurdeehitus Sillutise tänavale oli küll tehniliselt teostatav, kuid polnud linnaruumiliselt ja tulevikuvajadusi arvestades mõistlik. Oli vaja otsust!

40

Radiologist Dr Saulius Daubaris and anaesthesiologist Dr Kairi Pakkonen in the old hospital building at Sillutise 6

KAKS STSENAARIUMI

?

REFORM Radioloog dr Saulius Daubaris ning anestesioloog dr Kairi Pakkonen vanas Sillutise 6 haiglahoones

REFORM

The lack of space in the Pärnu Hospital and incon-

The new chapter in the history of the Pärnu

formity of the buildings with modern requirements

Hospital was opened by the decision of the Pärnu

had still no solution. The buildings used had no

Town Council (15.06.1995) to allocate the land lot

prospects for use as hospital buildings, and the

in Ristiku Street as the site of the future hospital

construction of the inpatient clinic complex started

building. This decision made it possible to continue

during the Soviet period had stopped at only a day’s

with the new development vision of the hospital.

notice. Two scenarios were discussed – extension

Now it was necessary to choose the orientation –

in Sillutise Street or continuation of the stopped

whether to become a regional acute care teaching

construction in Ristiku Street. According to the

hospital or to provide mainly long-term care and

preliminary calculations made in preparing the

nursing services. Besides it was necessary to

terms of reference for the development plan, the

adopt political decisions on the transition to the

completion of the construction in Ristiku Street

system of family physicians and on the reform plan

would have cost less than the construction of an

concerning the existing healthcare institutions.

extension in Sillutise Street. While the construction of an extension to Sillutise Street was technically feasible, it was not reasonable considering the urban space and future requirements. A decision had to be made!

41


REFORM

REFORM

KAKS SAMMU KORRAGA

TWO STEPS AT A TIME

6. oktoobril 1995 võttis Pärnu Linnavalitsus

Reformi käigus liideti iseseisvad munitsipaal-

On 6 October 1995 the Pärnu Town Government led

The following independent municipal institutions

linnapea Väino Linde eestvedamisel vastu otsuse

asutused: Pärnu polikliinik, Pärnu lastepolikliinik,

by Mayor Väino Linde adopted the decision to start

were merged in the course of the reform: the

alustada Pärnus tervishoiureformi ning liita haigla

Pärnu haigla, Pärnu kopsuhaiguste kabinet ja

the healthcare reform in Pärnu and to merge the

Pärnu Polyclinic, the Pärnu Pediatric Polyclinic, the

ja polikliinik. Otsuse oluliseks ajendiks oli soov

Pärnu nahahaiguste haigla. Eriarstid lahutati Pärnu

hospital with the polyclinic. An important motivation

Pärnu Hospital, the Pärnu Office of Pulmonary

korrastada killustunud raviasutuste süsteemi ja

polikliinikust ja liideti munitsipaalse Pärnu haiglaga.

for the decision was the intention to regulate the

Diseases and the Pärnu Dermatology Hospital.

tugevdada tervishoiujuhtimist.

Allesjäänud jaoskonnad koos üldpediaatriliste

fragmented system of medical establishments and

Medical specialists were separated from the

jaoskondade arstidega moodustasid AS Pärnu

to strengthen healthcare management.

Pärnu Polyclinic and employed by the municipal

Tervishoiureformi algatamise otsus tehti Pärnus

Perearstikeskuse. Hiljem liideti haiglaga ka Pärnu

esimesena taasiseseisvunud Eestis.

kiirabi ja Pärnu veretalitus.

Pärnu Hospital. The remaining district physicians

Tervishoiureformi käigus jõuti tuliste debattidega

Pärnu was the first to adopt the decision to start

together with district physicians of general

the healthcare reform after Estonia had regained

pediatrics established the public limited company

independence.

Pärnu Perearstikeskus (Pärnu Centre of Family Physicians). Later also the Pärnu Ambulance

kokkuleppele teha kaks sammu korraga: kogu eriarstiabi liita Pärnu haiglaga ja luua iseseisev

In the course of the healthcare reform it was

perearstisüsteem. Sündis idee kahest iseseisvast

decided as a result of heated discussions to take

asutusest, kellel on selged ja teineteist toetavad

two steps at a time: to merge all specialised

rollid tulevases tervishoius.

medical care with the Pärnu Hospital and to create

Service and the Pärnu Blood Service were merged with the hospital.

an independent system of family physicians. It was a new idea of creating two independent institutions who would have clearly defined and mutually supporting roles in the future healthcare system.

43

42 Linnapea Väino Linde.

Mayor Väino Linde


REFORM

REFORM

PÄRNU HAIGLA ARENDAJA ROLLIS

PÄRNU HOSPITAL AS THE DEVELOPER

Tervishoiusüsteemi korraldamist ja uue mudeli

Üks väga oluline küsimus vajas veel otsustamist

Many issues related to the reorganisation of the

But another very important issue had to be decided

ülesehitamist puudutavad küsimused vajasid

ja seda kogu vabariigis. Määratlemata oli haiglate

healthcare system and building up the new system

on the national scale. The future legal form of busi-

selgeid vastuseid kõikides Eesti tõmbekeskustes.

tulevane õiguslik vorm. Pärnu haigla oli sel

needed clear answers in all centres of attraction in

ness activities of hospitals had to be defined. The

Seetõttu sai Pärnus läbiviidud reformist

hetkel ainulaadse staatusega: linnaasutus, millel

Estonia. That way the reform carried out in Pärnu

Pärnu Hospital had a unique status at the moment:

tõestusmaterjal, et mastaapsed muutused

oli oma põhikiri ja eelarve. Pärnu maavalitsus

demonstrated that large-scale changes in health-

a municipal institution with its own statutes and

tervishoius pole mitte ainult möödapääsmatud,

maavanem Toomas Kivimägi isikus ja linnavalitsus

care are not only unavoidable but also feasible in

budget. The Pärnu County Government represent-

vaid on ka reaalses elus läbiviidavad ja loovad head

saatsid 30. aprillil 1996 valitsusele ettepaneku

practice and will create good preconditions for

ed by the County Governor Toomas Kivimägi and

eeldused juhtimise tõhustamiseks.

määratleda haigla õiguslik vorm ja asutada ühiselt

raising management efficiency.

the Town Government submitted a proposal to the

Sihtasutus Pärnu Haigla. Ettepaneku elluviimine

Government on 30 April 1996 to define the busi-

Loogilise käiguna sai Pärnust ka esimene piirkond,

võttis väga pikalt aega ja seda ei õnnestunud

It was only logical that Pärnu became also the first

ness form of the hospital and to establish jointly

kus haigekassa ja haigla vahel loodi 1995. aastal

realiseerida koos riigiga, küll aga koostöös linnaga ja

region where functioning data communication

the Pärnu Hospital Foundation. Implementation of

pilootprojektina PHARE projekti raames toimiv

tervishoiumudelit tervikuna arendades.

between the Health Insurance Fund and the

that proposal took a very long time and it was not

Hospital was set up in 1995 in the framework

possible to achieve that with the participation of the

of a PHARE pilot project.

state but it was achieved in cooperation with the

andmesideühendus. Tänaseks annab Eesti tervishoiuteenuste korraldamise seadus haiglapidajatele võimaluse

Town Government and by developing further the

juriidiliselt tegutseda kas sihtasutuse või

entire healthcare model.

aktsiaseltsina. By now the Estonian Health Services Organisation Act allows hospital operators to conduct their activities in the legal form of a foundation or a Computed tomography

44

Kompuutertomograaf

public limited company.

45


REFORM SIHTASUTUSE ASUTAMINE

REFORM PÄRNU HAIGLAS OSUTATAVAD TERVISHOIUTEENUSED

ESTABLISHMENT OF THE FOUNDATION

HEALTHCARE SERVICES PROVIDED IN THE PÄRNU HOSPITAL

Siseerialad

Anestesioloogia-, operatiiv- ja intensiivravi

On 21 September 2000 the Pärnu Town Council

Internal Diseases

Anaesthesiology, Operative and Intensive Care

anestesioloogia- ja intensiivravi

adopted the unanimous decision to establish the

internal diseases

anaesthesiology and intensive care

21. septembril 2000 võttis Pärnu linnavolikogu ühehäälselt vastu otsuse asutada Sihtasutus Pärnu Haigla. Selle otsusega ühendati ka senised munitsipaalasutused Pärnu haigla ja Pärnu kiirabi. Loodi õiguslik baas valitsuse otsusega 30. mail 2000 heaks kiidetud haiglavõrgu arengukava realiseerimiseks Edela- ja Lääne-Eesti piirkonnas. 1. septembril 2003. aastal liideti Pärnu haiglaga munitsipaalasutus Pärnu veretalitus ja 2006. aastal Lihula kiirabi. Tänaseks on sihtasutus õigusliku vormina end kogu vabariigis tõestanud ja poliitiliselt korrektselt ning ettevaatavalt läbiviidud asutamisprotsess on loonud head eeldused haigla strateegiliseks juhtimiseks ja toimiva juhtimissüsteemi ülesehitamiseks.

sisehaigused

kardioloogia

erakorraline meditsiin

Pärnu Hospital Foundation. With this decision

cardiology

emergency medicine

neuroloogia

kiirabiteenused

also the municipal institutions Pärnu Hospital and

neurology

ambulance services

the Pärnu Ambulance Service were merged. This

infectious diseases

Psühhiaatria

laid the legal basis for the implementation of the

dermato-venereology

Psychiatry

infektsioonhaigused

dermatoveneroloogia

taastusravi, spordimeditsiin ja füsiaatria

üldpsühhiaatria

Development Plan for the Network of Hospitals

rehabilitation, sports medicine and physiatry

general psychiatry

geriaatria ja rehabilitatsioon

akuutravi

of Southeast and West Estonia that had been

gerontology and geriatric assessment

acute care

ebastabiilse remissiooniga haigete ravi

approved with the Decision of the Government on

rheumatology

treatment of patients with unstable remissions

30 May 2000. On 1 September 2003 the municipal

pulmonology

reumatoloogia

pulmonoloogia

nefroloogia

Diagnostika

institution Pärnu Blood Service and in 2006 the

nephrology

Diagnostics

hematoloogia

laboriteenused

Lihula Ambulance Service were merged with the

haematology

laboratory services

Pärnu Hospital.

endocrinology

pathology

gastroenterology

radiology

By now, foundation as a form of business activities

pediatrics

Õendusteenused

has proven itself in Estonia as a whole, and the

occupational health care

hooldusravi

politically correct conduction of the establishment

nursing care

koduõendus

process with appropriate foresight has created

Surgical Diseases

home nursing

hoolekanne

good preconditions for the strategic management

general surgery

welfare

of the hospital and building up a functioning

urology

management system.

orthopaedics

otorhinolaryngology

endokrinoloogia

patoloogia

gastroenteroloogia

radioloogia

pediaatria

töötervishoid

Sihtasutus ja aktsiaselts on nagu vorst ja sült, mõlemad on maitsvad, kuid temperatuuri tõustes vorst säilitab oma vormi, sült mitte.

