What we have learned: COVID-19 stories by GE Healthcare employees

BEHIND THE SCENES H O W I N D U S T RY S U P P O RT E D F R O N T L I N E WO R K E R S

What we have learned:

It seemed like Mission Impossible.

But 787 ultrasound systems were delivered in just 14 weeks PAGE

COVID-19 STORIES

by GE Healthcare employees

“The whole world started calling, asking for monitors!”

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The art of installing medical equipment and doing maintenance and service during a pandemic PAGE

When big CT scanners come in a box, easy to unpack and ready to use PAGE

Ramping up: How to build and deliver 4 years’ worth of patient monitors PAGE

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What we have learned: COVID-19 stories by GE Healthcare employees

When the COVID-19 pandemic started to accelerate in the first months of 2020, it caught most countries around the world by surprise. National healthcare systems came under immediate and severe pressure, facing a seemingly impossible task: How do we prepare to receive a potentially enormous number of patients with an almost unknown, yet also very contagious disease? – How do we scale up our capacity dramatically in no time without compromising standards? – In fact: How do we avoid a break down?

In the months that followed, the learning curve proved to be steep but also a very valuable experience for many involved. In this series of COVID-19 stories, you can read about how GE Healthcare in different ways has helped customers and hospitals that suddenly faced new challenges during the pandemic. Healthcare systems were in need of large amounts of equipment in a short time and also needed their existing equipment to be serviced in a time when almost everyone was forbidden access to hospitals.

These stories give examples of how we functioned as one important cog among many in the large and complex machinery that a healthcare system constitutes. And not least: What we have learned that we will not forget, even when the COVID-19 crisis is finally over.

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It seemed like Mission Impossible.

But 787 ultrasound systems were delivered in just 14 weeks

As the COVID-19 crisis started to have a real impact in the UK, GE Healthcare was approached by the supply chain section of National Health Service England, (NHS).

The message was as unmistakably clear as it was completely unheard of: We need you to deliver as many ultrasound systems as possible, starting with 160, as soon as possible, preferably within two weeks. Can you do that?

“A request for that number of ultrasound systems delivered in that timeframe was completely off the scale, not only for GE but for the whole of the industry,” said Jon Robinson, Segment Manager for Point of Care Ultrasound at GE Healthcare in the UK and Ireland. When the NHS called, it was Jon who was appointed by Roy Tappin, General Manager for Ultrasound at GE Healthcare in the UK and Ireland, to lead the GE Healthcare task force.

“We never dreamt for one moment that we would be tasked with providing so

many systems that quickly in the middle of a pandemic. It would be easy to feel overwhelmed. But to be honest I feel more overwhelmed now after having gone through that process. At the time we just had to pull ourselves together quickly as a team. We felt that if we didn’t deliver, we would let people down. That was not an option.”

Even though the initial 160 systems seemed off the scale, the number soon grew to 520 and eventually to 787 systems. Ultrasound is a crucial tool in the fight against COVID-19 where patients typically are displaying symptoms related to respiratory infections and where the need is to scan the heart as well as lungs.

“It wouldn’t have been possible without good relationships. Trust doesn’t just happen overnight.”

However, it wasn’t just a matter of getting the number of systems right, but also of getting the systems calibrated the right way, Roy explains.

“We felt that if we didn’t deliver, we would let people down. That was not an option.”

Jon Robinson, Segment Manager, Point of Care Ultrasound, GE Healthcare UKI “In the beginning, the NHS wasn’t sure about the specific clinical requirements needed for the systems. They were relying on our expertise and guidance in the process of identifying the best specifications for the systems. It’s a huge responsibility, and I don’t think that would have happened without the ongoing and professional close working relationship we have had with the NHS supply chain for the past 10 years or so.

Trust doesn’t just happen overnight.

They were confident in our ability to

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“From the beginning GE have been brilliant to work with, positive and proactive in a constantly changing situation. Consistently delivering on their commitments, including some very last-minute requests; nothing was too much! A huge number of systems delivered in record time, a massive achievement by all involved,” says Jenny Rayne, Senior Buyer Women’s Health, NHS Supply chain and continues: “As the Ultrasound allocation model progressed, GE worked with us to set up processes which ensured Trusts were able to receive the systems they requested, moving quickly and adapting to the changing requirements of the project. There were some frustrating times along the way but our excellent relationship with GE made this much easier to manage.“

“The biggest problem was the breakdown in freight and airline logistics that effectively just stopped at one point.”