Kirurgilised erialad •

üldkirurgia

uroloogia

ortopeedia

otorinolarüngoloogia

oftalmoloogia

A foundation and a public limited company are

ophthalmology

sünnitusabi ja günekoloogia

like sausage and meat jelly, both are delicious

obstetrics and gynaecology

Veretalitus

Nursing Services

Blood Service

but with an increase in temperature sausage will retain its form unlike meat jelly.

46

47


REFORM

REFORM

JUHTIMINE JA KVALITEET

MANAGEMENT AND QUALITY

Pärnu haigla alustas juhtimiskvaliteedi parandamist

juhatuse liige. Õendus-hoolduspersonali tööd

The Pärnu Hospital started systematic enhance-

Board coordinates the activities in the facilities

süsteemselt 2001. aasta kevadel, mil viidi läbi

koordineerib juhatuse otsealluvuses õendusjuht.

ment of its quality of management in spring 2001

management and IT area. The work of the nursing

juhtimissüsteemi analüüs ja koostati juhtimis-

Lisaks tegeleb juhatuse otsealluvuses

when the analysis of the management system was

and nursing assistant staff is coordinated by the

süsteemi arendamise projekt. Põhiliseks lähene-

kvaliteedijuhtimisega kvaliteediteenistus.

performed and a project for the development of

Head of the Nursing Service directly subordinated

misviisiks valiti lähtumine tervikliku kvaliteedijuhtimise põhimõttest (ETQM).

the management system was prepared. The main

to the Executive Board. Besides, the Quality Ser-

Pärnu haigla tegevus jaotati struktuurselt

approach selected was to proceed from the total

vice directly subordinated to the Executive Board is

järgnevalt: Kliinikud: sisehaiguste kliinik, naiste- ja

quality management (ETQM) principle.

responsible for quality management.

lastekliinik, kirurgiakliinik, psühhiaatriakliinik.

kvaliteedi parendamise süsteemist, mille eesmärk

Meditsiinilised teenistused: anestesioloogia-,

Management policy is a part of the system for the

The activities of the Pärnu Hospital were

on paremate ravitulemuste saamine. Pärnu haigla

operatiiv- ja intensiivraviteenistus, erakorralise

enhancement of the quality of healthcare services

organised according to the following structure:

on sõnastanud tervisele ja elukvaliteedile orien-

meditsiiniabi teenistus, diagnostikateenistus,

in order to achieve a higher performance in therapy.

Clinics: Clinic of Internal Diseases, Women’s and

teerituse haigla missioonina ja oma tunnuslauses.

radioloogiateenistus, apteek. Tugiteenistused:

The Pärnu Hospital has included orientation to

Children’s Clinic, Surgery Clinic, Psychiatry Clinic.

Normiks on teenuste kvaliteet ja patsiendikesksus.

kantselei, informaatikateenistus, ökonoomika

health and quality of life in the mission and slogan

Medical services: Anaesthesiology, Operative

of the hospital. High-quality and patient-centred

and Intensive Care Service, Emergency Medical

services are the standard.

Service, Diagnostics Service, Radiology Service,

Sihtasutuse loomisega muutus haigla

meditsiinitehnoloogia teenistus.

juhtimismudel. Üldjuhtimise, finantsjuhtimise ja arendustegevuste koordineerimisega tegeleb

Sihtasutuse Pärnu Haigla asutamisega viidi lõpule

juhatuse esimees, ravi-, õppe- ja teadustööd

Pärnumaal 1994. aastast käivitunud ja pingsalt

koordineerib juhatuse liige, kes on ka ravijuht,

kulgenud tervishoiukorralduse reform.

Ravijuht dr Veiko Vahula

ja raamatupidamise teenistus, haldusteenistus,

Medical Director Dr Veiko Vahula

Juhtimise poliitika on osa tervishoiuteenuste

haldus- ja IT valdkonda koordineerib kolmas

With the creation of the foundation, the manage-

IT Service, Financial and Accounting Service,

ment model of the hospital changed. The Chairman

Facilities Management Service, Medical Technology

of the Executive Board is responsible for general

Service.

management, financial management and coordiJuhtida saab inimesi, aega ja kulusid, leppides

People, time and costs can be managed by agreeing

selleks kokku standardid. Olulisim on juhtida inimesi.

on the respective standards. Management of people is

Kvalifitseeritud inimesed on kõige piiratum ressurss.

most important. Qualified people are the most limited

Juhtimise eesmärk on, et inimesed teeksid enda jaoks

resource. The goal of management is to have people do

kõige õigemat tööd õigetes suhetes teistega.

the most appropriate work for themselves and in right relationships with others.

48

Pharmacy. Support Services: Administrative Office,

nation of development activities, a Member of the

The healthcare system reform which had started in

Executive Board who is also the Medical Direc-

Pärnumaa in 1994 and had brought about a lot of

tor coordinates medicine, training and research

tension was completed with the establishment of

activities, and the third Member of the Executive

the Pärnu Hospital Foundation.

49


e n o o h a l g i a Uus h g n i d l i u b l a t i p s o h New


UUS HOONE

NEW BUILDING

Pikk

TULEVIKUHAIGLA KAVANDAMINE

PLANNING OF THE FUTURE HOSPITAL

1992–1995: Pärnu haigla arengukava ja uuele

Eesti taasiseseisvumise järel üritati 1992.

hoonele asukoha otsimine

aastal poolelijäänud haiglahoone ehitust veel kord käivitada, kuid edutult. Selgunud on, et

Järgmine hüpe tervishoiukorralduses oli võimalik

nõukogude ajal planeeritud haiglahoone ei oleks

alles uue haiglahoone valmimisel. 2001. aastast

sobinud iseseisva Eesti tervishoiukorralduse ja

käivitus ka maakondliku järel- ja hooldusravi

võimalustega.

problemaatika arutelu koostöös maakonna kolme väikehaiglaga.

1994. aastal töötati sotsiaalminister Marju Lauristini toetusel Maailmapanga Eesti tervishoiuprojekti

Koos kõikide abiteenistustega haldas Pärnu haigla

raames välja Pärnu haigla esimene arengukava,

kokku üle 10 hoone, mis ei olnud algupäraselt

mis oli arvatavasti esimene haigla arengukava

ehitatud ravihooneteks ega vastanud tänapäeva

Eestis üldse. Valmis ka Sillutise 6 juurdeehituse

raviasutuse nõuetele. Ruumipuudusel ei olnud

eskiisprojekt. Selle valmimine oli arstkonna ja

võimalik kasutusele võtta kaasaegseid ravi-

pärnakate soov sel ajal.Pärnu linnavolikogus see

diagnostilisi vahendeid, kehvas seisus olid

plaan toetust ei leidnud ning otsustati ehitada

olmeruumid. 1985. aastal projekteeritud ning 1988.

uus haiglahoone sinna, kuhu algselt planeeritud

aastal ehitusega alustatud uue haiglahoone ehitus

– Ristiku 1. Sillutise 6 territooriumile ei oleks

Ristiku 1 lõppes Nõukogude Liidu lagunemisel.

kaasaegne haigla ära mahtunud ja logistiliselt oleks

Poli (Suur kliinik - Se pa 16) bi e ka t s u 3) aig suh (Roosi p o K

Is

ne t

Ka

t ta

si

a on

a

Si r(

Ri

ll

ia

rja

is ut

m

e

6)

III statsionaar (Sääs

e 3)

. Ta

mm

saa

re p

st

ka personali transpordivajaduse osakondade vahel ning kallihinnaliste kõrgtehnoloogiliste seadmete

Paralleelselt valmis Pärnu Maavalituses Pärnu

dubleerimise.

maakonna tervishoiuvõrgu arengukava, mis

II

ion s tat s

2) R av i aar (

The next leap in the reorganisation of the health

any success. And it was good as the hospital

care system was possible only with the completion

building planned for the Soviet healthcare system

of the new hospital building. In 2001 also the

certainly would not have been appropriate for

discussions of the problems related to rehabilitation

the new healthcare system that was created for

and nursing care in the county started in

independent Estonia or for the resources available

cooperation with the three small hospitals located

for Estonia.

The Pärnu Hospital together with all of its support

for the Pärnu Hospital with the support of the

services managed in total more than 10 buildings

Minister of Social Affairs Marju Lauristin in the

which had not initially been built for medical

framework of the Estonian Healthcare Project of

purposes and did not meet the needs of a modern

the World Bank and this was probably the very first

medical establishment. Due to the lack of space

development plan of a hospital in Estonia. Even the

it was not possible to take into use up-to-date

preliminary design of the extension to the so-called

therapeutic and diagnostic equipment, and also the

old hospital (Sillutise 6) was prepared. It was the

staff rooms were in a poor condition. Construction

intention of the medical staff and presumably the

of the new hospital building which had been

Pärnu people at that time – to build an extension to

designed in 1985 had started in 1988 at Ristiku 1

the old hospital. This plan did not, however, achieve

but stopped with the disintegration of the Soviet

the support of the Pärnu Town Council and it was

Union.

definitely decided to build the new hospital building at the initially planned site – Ristiku 1. A modern

toetas Pärnus ja Pärnumaal järgnevatel aastatel tervishoiureformi läbiviimist. Ka sellega oli Pärnumaa taas Eestis esimene. Haigla ehitus on struktuuri valamine betooni.

Construction of a hospital is like casting of its structure into concrete.

52

attempted to resume in 1992 the construction of

In 1994 the first development plan was prepared

Kiirabi (Kanali 10)

juurdepääsudega.

1995 and finding the site for the new building

within the county.

nt

peagi tekkinud lahendamatud probleemid haiglale Haigla asumine eri korpustes tingis nii haigete kui

After Estonia regained independence it was the hospital building that had stopped but without

s Veretalitu ) 1 a (mets A. H

Strategy Plan of the Pärnu Hospital for 1992–

Due to the location of the hospital in different

hospital would not have enough space in the

buildings it was necessary to transport both

territory of Sillutise 6 and logistics problems would

patients and the staff between different

have arisen soon with accesses to the hospital.

departments and have expensive high-technology equipment at different places.

53


1995–1996: Pärnu haigla uue hoone ehitamiseks

2003: Pärnu haigla uue hoone finantseerimis-

Looking for the source of financing for the

Decision on the financing of the new building of

rahapaja otsimine. Mine sinna. Ei tea, kuhu? Tee

otsus. 2003–2004: Pärnu haigla uue hoone

construction of the new building of the Pärnu

the Pärnu Hospital in 2003. Construction works

seda. Ei tea, mida?

ehitustööd

Hospital in 1995–1996 Go there. I don’t know

of the new building of the Pärnu Hospital in

where? Do that. I don’t know what?

2003–2004

In cooperation with the Kingdom of Denmark and

Construction of the hospital building was resumed in

the Holsterbro Hospital the new functional plan

October 2003, and on 15 November 2004 the repre-

was prepared in 1996 for the unfinished building

sentatives of the FKSM construction company, Riigi

at Ristiku 1. 10 million kroons were allocated from

Kinnisvara AS and Pärnu Hospital Foundation signed

the Estonian state budget for the construction of

with the respective ceremony the Delivery and Ac-

the Pärnu Hospital – this made it possible to start

ceptance Report for the building.