The power of relationships also proved vital when starting to contact all the different stakeholders across the supply chain – from production plants to transport.

“It wouldn’t have been possible without good relationships. Trust doesn’t just happen overnight.”

Roy Tappin, General Manager, Ultrasound, GE Healthcare UKI

“Within the space of a week, our team had set up an ultrasound hub in partnership with our colleagues at GE Power in Rugby, UK. This enabled us to configure and ship the systems so that physicians could start using them straight away. It wasn’t easy. It was a matter of being in meetings constantly or on the phone with someone from GE or with external partners. It was a crazy puzzle! It wasn’t just about problems with key components not being available, with breakdown in supply chains, or difficulties in manufacturing centers around the world. The biggest problem was the breakdown in freight and airline logistics that effectively just came to a halt at one point.”

“So, what do you do? I had bad dreams at night speculating if systems would arrive in time, if we would get all the bits and pieces we needed, even down to the simplest things such as a power cord.

But in the end, we were again helped by our relationships, by the fact that we have invested in our network and optimized our supply chain over many years. That has really been an important lesson for me,” says Jon.

“As a result, everybody rallied around the project and made it possible.”

Starting with 6-7 persons, the team quickly grew to nearly 50 people directly involved in the project. A milestone plan listing every deliverable needed within each milestone was put in place. And then executing through daily, sometimes hourly, routines to make sure to every task was taken care of, and then tick the box and move on. From Roy’s perspective it was important to build this team effort on a clear set of values.

“From the beginning GE have been brilliant to work with, positive and proactive in a constantly changing situation.

A huge number of systems delivered in record time, a massive achievement by all involved.”

Jenny Rayne, Senior Buyer Women’s Health, NHS Supply chain

GE Healthcare and GE Power employees who worked together to get the 787 ultrasound systems ready for Britain’s National Health Service.

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VenueTM systems assembled and ready to be shipped to Britain’s National Health Service.

“I remember the reaction on one of the first group calls when I announced that we had to deliver no less than 160 systems.

The reaction was Wow! – And as the number then grew during the next weeks to 520 and then again to 787 systems, I also made it clear, that if we had to go back and tell the NHS that we could only deliver 600 systems, then that was what we would do, because trust is perhaps our most important asset.”

“As a result, the team spirit grew even stronger and everybody rallied around the project and made it possible to deliver all 787 systems – fully configured and ready for use at the bedside by the physicians within 10 minutes of being unpacked. I think we can all be proud of that. This was a team effort, teamwork matters and so does open and honest communication between all parties, no matter if the message is a good or a tough one. I guess we knew that already, but perhaps we all know it a bit better now.”

“We were given fantastic support by GE during our fight against COVID-19. The brilliant design of the Venue machines that we received allowed us to deliver point of care diagnostic and procedural ultrasound using state of the art technology and AI”, says Dr Redmond Tully, Critical Care Consultant at the Royal Oldham Hospital.

“The Vivid IQ machines allowed us to see the cardiac condition of critically unwell COVID-19 patients in great detail due to the amazing image quality that they produce. The systems were quickly and efficiently set up and delivered to us when we needed them most and as ever we were given great support by the whole point of care team.“

“We’ve learned that strong remote support is very important.”

But the job doesn’t end here, Jon adds: “Delivering all these systems is the start of the journey, not the end. We now have an obligation to look after these new

installations on top of the ones already in use at the NHS, and this involves using digital tools to expand our education service and support even more.”

“One thing that we really learned during this process is how important remote support can be, and we worked hard to find new ways to improve the support.

As a simple example, we decided early on to attach a QR code sticker to every product. This was a good and easy way to guide the doctors, via their own mobile phones, straight to a webpage with all the relevant information, tips and tricks and even videos explaining how to use the ultrasound system in the smartest way.

This was received enormously well. “ “I think that the COVID crisis has really accelerated the power of easy-to-use, digital remote support. And on a larger scale, digital tools will certainly also be an asset we should use more to educate and provide our customers with good, timely and easy-to-use information,” Jon says.

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“The whole world started calling, asking for monitors!”

As the big wheels of the world began to slow down in March, and in some places even came to a complete stand still because of the developing COVID-19 pandemic, things were just starting to heat up in the suburb of Vallila on the outskirts of the Finnish capital of Helsinki. This is where GE Healthcare assembles, configures and ships patient monitors and gas measurement modules for most of the world except for the Americas and parts of the developing world.

monitors. Some were even saying: “We will buy everything you have if you can deliver within two weeks.”

In his office, Risto Rossi, Senior Global Product Manager at GE’s patient monitoring division, clearly recalls the days when the whole world seemed to call him with requests for more monitors.

Basically, doctors monitor a patient through the doctor’s own experienced eyes and through a monitor that compiles all relevant metering and measurements from a patient, e.g. heart rate and pulse, blood pressure, respiration and ECG to name a few.

“There is a first time for everything, and this was certainly the first time I was approached by customers who were close to panicking when asking for delivery of

“But monitors are custom-built devices, that have to be assembled and configured specifically in order to meet the customers’ needs and they vary a lot. We don’t have some thousand monitors on a shelf in a storage facility just waiting to be shipped. That is not how it works.”

“In a situation where most people were asked to stay at home, we were asking people to come to work.”

Juho Niskanen, Service Operations Leader at GE Healthcare’s factory for Monitoring Solutions in Finland

“Ventilators can’t be used properly without a monitor.“

“In the media, there was a lot of focus on the need for ventilators in the treatment

of patients with severe COVID-19. But monitors are just as important, because ventilators can’t be used properly without a monitor to measure, how effectively the patient is getting oxygen, how well the lungs are working, if the heart rate is okay etc. Without this combined picture of the patient’s current condition, the doctor at the bedside is to a large extent left in the dark,” explains Risto Rossi.

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“Looking back, the biggest learnings for me is that teamwork is key when facing a challenge like this one.”

Risto Rossi, Senior Global Product Manager, Patient monitoring, GE Healthcare Finland

“We wanted a fair and compassionate way of prioritizing. “ The demand for monitors began to grow in February, but slowly. Then in March, the demand went through the roof and then demand followed the spread of the virus.

At the plant in Vallila, they didn’t have to watch the news to follow the current Corona hot spots around the world. They just had to look at where the requests came from.

“We felt the pressure for sure. Every country, every region, every hospital, every doctor essentially wants to have enough of our monitors in order to treat their patients and to be prepared for an unknown influx of even more patients. No one wants to wait. Everyone feels that their need is particularly important and vital, and I can absolutely relate to that.”

on certain key factors: the number of recorded cases of people infected with Corona virus, the number of patients hospitalized with COVID-19, on the number of patients in intensive care units and deaths due to COVID-19.

“It felt like playing the video game ‘Whack-A-Mole’, where you have to hammer down a mole each time it pops up from a new hole. New problems popped up constantly, and we were hammering away.”

As the requests for more monitors began to grow, the strain on the supply chain was soon felt. Modern supply chains are very Lean and optimized on the premise that components and parts are available when needed. The idea being, that if you can avoid having costly products on storage, you will want to do that. But lean supply chains are not made for pandemics and global lockdowns.

“Luckily, our supply chain is quite diverse.

We have suppliers from all over the world, so we did have some maneuvering space to change between suppliers as all sorts of different problems kept popping up along the supply chain. It felt like playing the video game ‘Whack-A- Mole’, where you have to hammer down a mole each time it pops up from a new hole.

New problems popped up constantly, and we were hammering away.”

“At one time, for example, we had supplies getting stuck at the customs in India; they were working on reduced capacity due to COVID-19 infections at the customs.

It’s frustrating when you badly need components for building monitors. We had to call them every day for two weeks before we could finally get them out.”

“And then I haven’t even mentioned the problems with cancelled flights, which was a logistical nightmare of its own. We often had to charter our own planes, and we had cargo planes going from Asia to Europe and from Europe to the US, almost on a daily basis with components and readymade monitors,” says Juho Niskanen, who is service operations leader at the factory in Vallila.

“Soon we were producing patient monitors in three shifts on a 24/7 basis where in normal times we only work one shift.”

Juho Niskanen, Service Operations Leader at GE Healthcare’s factory for Monitoring Solutions in Finland

“But we soon realized that we couldn’t possibly meet all requests at the same time, and so we decided to set up a transparent prioritizing system based on the urgency in each country, so that big countries and markets didn’t get monitors first just because they were big. We wanted to set up a fair and compassionate way of prioritizing who would get monitors first and who would have to wait a bit.”

Through discussions in the crossfunctional taskforce that GE Healthcare set up as one of the first actions, the model for prioritizing was set to be based

Employee working on gas module at GE Healthcare’s factory in Finland during COVID-19.

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GE Healthcare Finland built a new production line for the CARESCAPETM B450 patient monitor – in just two days, to meet the demand in patient monitors from around the world due to COVID.

“Tiger Teams made it work! Soon we were producing in three shifts on a 24/7 basis where in normal times we only work one shift.”