Koostöös Taani Kuningriigi ja Holsterbro haiglaga

Haiglahoone ehitus taaskäivitus 2003. aasta oktoobris

koostati 1996. aastal poolelijäänud hoonele Ristiku

ning 2004. aasta 15. novembril kirjutasid ehitusfirma

1 uus funktsionaalplaneering. Eesti riigieelarvest

FKSM, Riigi Kinnisvara AS ja SA Pärnu Haigla esindajad

eraldati 10 miljonit krooni Pärnu haigla ehituseks,

pidulikult alla hoone üleandmis-vastuvõtmisaktile.

mis võimaldas hakata sulgema hoonekarpi, teha püsivusuuringuid ning projekteerida maja ringi

Üks keerulisemaid asju kogu ehituse juures oli

vastavalt praegustele nõudmistele. Nõukogude

ehituse rahastamise skeem. Eesti tervishoiuvõrgu

ajal planeeritud hoonest võeti kasutusele ainult

investeeringute koguvajaduseks olid eksperdid

240-kohaliseks planeeritud kirurgiakorpus, millest

hinnanud ca 5 miljardit krooni, mille leidmiseks

tänapäeval on kasutusel 27 058 m2. Haiglahoonet

tuli poliitikutel leida jätkusuutlik lahendus kõigile

hakati taas ehitama 1997. aastal.

Eesti raviasutustele. Erinevad valitsuskabinetid jäid arutelude käigus pidama nn. public private partnership

1999. aastal ehitus peatus, sest oodati riikliku

(PPP) mudelile, mille rakendamiseks tuli muu

arengukava valmimist. Valitsuse otsusega 30.

hulgas tuua ravikindlustusseadusesse sisse haiglate

maist 2000 kiideti heaks haiglavõrgu arengukaval

kapitalikulude mõiste ja nende eest tasumise kord.

baseeruv “Eesti tervishoiuprojekt 2015”, mille

See tähendab, et tervishoiuteenuste hinnad, mille

kohaselt Pärnu haigla on Edela-Eesti olulisim

eest tasub haigekassa, hakkasid sisaldama ka haiglate

raviasutus, mille teeninduspiirkonnas elab üle 100

kapitalikulusid. Pärnu haigla oligi Eesti esimene selline

000 inimese.

suurprojekt, kus Sihtasutusele Pärnu Haigla kuulunud haiglahoone võõrandati riigi äriühingule Riigi Kinnisvara Aktsiaselts (RKAS), riik omanikuna laiendas viimase aktsiakapitali ehituseks mineva raha võrra, RKAS ehitas valmis haiglahoone ja rentis selle välja Sihtasutusele Pärnu Haigla, mis omakorda hakkas tasuma RKAS-le renti, milleks vajaminevad vahendid on haigekassa poolt tasustatavate teenuste hindade sisse arvestatud.

54

Administrative Director Karl Kukk and Development Project Manager Jan Põlluste at the construction site of the new building

NEW BUILDING Juhatuse liige haldusalal Karl Kukk ning arenduse projektijuht Jan Põlluste uue korpuse ehitusel

UUS HOONE

the completion of the external walls of the building, make stability surveys and redesign the building

One of the most complicated things with the construc-

according to current requirements. Only the

tion was the financing scheme of the construction.

surgery block planned for 240 beds was eventually

According to the expert assessment the total invest-

taken into use from the building planned during the

ment requirement of the Estonian healthcare system

Soviet period; 27,058 m of it is currently used. The

was ca 5 billion kroons, with which politicians had to

construction of the hospital building was resumed

achieve sustainable solutions for all Estonian health

in 1997.

care institutions. Successive governments finally

2

started to prefer the public private partnership (PPP) In 1999 the construction was suspended to await

model as a result of discussions, which among other

the completion of the National Development Plan.

things required the inclusion of the concept of capital

Estonian Healthcare Project 2015 based on the

expenditures of hospitals and the procedure of cover-

Development Plan of the Hospital Network was

ing them in the Health Insurance Act. This means that

approved with the Decision of the Government

also capital costs were included in prices of healthcare

of 30 May 2000 and according to that project the

services paid by the Health Insurance Fund.

Pärnu Hospital is the most important medical establishment in Southeast Estonia with the population of more than 100,000 in its service area.

55


Võitlus haiglahoone ehitamise eest käis väga pikalt.

2004. aastal vaja veel ainult poliitilist otsust

Ehituskonkurssi tehes võttis haigla päris suuri riske.

rahastamisskeemi rakendamiseks, mille järel

Haiglal oli küll rahandusministri ühiste kavatsuste

korrigeeriti ja kooskõlastati (vahepeal rakendunud

dokument, et uus Pärnu haiglahoone on vajalik, kuid

uute) õigusaktide kohaselt veel kord haigla

raha ehituse finantseerimiseks ei olnud. Lõpuks leiti

arengukava ja ehitusprojekti meditsiinitehnoloogia

unikaalne lahendus, kus Riigi Kinnisvara AS ehitas

osa, seati sisse konstruktiivsed lepingulised

maja ning haigla sai üürnikuks.

partnerlussuhted SA Pärnu Haigla ning RKAS-i vahel. Uus hoone valmis ennetähtaegselt juba 1.

Praegu on haiglahoone omanik Sihtasutus Pärnu

novembriks 2004.

Haigla. See annab paindliku võimaluse hoonet vastavalt vajadustele ümber ehitada.

Tõsiseks katsumuseks oli haiglahoone sisustamine. 2005. aasta jooksul viidi läbi üle 50 riigihanke, kus enamasti osales 3–6 pakkujat. Psüühiline pinge ja surve sel perioodil olid tohutud, tempo enneolematu, kõik ehituse ja sisustamisega seotu toimus põhitööd katkestamata – tervishoiuteenuste osutamine jätkus samas mahus nagu tavaliselt. Lisaks ei olnud põhilise osa riigihangete läbiviimise ajal 2005. aastal veel selge hangete rahastamine Euroopa Liidu struktuurifondide vahendite arvelt, milleks esitati taotlus sotsiaalministeeriumile juba 2004. aasta lõpus.

56

Head of the Anaesthesiology, Operative and Intensive Care Service Dr Raido Paasma, Project Manager for relocation to the new building

Peale rahastamisvõimaluste selgumist oli

Anestesioloogia-, operatiiv- ja intensiivravi teenistuse juhataja dr Raido Paasma, uude majja kolimise projektijuht

UUS HOONE

NEW BUILDING The Pärnu Hospital was the first such major

enormous mental stress and tension during that

project with which the hospital building owned

period, everything proceeded at unprecedented

by the Pärnu Hospital Foundation was transferred

pace and the construction and furnishing activities

to the ownership of the state-owned real estate

could not interrupt the daily operation – provision

management company Riigi Kinnisvara Aktsiaselts

of healthcare services continued in the same

(RKAS), the state as the owner increased the share

volume as usual. Besides, at the time of conducting

capital of the latter by the amount required for the

most public procurement procedures in 2005 the

construction, RKAS completed the construction of

financing from the EU Structural Funds was not

the hospital building and rented it out to the Pärnu

yet certain, although the respective application had

Hospital Foundation which started to pay rent to

been submitted to the Ministry of Social Affairs

RKAS from funds included in the price of services

already at the end of 2004.

paid by the Health Insurance Fund. The fight for the construction of the hospital After decisions on the financing possibilities it

building took very long. The hospital took

was necessary in 2004 to adopt only the political

considerable risks in declaring the call for tenders

decision on the implementation of the financing

for the construction. While the hospital had a

scheme, after which the Development Plan of

Memorandum of Understanding signed by the

the hospital and the medical technology part

Minister of Finance on the necessity of the Pärnu

of the construction design were updated and

Hospital building, there were no funds for the

coordinated again according to the new legislation

financing of the construction. Finally a unique

(adopted meanwhile), and constructive contractual

solution was found to have Riigi Kinnisvara AS

partnership relations were established between

complete the construction and rent it out to the

the Pärnu Hospital Foundation and RKAS. The new

hospital.

building was completed ahead of time already by 1 November 2004.

The current owner of the hospital building is the Pärnu Hospital Foundation. This provides flexibility

Furnishing of the hospital building was a real

for the reconstruction of the building if necessary.

challenge. More than 50 public procurement procedures were carried out in 2005 with mostly 3–6 tenderers in each. The management was under

57


ne kohvik

R

aiglahoo istiku tn h

– Cafeteria

o

ilding

ospital bu

Street h f the Ristiku


Naiste- ja lastekliiniku juhataja dr Kadri-Liina Vahula Head of the Women’s and Children’s Clinic Dr Kadri-Liina Vahula

President Arnold Rüütli visiit Pärnu haiglasse, 25. aprill 2006 Visit of President Arnold Rüütel to the Pärnu Hospital on 25 April 2006

Ämmaemand Jelena Laanemets Midwife Jelena Laanemets


UUS HOONE

NEW BUILDING

PÄRNU HAIGLA UUES MAJAS AASTAST 2005

THE PÄRNU HOSPITAL IN THE NEW BUILDING FROM 2005

Oskus tervist hoida ja taastada, leida uusi

Ristiku tänava haiglahoone kasutuselevõtmisega

The know-how of maintaining and restoring

With the taking into use of the hospital building in

lahendusi ja neid finantseerida…

alustasid seni kümnes hoones töötanud erineva

health, finding new solutions and financing

Ristiku Street, people with different work culture

töökultuuri ja oskustega inimesed tööd päevapealt

them…

and skills who had worked in ten different buildings

Pärnu haigla kolis Ristiku tänava hoonesse 2005.

üheskoos ja ühes majas. Kohanemist nõudis nii

aasta veebruaris. Funktsioneeriva haigla kolimine

majas orienteerumine kui ka uue tehnoloogia

The Pärnu Hospital moved to the building in Ristiku

started to work together and in the same building overnight. Both finding one’s way in the new

oli planeeritud nädalale, kuid see õnnestus läbi viia

tundmaõppimine. Uus hoone seadis uued

Street in February 2005. It was planned to move

building and becoming familiar with new technol-

1,5 päevaga, katkestamata patsientide meditsiinilist

tingimused suhetele organisatsiooni sees ja

the functioning hospital in the course of a week but

ogy required some adjustment. The new building

teenindamist. Uskumatuna tundub tagasi vaadates

teenuste osutamisel. Kohanemist nõudsid

it was succeeded in 1.5 days without interruptions

set new requirements to relationships within the

fakt, et kolimise ajal ei olnud kahe päeva jooksul

uus asukoht, uus logistika, uute kolleegide

in the provision of medical services to patients.

organisation and to the provision of services. They

ühtegi sünnitust, uues majas aga oli neid esimesel

tundmaõppimine ning nendega koostöö, uus

It seems unbelievable when looking back to that

had to adjust themselves also to the new location,

päeval 11!

struktuur ja muutunud tööülesanded. See oli ühtlasi

time that there were no births during the two days

new logistics, getting to know new colleagues and

digiajastu võit Pärnu Haiglas.

of moving but 11 births on the first day in the new

having cooperation with them, new structure and

building!

changed duties. This was also the victory of the

Selline kolimine on Eestis pretsedenditu,

liikmeid töökangelasteks.” – dr Urmas Sule

teadaolevalt ei ole ükski teine haigla tervikuna kolinud oma tegevust katkestamata. Haigla uusehitus avati 8. aprillil 2005. aastal.

Ristiku tn 1 haiglahoone peakorpus

ja kohanemisega uues majas ning pean kollektiivi

Main building of the Ristiku 1 hospital

“Hindan haigla kollektiivi saavutusi seoses kolimise

Kui maja ehitamine oli väikese hulga inimeste teene, siis

While the construction of the building was an effort

maja kasutuselevõtt oli kollegiaalne saavutus. Juhtiv ja

of a small number of people, its taking into use was a

koordineeriv tegevus ei olnud nii olulised kui inimeste

collective achievement. Administrative and coordinating

võime ise lahendusi leida.

activities were less important than the ability of people to find solutions themselves.

62

digital era in the Pärnu Hospital. “I appreciate the achievements of the hospital staff in connection with the moving and adjustment to

Such relocation was unprecedented in Estonia, no

the building and I see the staff members as real

other hospital is known to have moved as a whole

work heroes.” – Dr Urmas Sule

without interrupting its activities. The new building of the hospital was opened on 8 April 2005.

63


UUS HOONE

NEW BUILDING

MEDITSIINITEHNOLOOGIA UUENDAMINE

ACQUISITION OF NEW MEDICAL TECHNOLOGY

Meditsiinitehnoloogia suurem uuendamine toimus Ristiku tänava hoone kasutuselevõtt oli

The most important updating of the medical

seoses haigla uue hoone valmimisega.

kvaliteedihüpe, mis tõi iga palati juurde olmeruumid ja täiesti uudsed tehnilised lahendused.

Taking into use the building in Ristiku Street

technology was carried out with the completion of

was a leap in quality which brought hygiene

the new building.

rooms for each ward and completely innovative

• Täiesti uue sisu ja tehnoloogia said

Kui eelmine maja oli jalgratas, siis uus maja

operatsiooniblokk 5 operatsioonitoaga ja

technical solutions. If the previous building was

tähendas hüpet vormelautosse.

intensiivraviosakond 10 voodikohaga ning

a bicycle, the new building meant a jump into a

the Intensive Care Department with 10 beds

kesksterilisatsiooni plokk.

Formula 1 car.

and the Central Sterilisation Block acquired

Aastal 2005 valminud SA Pärnu Haigla uus hoone

• Loodi uus struktuuriüksus – erakorralise

• The Surgery Block with 5 operating room and

completely new furnishing and technology.

aitas kaasa personali motiveerituse tõusule – uues

meditsiiniabi osakond, mis liitis seni eri majades

The new building of the Pärnu Hospital which

hoones on kaasaegsem ja parem töökeskkond.

tegutsenud vastuvõtuosakonnad ja traumapunkti

was completed in 2005 helped to improve the

Medical Department which now included the

Uude majja kolimine kiirendas ja lihtsustas

ning on võimeline teenindama patsiente ka

motivation of the staff – with the more modern

earlier admission departments of different

informatsiooni edastamist ja koostööd. Mõningaid

suurõnnetuste ajal.

and better work environment of the new

buildings and the first-aid station and is able to

building. Moving into the new building made the

provide services to patients also during major

communication of information and cooperation

disasters.

uude majja kolimisega ka patsiendikesksemaks ja kvaliteetsemat teenust pakkuvaks. Haigla on varustatud meditsiinitehnoloogia seadmetega vastavalt nõuetele ja pakub kõiki õigusaktides ettenähtud tervishoiuteenuseid.

• Käivitati päevaravi ja päevakirurgia osakond koos ambulatoorse operatsioonitoaga. instrumentide pesu- ja sterilisatsiooniseadmed

used more economically and efficiently. With the

ning uus desinfektsioonitehnoloogia.

moving into the new building the Pärnu Hospital certainly became also more patient-centred and

• Statsionaarsetes osakondades loodi intensiivravi

• Outpatient care and Outpatient Surgery Department started operation together with an outpatient operating room. • The departments took into use new instrument

ja kohapealse isolatsiooni võimalused,

could provide services at higher quality. The hospital

washing and sterilisation equipment and the

kasutusele võeti kaasaegsed patsientide

is equipped with medical technology according

new disinfection technology.

monitoorimise, videovalve ja õekutsungi süsteemid.

64

faster and easier. Certain resources could now be

• Osakondades võeti kasutusele uued

Visit to the Intensive Care Ward

efektiivsemalt. Kindlasti muutus Pärnu haigla

Visiit intensiivravipalatisse

ressursse sai hakata kasutama säästlikumalt ja

• A new subunit was created – Emergency

to the requirements and provides all healthcare services required by legislative acts.

• Inpatient departments acquired possibilities for intensive care and local isolation and could now use modern systems for the monitoring of patients, video surveillance and nurse calls.

65


UUS HOONE

NEW BUILDING

• Nakkusosakond sai erilahendusega

• The Department of Infectious Diseases

ventilatsiooni- ja kanalisatsioonisüsteemi. • Laienesid peresünnituse võimalused,

• Täielikult uuendati labori seadmeid ja sisustust, integreeriti see haigla

acquired a specially designed ventilation and

were completely updated, it was integrated to

infosüsteemiga ning tänaseks on jõutud

sewage system.

the information system of the hospital and by

sünnitustubade arv suurenes neljani,

suures osas täisautomaatsete analüsaatorite

sünnitusabis lisandus vannisünnituse

kasutuselevõtuni.

võimalus, alustati loote STAN-monitooringut sünnitusabis, loote vere pH ja happe-leelis tasakaalu määramist ning 3D ultraheli uuringuid sünnitusabis. • Radioloogias mindi üle digitaalsele pilditekitamisele, -töötlemisele ja -salvestamisele, liituti üleriigilise piltdiagnostika arhiveerimise süsteemiga (PAKS), mis võimaldab uuringute tulemusi konsulteerida interneti vahendusel teiste raviasutuste

• The equipment and furnishings of the laboratory

• Opportunities for family births were expanded, the number of delivery rooms increased to

now largely fully automatic analysers are used. • The laboratory of the hospital includes its own

four, the opportunity for deliveries in a bath was

laboratory of microbiology for both clinical

mikrobioloogia labor nii kliiniliseks diagnostikaks

added, foetal STAN-monitoring was started

diagnostics and internal control of infectious

kui ka nakkustõrje sisekontrolliks.

in obstetrics, foetal blood pH and acid/alkali

• Haigla labori koosseisus loodi oma

balance tests and 3D ultrasound examinations

• Uue ruumilahenduse ja varustuse sai

in obstetrics.

endoskoopiaüksus, võimalik on ka

• In radiology the transition to digital imaging,

endoskoopiliste uuringute tulemuste

image processing and storage was performed

sisestamine üleriigilisse PAKS-i.

with access to the national diagnostic images

• Funktsionaaldiagnostika integreeriti täielikult

archiving system (PAKS) which makes it

ühtsesse infosüsteemi.

possible to consult specialists of other medical

• Ehhokardiograafia hakkas töötama ühtse

diseases. • The Endoscopy Unit acquired a new layout of rooms and equipment and it is also possible to enter the results of endoscopic examinations in the national PAKS. • Functional diagnostics was fully integrated with the common information system. • Echocardiography was included in the common

spetsialistidega ning samuti diagnostikute

infosüsteemina, tagati integratsioon üleriigilise

establishments by displaying examination

information system, its integration with

kaugtööd väljaspool haiglat.

PAKS-iga, soetati täiendavad paiksed ja

results over the internet and also allows the

the national PAKS was ensured, additional

portatiivsed ehhokardiograafid ning alustati

diagnostic team to perform remote work

stationary and portative echocardiographs were

söögitorukaudse ehhokardiograafiaga (TEE).

outside the hospital.

acquired and transesophageal echocardiography

• Neuroloogiliste haiguste diagnostikas võeti

(TEE) was taken into use.

koostöös teiste haiglate spetsialistidega

electroencephalography and electromyography

elektromüograafia.

were taken into use in cooperation with Laboratory of Microbiology

kasutusse elektroentsefalograafia ja

Mikrobioloogia labor

66

• In the diagnostics of neurological diseases,

specialists of other hospitals.

67


• Koostöös Põhja-Eesti Regionaalhaigla juhtivate

on ülioluline, et uus kaasaegne hoone võimaldab

spetsialistidega alustati südame tehisrütmurite

olla pidevas arengulises muutumises ning võtta

(pacemaker’ite) paigaldamist Pärnus. Esimese

kasutusele üha uusi meditsiinitehnoloogiaid ja

pacemaker’i paigaldas Pärnus dr Jüri Voitk

-teenuseid.

25. septembril 2008. • Operatsiooniplokki ehitati esimesena Eestis 2012.

Nii on pärast haigla uue hoone kasutuselevõttu

aastal juurde nn hübriidoperatisoonituba ning

jätkunud pidev areng ka haigla ruumiprogrammis ja

sisustati see esimese angiograafiaseadmega

tehnoloogiates.

Pärnumaal, mis võimaldab angiograafiat teostada ka operatsioonitoa tingimustes.

• 2006–2007 kaasajastati endoskoopiaosakonna

• See omakorda on loonud võimaluse alustada

ruumide jaotust, viidi sisse hulk

koostöös regionaalhaiglate juhtivate spetsialistidega

töökorralduslikke muudatusi ning võeti

plaanilisi invasiivkardioloogilisi südameprotseduure

kasutusele innovaatilisi lahendusi patsientide

(südame sondeerimine ja südamesoonte

uurimiseks ja infektsiooni leviku vältimiseks,

laiendamine). Esimese koronaarinterventsiooni

soetati uute uurimisvõimalustega

Pärnus teostas 17. oktoobril 2012 professor Jaan

videoprotsessor koos valgusallika ja kahe

Eha.

uue endoskoobiga ning uus endoskoopide

• Alustatud on perifeerse angiograafia protseduure.

pesumasin.

• Oluliselt arendati laparaskoopia seadmeparki, alustati laparaskoopiliselt assisteeritud vaginaalse

Professor Jaan Eha teeb Pärnu haiglas esimest koronaarinterventsiooni. Assisteerivad kardioloog dr Kaarel Puusepp ja õde Piret Tuuling

Ükski haigla ei saa kunagi lõpuni valmis. Seetõttu

NEW BUILDING Professor Jaan Eha performing the first coronary intervention in the Pärnu Hospital. Cardiologist Dr Kaarel Puusepp and nurse Piret Tuuling assisting.

UUS HOONE

hüsterektoomia (LAVH), laparaskoopilise

In cooperation with the leading specialists of the

it is extremely important that the modern building

North Estonia Medical Centre the implantation

makes it possible to have constant development

of pacemakers was started in Pärnu. The first

and make new changes and take into use new

pacemaker was implanted in Pärnu by Dr Jüri Voitk

medical technologies and services.

on 25 September 2008. •

The so-called hybrid operating room was built for

Also after the new building was taken into use,

the Surgery Block in 2012 as the first in Estonia

the allotment of space and the technologies of the

and it was supplied with the first angiography

hospital have been constantly developed further.

equipment in Pärnumaa, which makes it possible to perform angiography also in the conditions of an

operating room.

In 2006–2007 the allotment of space in the Endoscopy Department was modernised, a

This in its turn has made it possible to start

number of changes in the organisation of work

performing planned invasive cardiac procedures

were made and innovative solutions were

(coronary angiography and coronary balloon

taken into use for the examination of patients

angioplasty) in cooperation with the leading

and prevention of the spread of infections,

specialists of regional hospitals. The first coronary

a video processor with new examination

intervention in Pärnu was performed on 17 October 2012 by Professor Jaan Eha.

functions was acquired together with lighting and two new endoscopes, and a new

Performance of peripheral angiography procedures has been started.

endoscope washing machine. •

The choice of laparoscopic equipment available

hüsterektoomia (LH), laparaskoopiliselt

Olulised uuendused on ka:

Other important innovations are:

was considerably developed, and laparoscopically

assisteeritud supratservikaalse hüsterektoomia

• Uued tupe plastilised operatsioonid

• New vaginal plastic surgeries with mesh materials in

assisted vaginal hysterectomy (LAVH),

(LASH) ja bariaatrilise kirurgiaga Pärnus.

võrgumaterjalidega urogünekoloogias.

urogynaecology.

laparoscopic hysterectomy (LH), laparoscopically

• Staplerite laialdane kasutamine kirurgias.

• Widespread use of staplers in surgery.

assisted supracervical hysterectomy (LASH) and

• Apteek, steriilsed ravimid ja tsütostaatikumid.

• Pharmacy, sterile medicaments and cytostatics.

bariatric surgeries were started in Pärnu.

• Magnetresonantstomograaf.

• Magnetic resonance tomography.

• Naha- ja suguhaiguste laserravi ja päevakirurgia.

• Laser therapy and outpatient surgery of dermatological and venereal diseases.

68

No hospital will ever be quite complete. Therefore

69


UUS HOONE

NEW BUILDING

Lisaks toimub kaasaegsete meditsiiniseadmete

There is a lot of pressure on IT development

Besides, integration of modern medical equipment

tehnoloogia arendamisele. Kõik meditsiiniseadmed

integreerimine arvutivõrgu ja teiste nõrkvoolu-

in the provision of up-to-date medical care. All

with the computer network and other low-current

on arvutipõhised ning omavahel võrgustatavad.

süsteemidega, senisest efektiivsema intsidendi- ja

medical equipment are computer-based and can

equipment, raising the efficiency of incident and

Kasutajasõbraliku süsteemi loomine on aga tõeline

veahalduse korraldamine (sh helpdesk), kaasaegse

be connected to networks. Creation of a user-

error management (incl. the Helpdesk), introduction

väljakutse. Info- ja kommunikatsioonitehnoloogia

dokumendihalduse ja Intraneti portaali juurutamine

friendly system is a real challenge, however. All

of a modern document management and Intranet

(IKT) kaasaegsete lahenduste ja seadmetega on

(sh digiallkirjastus), rahvusvahelistele standarditele

hospital buildings and employees are supplied with

portal (incl. digital signatures), introduction of ICT

varustatud kõik haigla hooned ja töötajad lähtudes

vastavate IKT juhtimismeetodite ITIL ja ISKE põhi-

modern ICT solutions and equipment depending

management methods according to the principles of

töö- ja ametikoha iseloomust. Suurima IKT-alase

mõtetest lähtuv juurutamine. Esimesena Eestis

on the nature of their workplace and job. The

international standards ITIL and ISKE are going on.

kvalitatiivse arenguhüppe tegi Pärnu haigla läbi

suutis Pärnu haigla uues majas pakkuda kogu maja

2004–2005. aastal, kui võeti kasutusele Ristiku

ulatuses avatud ja kasutajale tasuta kättesaadavat

tänava uus haiglahoone. Käivitatud õekutsesüsteem

WiFi võrku.

semaid lahendusi omataoliste seas Eesti haiglates.

Tohutult on arenenud kõik haigla infosüsteemid,

Esimesena Eestis suutis Pärnu haigla uues majas

haigla infosüsteem ESTER on liitunud riikliku digi-

pakkuda kogu maja ulatuses avatud ja kasutajale

looga, üle on mindud digitaalsetele retseptidele

tasuta kättesaadavat WiFi võrku. Haiglas on kokku

ning kohe-kohe algab digitaalsete töövõimetus-

üle 1000 arvutitöökoha ja -kasutaja.

lehtede väljastamine, loodud on mitmeid uusi info-

Head of the Radiology Service Dr Aadu Simisker

ühendatuna telefonijaamaga on üks innovaatili-

Rardioloogiateenistuse juhataja dr Aadu Simisker

Kaasaegse arstiabi pakkumisel on suur surve info-

in ICT development in 2004–2005 when the new

All information systems of the hospital have

hospital building in Ristiku Street was taken into

undergone enormous development, the ESTER

use. The new nurse calls system connected to the

information system of the hospital has been

telephone exchange is one of the most innovative

connected to the national database of electronic

solutions among other similar systems in Estonian

health records, transfer to digital prescriptions has

hospitals. The Pärnu Hospital was the first one in

been completed and the issue of digital certificates

Estonia to be able to offer an open WiFi network

of incapacity for work will start very soon; several

covering the whole building free of charge for

new information systems and data sets have

süsteeme ja andmekogusid, arvlemine ja suhtle-

Uus tasand tehnoloogia arengus on see, et kõik tänapäeva

On the new level of technology, all modern medical equip-

users. The hospital has in total more than 1,000

been created, payments and communication with

mine haigekassaga toimub vaid digitaalselt, välja

meditsiiniseadmed, mis enne olid üksi töötavad ja lokaalsed,

ment which functioned separately and locally earlier, are now

computerised workplaces and computer users.

the Health Insurance Fund are performed only

on arendatud asutuse siseveeb ja elektroonne

on täna andmebaasi- ja serveripõhised. Ühes seadmes tehtud

based on databases and servers. Examinations performed in

electronically, the Intranet and electronic document

asjaajamine, jõudsalt arenevad elektroonsed

uuringud, mis enne prinditi välja kõrvalolevast printerist,

one equipment which were printed out earlier from the ad-

management of the institution have been

suhtluskanalid, välisveeb, avatud on mitmed

peavad nüüd olema võrgust nähtavad nii oma maja arstidele

joining printer now have to be visible in the network both for

developed, electronic communication channels

kaugtöö võimalused väljaspool haiglat, sh kodu-

kui teistele majadele.

physicians of the same building and in other buildings.

and extranet are developing fast, there are several

Meditsiinitehnika: muljetavaldav areng toimus Ristiku tänava

Medical equipment: development of intensive care was

incl. in home duty, opportunities have been created

majja kolimisega intensiivravis, kus on täiesti uus kogu

impressive with moving to the building in Ristiku Street –

for telemedicine applications for the remote

opiploki sisustus ning inimeste parameetrite monitoorimise

the whole furnishing of the Surgery Block is quite new, also

monitoring of pacemakers.

süsteem. Kui vanasti oli intensiivravis haige kõrval monitor,

the patient vital signs monitoring system. While there was

siis nüüd on lisaks keskmonitorid.

a monitor next to a patient in intensive care earlier, we now

valves, loodud on eeldused telemeditsiini rakendusteks südame tehisrütmurite kaugkontrolliks.

70

Pärnu Hospital took the biggest qualitative leap

opportunities for remote work outside the hospital,

have in addition also the central monitors.

71


UUS HOONE Üldpind

27058 m2.

Ehitamise aeg

1988–1990;

15.10.2003–15.11.2004. Ehituse maksumus 263 milj krooni (meditsiiniseadmeteta). Projekteerija:

Eesti Projekt,

arhitekt Hansi Aru. Sisekujundus:

AB Emil Urbel OÜ, Taso Mähar.

Ehitaja:

AS FKSM (24 alltöövõtjat,

250 töölist). 317 voodikohta (neist 17 päevaravikohta, 10 intensiivravikohta).

HAMBARAVI ERALDUMINE

Hospital building in Ristiku Street Total area:

Haiglahoone ruumiprogramm ei võimaldanud ruume hambaravi jaoks. Koostöös töötajatega likvideeriti

15.10.2003–15.11.2004.

haigla juures asunud hambaravikliinik. Kõik töötajad

Construction cost: 263 million kroons

leidsid tööd vastloodud Pärnu hambapolikliinikus ja

teistes hambaraviasutustes.

architect Hansi Aru. Interior design: AB Emil Urbel OÜ, Taso Mähar. Construction company: AS FKSM

Hooldusravi ning taastusravi ambulatoorseks kolimist asusid Ravi t 2 tegutsema 40-kohaline

Selgunud oli ka vajadus liita psühhiaatria ja nahaning suguhaiguste osakond haiglakompleksiga. Esimesena Eestis oli kogu Ristiku 1 haiglahoones klientide ja külastajate kasutuses vaba WiFi võrk (aastast 2005)

72

Pärnu haiglas teostatakse aastas üle 7000 kirurgiline operatsiooni

hooldusravi osakond ja taastusravi ambulatoorne

võetud ning käivitatud hooldusravi kompleks.

SEPARATION OF DENTAL CARE Allocation of space in the hospital building did not leave any space for dental care. The dental clinic of the hospital was liquidated in cooperation with the staff. The whole staff was employed by the new Pärnu Dental Polyclinic created and other dental care establishments.

NURSING CARE AND REHABILITATION BUILDING

(24 subcontractors,

tööks kohandati Ravi 2 ruumid. Pärast 2005. aasta

2007. aastaks oli uus haiglahoone kasutusele

(without medical equipment).

Construction design: Eesti Projekt,

HOOLDUS- JA TAASTUSRAVIHOONE

osakond.

27,058 m2.

Time of construction: 1988–1990;

More than 7,000 surgeries are annually performed in the Pärnu Hospital

Ristiku tänava haiglahoone

NEW BUILDING

250 workers).

The premises at Ravi 2 were adjusted for nursing

317 beds (incl. 17 for outpatients,

care and outpatient rehabilitation treatment. After

10 intensive care beds).

relocation of the hospital in 2005 the Nursing Care Department with 40 beds and the Rehabilitation Department for outpatient care started operation at Ravi 2. By 2007 the new hospital building had been taken into use and the nursing care complex put into operation. Also the need to integrate the Psychiatry Department and the Dermatological and Venereological Department with the hospital complex had become evident. Open WiFi network free of charge for clients and visitors in the whole hospital building at Ristiku 1 (for the first time in Estonia since 2005).

73


HISTORY

t u k a n n i l e s i v r e t s Kak s e s u p m a c e r a c h t l a e h Two 75


Tal li

nn -

KAKS LINNAKUT

rnu

- Ik

TWO CAMPUSES

la

O ja R is t ik linna u k

KAHE TERVISELINNAKU KONTSEPTSIOON

CONCEPT OF TWO GROUPS OF HEALTH BUILDINGS

Juba Ristiku tänavale uut haiglahoonet planeerides

Pärast haigla uusehituse valmimist Ristiku tänaval

It was evident already when planning the new

Thus there were two scenarios for further devel-

oli selge, et see ei suuda mahutada kogu

tuligi otsustada, kuidas lahendada täiendav

building for Ristiku Street that it would not be

opment – to develop as one group of healthcare

Pärnumaale vajalikku keskhaigla sisu. Haigla

ruumivajadus, võttes aluseks haigla olemasolevad

able to contain everything required for the central

buildings or to develop two separate groups of

uusehitusele ei mahtunud psühhiaatria, naha- ja

kinnistud Ristiku 1 ja Ravi 2.

hospital of the Pärnu County. The new building

healthcare buildings. They proceeded from the

of the hospital had no space for psychiatry,

argumentation that while it is reasonable to con-

dermatological and venereological inpatient and

centrate specialised medical care and acute care

outpatient services and outpatient rehabilitation

to one centre with well interconnected logistics,

services, also the blood station and ambulance

the rapidly developing nursing and caregiving field

suguhaiguste ambulatoorsed ja statsionaarsed teenused ning taastusravi ambulatoorsed teenused,

Niisiis oli edasiseks arenguks kaks stsenaariumit

samuti verejaam ja kiirabi ning õendus-hooldusabi

– areneda ühe terviselinnakuna või arendada välja

ambulatoorsed ja statsionaarsed teenused. Puudu

kaks eraldi asuvat terviselinnakut. Lähtuti sellest, et

jäi ka rasedate teenindamise tänapäevastest

kui eriarstiabi ja akuutravi on otstarbekas koondada

service and the inpatient and outpatient nursing

could use their premises successfully also sepa-

võimalustest perekooli ruumide näol. Seega nähti

ühte logistiliselt hästiseotud keskusesse, siis

care services. Also the modern opportunities for

rately from specialised medical care.

haigla esimeses arengukavas kohe ette täiendav

kiiresti arenev õendus- ja hooldusteenuste valdkond

maternity services were lacking in the form of

ruumivajadus ning nende ruumide väljaehitamine

saaks edukalt kasutada oma ruumiprogrammi ka

parenting and family classes. Therefore the first

Proceeding from the above-mentioned argumenta-

järgmistes arenguetappides.

eriarstiabist eraldiseisvana.

Development Plan for the hospital included the

tion and economic considerations, the Pärnu

need for additional space and construction of such

Hospital chose the model of two groups of

Pärnu haigla valis kahe terviselinnaku mudeli.

facilities in the next stages of development.

healthcare buildings.

Ravi tänavale tekib kompetentsikeskus, mis

After the completion of the new building of the

This will become a centre of competence

tegeleb vanemate inimeste mitte enam väga

hospital in Ristiku Street the solution of the need

focused on the health problems of the elderly,

ägedate tervisehädadega. Koduõendusteenust

for additional space had to be decided based on the

which are not so acute any more. Home

osutavad praegu Pärnu haigla osakondade õed,

existing properties of the hospital at Ristiku 1 and

nursing is currently provided by nurses of the

edaspidi koondub selle juhtimine Ravi tänavale.

Ravi 2.

departments of the Pärnu Hospital, later its

Tam

mi

ste

tee

R lin av na i k

management will be transferred to Ravi Street.

76

M

ai

Ri

ia

m

nt

77


KAKS LINNAKUT

TWO CAMPUSES

RAVI LINNAK

TERVISETEENUSTE ARENGUD

RAVI STREET BUILDINGS

Ravi tänava terviselinnakusse koondati ambulatoor-

Praeguse trendina areneb enim haiguste mitte-

Inpatient and outpatient nursing care services

sed ja statsionaarsed õendus-hooldusteenused,

invasiivne (nn. veretu) diagnoosimine, samuti

were transferred to the group of buildings in Ravi

The current trend is to focus most on the develop-

integreerides need omakorda geriaatria, hoole-

telemeditsiini teenused. Kaasaegsed diagnostika-

Street, integrating them with geriatric, welfare,

ment of non-invasive (so-called bloodless) diag-

kande, taastusravi ja sotsiaalteenustega.

seadmed võimaldavad haigusi patsiendile mugavalt

rehabilitation and social services. In cooperation

nosing of diseases, also telemedicine services.

Regionaalarengu fondi poolt toetatud Ravi tänava

ning ohutult avastada ja täpselt diagnoosida juba

with Riigi Kinnisvara AS, the construction works

Modern diagnostic equipment is able to detect dis-

terviselinnaku ehitustööd valmisid 2012. aasta

varases staadiumis. Riiklikud strateegilised priori-

in the group of buildings in Ravi Street were

eases already at an early stage with methods which

juulikuus. Ravi tänava keskuses on 103 voodikohta.

teedid on kardiovaskulaarsete ja onkoloogiliste

completed by July 2012 with the support from

are convenient and relatively safe for the patient.

Neist 83 on statsionaarse hooldusravi jaoks,

haiguste ennetamine, varajane avastamine ja kiire

Regional Development Fund. There are 103 beds

National strategic priorities are the prevention, early

20 inimesele osutatakse hooldekodu teenuseid.

efektiivne ning ohutu ravi.

in the centre in Ravi Street. 83 of them are for

detection and fast, effective and safe treatment of

inpatient nursing care and care home services are

cardiovascular and oncological diseases.

Kaasaegne õendus-hoolduskeskus loob parimad

TRENDS IN THE PROVISION OF HEALTH SERVICES

võimalused Eestis õendus-hooldusteenuse

Ristiku 1 juurdeehituses avati esimene haigla oma

provided to 23 people. The modern Nursing Care

pakkumiseks.

magnetresonantstomograaf (MRT), mis võimaldab

Centre creates the best opportunities in Estonia for

The first magnetic resonance tomograph (MRT)

teostada kohapeal kõige erinevamate haigete, eriti

the provision of nursing care services.

owned by the hospital itself was taken into use

neuroloogiliste, ortopeediliste, onkoloogiliste ja

in the extension at Ristiku 1, which makes it

günekoloogiliste haigete, samuti kardioloogiliste

possible to perform examinations of patients with

haigete uuringuid. Väga suured arengud toimuvad

very different diseases, particularly neurological,

laborimeditsiinis. Pärnu haigla labor on sisustatud täisdigitaalse täisautomaatse analüsaatoriga, mis suudab teostada väga erinevaid analüüse.

Ravi 2 õendus- ja hoolduskeskus

Nursing Care Centre at Ravi 2

Netopind:

Net floor area:

4825,4 m2 (peahoone),

4,825.4 m2 (main building),

385,1 m (abihoone),

385.1 m (auxiliary building),

108,6 m2 (päevakeskus).

Ehitamise aeg:

november 2010–juuli 2012.

Time of construction:

November 2010 – July 2012.

Projekteerija:

Arhitektibüroo Vaarpuu & Kõll OÜ

Construction design:

Arhitektibüroo Vaarpuu & Kõll OÜ

Arhitekt:

Neeme Vaarpuu

Architect:

Neeme Vaarpuu

Sisearhitekt:

Anne Koppel

Interior design:

Anne Koppel

Ehitaja:

YIT Ehitus AS

Construction company:

YIT Ehitus AS

Number of beds:

103

2

Voodikohti: 103

78

orthopaedic, oncological and gynaecological and 2

108.6 (Day Centre).

also cardiac diseases. Laboratory medicine is undergoing very important developments. The Laboratory of the Pärnu Hospital is equipped with a fully digital, fully automatic analyser which can perform very different analyses.

79


Sotsiaalminister Hanno Pevkur, Pärnu linnapea Toomas Kivimägi, Pärnu haigla nõukogu esimees Cardo Remmel ja haigla juhatuse esimees Urmas Sule avavad õendus-hoolduskeskuse 14. septembril 2012 Minister of Social Affairs Hanno Pevkur, Mayor of Pärnu Toomas Kivimägi, Chairman of the Supervisory Board of the Pärnu Hospital Cardo Remmel and Chairman of the Management Board of the hospital Urmas Sule at the inauguration of the Nursing Care Centre on 14 September 2012

Õendusjuht Margit Seppik Head of the Nursing Service Margit Seppik

Õendusjuht Margit Seppik

Ravi tn 2 õendushoolduskeskus Nursing Care Centre at Ravi 2


Ristiku tänava terviselinnak keskendub aktiivravile ehk eriarstlikku sekkumist vajavale ravile ning siia

Uue korpuse kasutuselevõtt suurendab osutatavate taastusravi ja psühhiaatriliste teenuste mahtu.

on koondunud kogu eriarstiabi koos taastusravi ja psühhiaatriaga. 2013. aasta juulikuus valmis Ristiku

Taastusravi arendamiseks loodi infrastruktuur

1 taastusravi- ja psühhiaatriakorpuse ehitus.

kõikide kaasaegsete taastusravi ja spordimeditsiini teenuste osutamiseks haigla uue hoone

Seni erinevates hoonetes tegutsenud

kinnistul Ristiku 1 ning integreeriti see kõik

psühhiaatriakliinik on koondunud ühte hoonesse.

koostöös haigla naiste- ja lastekliiniku ning

Meie märksõnaks on integratiivsus. Nüüdsest on

psühhiaatriakliinikuga statsionaarse aktiivraviga,

võimalik pakkuda integreeritud teenust psühhiaatria

rehabilitatsiooni- ja sotsiaalteenuste osutamisega

ambulatoorsete, statsionaarsete akuutsete ja

ning sotsiaalteenuste, psühholoogilise, tervise-

krooniliste ebastabiilse remissiooniga patsientide

nõustamise jt terviseteenustega, sh perekooliga.

jaoks, depressiooni- ja ärevushäirega haigete jaoks ning päevaravi klientidele, pakkuda samal

“Pärnusse tööle tulles ja olukorraga tutvudes

ajal ka psühholoogilist tuge, tegevusteraapiat,

oli selge, et Pärnul on vaja psühhiaatriahaiglat.

rehabilitatsiooni- ja majutusteenuseid, integreerides

Inimesed viidi ravile Jämejalga. 1994. aastal

need omakorda somaatilise aktiivravi, taastusravi ja

oli psühhiaatriahaigla olematu. 1999. aastal

erinevate sotsiaalteenuste osutamisega.

avasime kliiniku, mida tuli juhtima Ants Puusild, Jämejala peaarst.” – dr Urmas Sule

Head of the Psychiatry Clinic Dr Ants Puusild with his team at the construction of the psychiatry building.

RISTIKU LINNAK

TWO CAMPUSES

Psühhiaatriakliiniku juhataja dr Ants Puusild oma meeskonnaga uue korpuse ehitusel

KAKS LINNAKUT

The group of buildings in Ristiku Street is focused

Taking the new building into use will increase the

on acute care, i.e. therapy which requires special-

volume of the rehabilitation and psychiatric services

ised medical intervention, and includes the whole

provided.

specialised medical care together with rehabilitation and psychiatry. In July 2013 the construction

For the development of rehabilitation therapy,

of the rehabilitation and psychiatry building was

an infrastructure was created for the provision

completed at Ristiku 1.

of all modern rehabilitation and sports medicine services in the new building at Ristiku 1 and it was

The Psychiatry Clinic which had been operating

all integrated in cooperation with the Women’s

in different buildings has now been gathered into

and Children’s Clinic and the Psychiatry Clinic with

one building. The keyword in our hospital model

inpatient acute care, provision of rehabilitation and

is integration. From now on it will be possible to

social services and the psychological and health

provide integrated outpatient and inpatient services

counselling and other health services, including

to the psychiatric patients who have acute diseases

parenting and family classes.

and chronic diseases with unstable remissions, to patients with depression and with anxiety disorder,

“It was obvious already years ago that Pärnu

and day care clients, to provide at the same time

would need a psychiatric hospital. People

psychological support, activity therapy, rehabilitation

were referred to the hospital at Jämejala. In

and accommodation services, integrating them in

1994 there was no psychiatric hospital. In 1999

Patsiendid soovivad saada kõik terviseteenused ühest

Patients would like to get all health services from

their turn with somatic acute care, rehabilitation

kohast. See toob esile taastusravi võimsama kompleksi

one place. This emphasizes the need to build a larger

we opened the clinic and Ants Puusild, Chief

treatment and provision of different social services.

vajaduse, mis suudaks pakkuda vesi- ja spordiravi

complex of rehabilitation treatment which could

Physician at Jämejala came to Pärnu to become

ning teisi taastusravi võimalusi. Kui sanatooriumid on

provide hydrotherapy and sports medicine and other

orienteeritud tervetele inimestele, siis haiglas on tegu

areas of rehabilitation treatment. While spas are

haigetega ning seda suurem on vajadus saada kogu

intended for healthy people, a hospital takes care of

ravi ühes kohas. Seetõttu on ka taastusravi teenuste

patients and their need to get all therapeutic procedures

arendamine ning vesiravi kompleksi loomine haigla

at one place is even more important. Therefore it is

juurde väga olulised.

also essential to create a hydrotherapy complex for the hospital and develop the rehabilitation services.

82

RISTIKU STREET BUILDINGS

the head of the clinic.” – Dr Urmas Sule

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iidi toorse vis . 0 0 ambula 0 10 2 nu Hospital le ü d in the Pär u haiglas e rn rm ä o P rf b e u p ally Aastas toim ts are annu tpatient visi u o 0 0 ,0 10 2 More than

84

Ristiku 1 taastusravi- ja psühhiaatriakorpus

Rehabilitation and Psychiatry building at Ristiku 1

Netopind:

7953,7 m .

Net floor area:

Ehitamise aeg:

veebruar 2012– juuni 2013.

Time of construction:

Projekteerija:

Innopolis Insenerid OÜ,

Construction design:

Innopolis Insenerid OÜ,

Arhitektibüroo Vaarpuu & Kõll OÜ

Arhitektibüroo Vaarpuu &

AS Maru Ehitus

Kõll OÜ, AS Maru Ehitus

Arhitekt:

Neeme Vaarpuu

Architect:

Neeme Vaarpuu

Sisekujundus:

OÜ Projekt Kuubis

Interior design:

OÜ Projekt Kuubis

Ehitaja:

Fund Ehitus OÜ

Construction company:

Fund Ehitus OÜ

Voodikohti: 55

Number of beds:

55

Ristiku 1 päevakeskus

Ristiku 1 Day Centre

Netopind:

740,9 m2.

Net floor area:

Ehitamise aeg:

aprill–detsember 2013

Time of construction:

April–December 2013

Projekteerija:

Pärnu EKE Projekt OÜ

Construction design:

Pärnu EKE Projekt OÜ

Arhitekt:

Kristjan Kullerkan

Architect:

Ehitaja:

Reparo Ehitus OÜ (I etapp)

Construction company:

Reparo Ehitus OÜ (Stage I)

Hostel places:

11

2

Ühiselamu kohti: 11

7,953.7 m2. February 2012 – June 2013.

740.9 m2.

Kristjan Kullerkan

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Paralleelselt Ravi 2 rekonstrueerimise ja Ristiku 1

Kirurgiliste protseduuride teostamisel lähtutakse

In parallel with the reconstruction of the Ravi 2

bariatric surgeries were started at the hospital,

uusehitusega ehitati 2012. aastal Ristiku 1 praegu

järjest enam patsiendi elukvaliteedi tõstmise

building and construction of the new building at

and laparoscopic and endoscopic procedures

juba kasutuses oleva hoone operatsiooniplokis välja

printsiipidest. Järjest laieneb endoproteseerimine,

Ristiku 1, a hybrid operating room with multi-

are developing fast in all surgery specialities.

universaalse angiograafiaseadmega hübriidope-

haiglas alustati bariaatrilise kirurgiaga, kiiresti

purpose angiography equipment was built in 2012 in

Concentration of acute care services to one

ratsioonituba. Seadme kasutuselevõtuks ehitati

arenevad laparoskoopilised ja endoskoopilised

the Surgery Block of the building at Ristiku 1 which

building made it possible to start performing also

esimesena Eestis hübriidoperatioonituba (angio-

protseduurid kõigil kirurgilistel erialadel. Aktiivravi

is already in use. In order to take the equipment

different dermato-venereological therapeutic

graafia kabinet + operatsioonituba) eesmärgiga

teenuste koondumine ühte korpusesse võimaldas

into use, the hybrid operating room (angiography

procedures, such as minor skin surgeries,

tagada angiograafiaseadme ja ruumiprogrammi

alustada ka erinevaid dermatoveneroloogilisi

office + operating room) which was the first

cryotherapy, laser therapy, etc.

võimalikult optimaalne kasutamine. 2012. aastal

raviprotseduure, nagu pisikirurgia nahal, külmaravi,

in Estonia, was built to ensure the as optimal

alustati hübriidopitoas nimetatud angiograafia-

laserravi jm.

use as possible of the angiography equipment

The so-to-say customer relationships have changed

and the space available. In 2012, performance

most in prenatal care and obstetrics. Therefore it

seadmega invasiivse kardioloogia uuringuid ja

of invasive cardiac tests and procedures were

is increasingly important to have cooperation with

abis ja sünnitusabis. Seetõttu on üha olulisem teha

started in the hybrid operating room with the

young people during the entire family planning

listidega. Alates 2013. a alustati ka perifeersete

koostööd noortega kogu pereplaneerimise tsüklis,

angiography equipment in cooperation with the

cycle, in the planning of both pregnancies and

veresoonte menetlusradioloogilisi protseduure,

nii raseduse kui ka sünnituse planeerimisel, samuti

leading specialists of the Tartu University Hospital

deliveries and also after delivery. The best solution

samuti laiendati röntgenoloogiliselt assisteeritud

sünnituse järel. Parim lahendus on korraldada pere-

Foundation and the North Estonia Medical Centre.

is to organise the whole complex of family

uuringuid ja protseduure operatsioonitoa

abi kompleksselt haiglavõrgustikus, pakkudes kaas-

In 2013 also the performance of interventional

counselling services in the hospital network by

tingimustes.

aegse sünnitusabi põhimõtteid vastukaaluks

radiological procedures of peripheral blood vessels

providing the principles of modern obstetrics as

was started and the range of radiologically assisted

opposed to those offered by social networks.

examinations and procedures performed in the

Modern parenting and family classes will start in

conditions of an operating room was expanded.

the new building at Ristiku 1 where comprehensive

sotsiaalvõrgustikes pakutule. Uues Ristiku 1 korpuses alustab kaasaegne perekool, kus nii rasedatele, sünnitajatele kui beebidele ja nende emadele osutatakse kõiki teenuseid alates eriarstiabi tervishoiuteenustest, erinevatest terviseteenustest kuni psühholoogilise ja sotsiaalnõustamiseni.

86

Swimming pool with adjustable depth, first in Estonia

Kõige enam on muutunud nn. kliendisuhe rasedate

ja SA Põhja-Eesti Regionaalhaigla juhtivate spetsia-

Eesti esimene reguleeritava sügavusega bassein

protseduure koostöös SA Tartu Ülikooli Kliinikumi

services will be provided related to pregnancy, Surgical procedures are increasingly performed

delivery, babies and their mothers, starting from

proceeding from the principles of improvement

healthcare services of specialised medical care,

of the quality of life of the patients. Use of

different health services and up to psychological

endoprostheses is increasingly widespread,

and social counselling.

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Uued kaasaegsed terviselinnakud loovad Pärnu

Starting from 2012 the Hospital Pharmacy was

New modern groups of health buildings create

apteek, alustati steriilsete ravimite süstelahuste

haiglale head tingimused Eesti prioriteetsete

thoroughly renovated and the preparation of

good conditions for the Pärnu Hospital for the

valmistamist ning tsütostaatikumide lahustamist

tervishoiustrateegiate ning elanikkonna kasvavate

sterile solutions for injection of medicaments and

implementation of the high-priority healthcare

keemiaraviks koostöös regionaalhaiglate

ootuste täitmiseks. Saame anda oma panuse

reconstitution of cytostatics for chemotherapy

strategies of Estonia and meeting the growing

juhtivate spetsialistidega. Uued teenused

vähi-, südamehaiguste ja ennetatavate surmade

was started in cooperation with the leading

expectations of the population. We can make our

tagavad patsientide ja töötajate suurema

strateegiate jälgimiseks, samuti tahtest olenematut

specialists of regional hospitals. The new services

contribution to the implementation of the strategies

ohutuse, keemiaravi kättesaadavuse kohapeal

psühhiaatrilist ravi saavate isikute õiguste kaitseks,

will ensure more safety for patients and the staff,

concerning oncological and cardiac diseases and

ning ka ravimite kulude kokkuhoiu, mis tuleneb

pere- ja emaduskoolituseks ning rasedusaja

local availability of chemotherapy and also more

preventable deaths, also for the protection of

tsentraalsest käitlemisest haigla apteegis.

kaasaegseks nõustamiseks.

economic use of medicaments due to their central

the rights of persons getting psychiatric therapy

handling in the Hospital Pharmacy.

regardless of their consent, family and motherhood

koormust ja survet praegusele aktiivravile ning luua arengukava I etapis planeeritud järel-, taastus- ja hooldusravi süsteem. Samas loob see tingimused kaasaegse, kompleksse, integreeritud arstiabi, õendusabi, hooldusabi, hoolekandeteenuste, sotsiaalabi ja rehabilitatsiooniteenuste osutamiseks.

88

Kirurgiakliiniku juhataja dr Guido Ratnik, Pärnu maakonnaarst 1994–2003

Arendusprojektide elluviimine võimaldab vähendada

Head of the Surgery Clinic Dr Guido Ratnik, Pärnu County Physician in 1994–2003

Alates 2012. a renoveeriti põhjalikult haigla

classes and pregnancy counselling. Implementation of development projects makes it possible to reduce the workload and pressure of the current acute care and to create the follow-up, rehabilitation and nursing care system planned in Stage I of the Development Plan. On the other hand, it will create conditions for the provision of modern, complex, integrated medical care, nursing care, caregiving, welfare services, social assistance and rehabilitation services.

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TULEVIK

FUTURE

Pärnu haigla pikaajaliste strateegiliste eesmärkide

Haigla on üha rohkemal määral terviklikult toimiva

The developments absolutely necessary for the

The Hospital is to an increasing extent a part of

täitmiseks üliolulised arendused on nüüdseks ellu

tervisesüsteemi osa, valdkondadevaheline

fulfilment of the long-term strategic goals of

the integrated health system, a multidisciplinary

viidud. Valminud on kaks moodsat terviselinnakut,

koostöö- ja kompetentsikeskus. Kompleksse ravi

the Pärnu Hospital have been implemented by

centre of cooperation and competence. Provision

mis toetavad haigla efektiivset juhtimist ja

pakkumine abivajajatele vajaliku kättesaadavusega

now. Two modern groups of buildings have been

of complex therapy with the required availability

arvestavad parimal võimalikul moel klientide

muutub järjest tähtsamaks. Aina enam räägime

completed which support efficient management

for patients is becoming increasingly important

vajadustega. Tehtu on väga oluline kvalitatiivne

teenuste integreeritusest, kus kasvava olulisusega

of the hospital and take the needs of clients into

We are increasingly talking about integration of

samm kogu meie piirkonna inimeste jaoks.

kuuluvad raviprotsessi spetsiifiline nõustamine ja

account as much as possible. The results achieved

services in which inclusion of specific counselling

ülitäpne diagnoosimine. Kui varem oli eakamate

constitute a very important qualitative step for all

and highly accurate diagnosing are becoming

inimeste ravis kasutusel pisut ebaselge sisuga

people in our region.

essential parts of the therapeutic process. While earlier the treatment of elderly people was referred

spetsialistidele arusaadaval moel termineid

to with the slightly unclear concept of long-term

geriaatria, õendus-hooldus ja järelravi. Pärnu haigla on selles võimaluste rägastikus patsiendi jaoks sild

Ühiskonna ja erinevate valdkondade arengule on omane pidevalt kasvav spetsialiseerumine, eriti tugevalt väljendub see tervishoius. Kaasaegse haigla suurimaks väljakutseks on olla abivajajate jaoks uute võimaluste pakkuja ja teha seda patsiendist tervikpilti nähes ning tema jaoks olulisi lihtsaid inimlikke väärtusi toetades.

92

Pärnu haigla Ristiku 1 hoonete kompleks linnulennult

õigel ajal õigete spetsialistide juurde jõudmiseks.

Bird’s eye view of the group of Pärnu Hospital buildings at Ristiku 1

mõiste “pikaravi”, siis täna tarvitatakse kõikidele

care, the current terms used are geriatrics, nursing care and follow-up treatment understandable for all specialists. In this maze of opportunities the Pärnu Hospital is a bridge for patients to reach the right specialists in due time. Development of the society and different fields are characterised by increasing specialisation, which is particularly manifested in the healthcare field. The main challenge for a modern hospital is to be a provider of new opportunities for patients and to do that by having an integrated view of each patient and supporting the simple human values important for the patient.

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VÕTMESÕNA ON KOOSTÖÖ

COOPERATION IS THE KEYWORD

Kogu tervishoiusektori arengu olulisemad mõjutajad

raviasutustega, kes on antud valdkonna eksperdid.

The most important factors influencing the

medical establishments who are experts in

on elanikkonna vananemine ja ravi-diagnostika

Niimoodi tegutsedes oleme saavutanud kitsaste

development of the whole healthcare sector are

the specific field. With such activities we have

võimaluste ning tehnoloogiate ülikiire areng.

erioskustega spetsialistide efektiivse rakendamise

the aging of the population and the extremely fast

achieved effective involvement of specialists of

koos õppe-arendustöö ekspordiga raviasutuste

development of the opportunities of therapy and

narrow specialisation together with the export of

vahel.

diagnostics, and technologies.

training and development work between medical

valmisolekut pidevateks muutusteks nii

Pärnu haigla koostöömudel ei toetu vaid

Therefore a modern hospital has to offer

juhtimismudelites kui ka ruumiprogrammis.

haiglate partnerlusele. Ravitöö järjepidevuse ja

increasingly more innovative opportunities. This

The cooperation model of the Pärnu Hospital is not

Kvaliteetse teenuse pakkumisel peab arvestama

patsiendisõbralikkuse oluliseks prioriteediks on

implies readiness for constant changes both in

only based on the partnership between hospitals.

olulise uue sisendiga, milleks on patsientide soov

selgel rollijaotusel baseeruv koostöö piirkonna

management models and in the allocation of space.

In order to maintain consistent and patient-

saada kõik vajalik mitte ainult kodule lähedalt,

perearstidega. Siin on kasvava tähtsusega nii

Provision of high-quality services has to take into

friendly therapeutic activities, the cooperation

vaid võimalusel ühest kohast. Iseäranis tähtis

elektroonse andmevahetuse ja e-teenuste

account an important new input which is the wish

with the family physicians of the region is a high

on see südame-veresoonkonna ja kasvajate ravi

arendamine kui ka erinevates vormides teadmiste

of patients to get everything not only close to their

priority and based on a clear division of tasks.

korraldamisel. Abivajajate arv kasvab pidevalt ja

vahetuse toetamine.

home but also, if possible, from one place. This is

Both the electronic exchange of information

particularly important in organising the treatment

and development of e-services is of increasing

Kaasaegne haigla peab seetõttu pakkuma aina enam innovatiivseid võimalusi. See tähendab

establishments.

parimate ravitulemuste saavutamiseks on olulise tähtsusega ka ühtsetel alustel haiglaeelne ja –

Kaasaegse tervishoiukorralduse oluliseks

of cardio-vascular and oncological diseases. The

importance in this respect, also supporting of the

järgne tegevus.

väljakutseks Eestis on arstiteaduse ja õenduse-

number of patients is constantly increasing an in

exchange of knowledge in different forms.

important to have also the activities before and

Creation of educational and practical training

ja selgete rollijaotustega raviasutuste vaheline

loomine võimalikult paljudes raviasutustes.

after inpatient care on a common basis.

opportunities for medical students and students

koostöö. Pärnu haiglal ei ole olnud ega saa

Riigi tervikhuve arvestav koostöö akadeemiliste

ka edaspidi olema plaanis konkureerida uute

asutuste ja sotsiaalministeeriumiga on selles

tehnoloogiate ja ravimeetodite väljatöötamise

koostöövaldkonnas eriti tähtis. Pärnu haigla

vallas selleks spetsialiseerunud haiglatega.

valmisolek ühiseks tegutsemiseks on siin suur.

Meie lähenemisviis keeruliste operatsioonide

Haigla, kus ei toimu õppe- ja teadustööd, ei oma

ja raviprotsesside puhul on ühine toimimine

perspektiivi oma ülesannete täitmisel.

94

Head of the Diagnostics Service Dr Ruth Pulk

order to achieve the best results in therapy it is

residentide õppe- ja praktiseerimisvõimaluste

Diagnostikateenistuse juhataja dr Ruth Pulk

ämmaemanduse tudengitele ning arstideRaviteenuste arendamise tulevik on süvenev

of nursing and midwifery and medical residents The future development of therapeutic services

in as many medical establishments as possible is

consists in increasingly deeper cooperation

an important challenge for the modern healthcare

between medical establishments, with clear

system in Estonia. Cooperation with academic

definition of roles. The Pärnu Hospital has not

institutions and the with the Ministry of Social

intended and will not intend to compete with

Affairs in the national interests is particularly

the hospitals specialised in the development of

important in this field of cooperation. The Pärnu

new technologies and treatment methods. Our

Hospital is very interested in such joint activities. A

approach with respect to complicated surgeries

hospital with no educational and research activities

and therapeutic processes is to cooperate with

95 has no prospects for the performance of its tasks.



KAKS LINNAKUT

TWO CAMPUSES

INVESTEERIME INIMESTESSE

WE INVEST IN PEOPLE

Tuleviku edu võtmeküsimus on tervishoiuteenuste

Pärnu haigla kui maakonna suurim tööandja peab

The key to the future success lies in the good

The Pärnu Hospital as the largest employer in the

hea kättesaadavus ja kvaliteet olukorras, kus

lisaks töötajate kompetentsusele aina olulisemaks

availability and high quality of healthcare services

county regards good human relations increasingly

ootused ületavad aina võimalusi. Haiglatelt

häid inimsuhted. Haigla personali rahulolu-

in a situation where expectations tend to be higher

important besides the competence of the staff.

oodatakse 24 tundi päevas ja 7 päeva nädalas

uuringutest tuleb selgesti välja, et kolleegide-

that the possibilities. Hospitals are expected to

The employee satisfaction survey of the hospital

valmisolekut paljudel erialadel.

vahelised head suhted ja eneseteostuse võimalus

have readiness in many specialities 24 hours a day

staff clearly shows that good relations between

on üks olulisemaid tööalaseid motivaatoreid.

and 7 days a week.

colleagues and opportunities for self-actualisation

Üha enam spetsialiseeruv eriarstiabi on

Professionaalsed oskused peavad harmoneeruma

kõrgtehnoloogiline teenus, mida osutatakse

sotsiaalse kompetentsusega.

are among the most important factors in employee

väikese hulga erioskustega spetsialistide juhitavate

The increasingly specialising medical care is

motivation. Professional skills have to be in

high-technology service provided by therapy

harmony with social competence.

Haigla juhtkonna jaoks on olnud oluline patsiendi

teams led by a low number of specialists with

seetõttu ravimeeskondade kui kogu organisatsiooni

huvidest lähtuva töökultuuri kasvatamine. Töötajate

narrow specialisation. Therefore the availability

Development of a work culture which proceeds

tasemel kompetentsete spetsialistide olemasolu,

omavahelisi häid suhteid aitavad hoida ka personali

of competent specialists, clear division of tasks

from the interests of a patient has been important

selged rollijaotused ja koostööoskused. Pärnu

ühised traditsioonid, üritused ja sündmused.

and teamwork skills are determining factors on

for the management of the hospital. Also common

the levels of both therapy teams and the whole

traditions and events of the staff help to keep up

organisation. The future of the Pärnu Hospital

good relations between the staff members.

Summar Days of the Hospital (2011)

ravimeeskondade poolt. Määrava tähtsusega on

haigla tuleviku määrab võimekus ligi tõmmata Haigla jaoks on ehitusprojektide realiseerimise periood mööda saanud. Nüüd tuleb loodud võimalused ja potentsiaal ellu rakendada. Järgmiste aastate investeeringud on suunatud eelkõige inimestesse.

98

Haigla suvepäevad (2011)

kompetentseid spetsialiste.

Motiveeritud, kompetentsed ja arengule orienteeritud,

Motivated, competent and development-orientated

koostööd ning inimsuhteid hindavad töötajad on haigla

employees who value cooperation and human relations

suurim väärtus.

are the biggest asset for the hospital.

depends on its capability of attracting competent specialists.

The period of implementation of construction projects is over now for the hospital. Now the opportunities and potential created will have to be used in practice. Investments of the next few years will be directed above all to people.

99


LÕPETUSEKS

FOR CONCLUSION

Sageli on külalised öelnud, et meie haiglas kohtavad nad üllatavalt palju naeratavaid inimesi ja

Visitors have often said that they meet surprisingly many smiling people in our hospital, and

küsinud, mis on selle põhjuseks.

they have asked for the reason.

Pärnu haigla töötajatele on inimeste ja ühiskonna jaoks olulise töö tegemine suur ning

Performing the work important for people and for the society is a great challenge for the Pärnu

pidevat eneseandmist tähendav väljakutse. Seda rolli on võimalik täita vaid tegutsedes koos

Hospital staff, which requires constant efforts. This role can only be performed if they have

heade koostööpartnerite, toetajate ja sõpradega. Ühised õnnestumised teevad aga inimesed

good cooperation partners, supporters and friends. It is the joint achievements that make

rõõmsaks ja õnnelikuks.

people glad and happy.

Pärnu haigla moto on Tervist!

The slogan of the Pärnu Hospital is Good health!