In normal times Juho leads a team of 30 colleagues in the service center. When the pandemic began to evolve, he was asked

by Pekka Huovinen, Plant Manager of the Helsinki plant, to lead a new and special type of cross functional teams in order to ramp up the production capacity quickly.

Tiger Teams they are called, and already in March the first increase in production began: “ Tiger Teams are a concept where different functions participate and collaborate – sourcing, product management, manufacturing, quality control etc. We had our first Tiger team meeting on 23 March, and this continued on a daily basis for the first couple of months. In the beginning we also formed sub Tiger teams for focusing specifically on areas such as manufacturing, materials and capacity.

And the Tiger Teams made it work! Soon we were producing in three shifts on a 24/7 basis where in normal times we only work one shift.”

“This is perhaps the biggest learning I’ve had during this period and we hope we will continue to use and develop – it is effective to not only think out of the box but also to think out of the siloes, so to speak. Blending people with insights

G E H E A LT H C A R E IN FINLAND

“In a situation where most people were asked to stay at home, we were asking people to come to work.”

100,000 shipments of medical devices to customers in 150+ countries each year.

During the second quarter of 2020, the Vallila factory was able increase production with more than 150 percent compared to the same period the year before. And components from suppliers around the world weren’t the only thing needed to make this happen. It was also necessary to quickly hire new employees – a lot of them, more than a hundred. Even though robots are used, the majority of the assembly is made by humans.

GE Healthcare in Finland is a Center of Excellence for Monitoring Solutions. The site is home to 700 employees and brings together a cross-functional set of teams under one roof, including: Engineering for Monitoring Solutions and Anesthesia & Respiratory Care, Advanced Technology Development, Healthcare IT, Product Management, Marketing, Sales & Service and Manufacturing.

“In a situation where most people were asked to stay at home, we were asking people to come to work. And as all hands-on deck wasn’t enough, we also had to hire a lot of new colleagues to try and meet the demand. So, we spread the word on social media and asked people to spread the message on our behalf.

We took contact to other technical industries in Finland asking if they had layoffs, as we had an urgent need for skilled production workers,” Juho says and is seconded by Risto:

“You can only win if you make sure you act as a team.”

“A main concern was to maintain our strict quality standards, we can never compromise on quality. Fortunately, we have good learning practices in place as well training material, and we even use artificial intelligence to reduce calibration lead time for gas measurement devices.

The Lean assembly processes we have used for the last decade is also an important factor, enabling us to ramp up production massively and quickly.”

The manufacturing team is made up of 200 employees who produce patient monitors, respiratory and hemodynamic modules and diagnostic cardiology equipment.

than before that you can only win if you make sure you act as a team and that everybody feel they are part of the team.

Another thing I will take with me going forward is that the decisions must be based on facts and solid data and that you must be prepared to communicate this in a transparent way. There can be a lot of feelings involved when a pandemic evolves rapidly. But the best way to fight it is to rely on data, always,” says Risto Rossi.

“Looking back, the biggest learnings for me is that teamwork is key when facing a challenge like this one. It’s not that I’m surprised by this, but I’m more convinced

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The art of installing medical equipment and doing maintenance and service during a pandemic

“We had to ensure that our customers knew we were going to continue supporting them.”

normal practices were turned upside down almost overnight.

2020 turned out to be far from normal.

From one day to another, all focus was put on keeping our equipment running so customers could diagnose and treat patients in the emerging COVID-19 pandemic.

“Could we just stop our service and maintenance in the middle of a pandemic?

Of course not. We had to ensure that our customers knew we were going to continue supporting them. It was the right thing to do.”

The onset of the pandemic meant that hundreds of hospitals and clinics throughout the UK and Ireland didn’t know if they were able to get vital equipment installed and maintained – in a time more critical than anyone could remember, when nobody knew just how many patients with COVID-19 would need diagnosis and treatment and when it was absolutely crucial to ensure minimal downtime for scanners and other machines.

With CT critical in the fight for COVID diagnosis, Jersey General Hospital in the UK, were desperate to get their CT installed back in March when the COVID situation started to escalate.

Dan Moss, Region Service Sales Manager for the UK and Ireland clearly remembers the days in March when routines and

“I was delighted to hear that you were going to reward the two engineers (John & John), who attended our relocatable site in Jersey. The situation in Jersey was getting near to a point where we were in lockdown, so they could have both ended up in quarantine on the island for two weeks or longer. I would like to say on behalf of the Radiology staff, the General Hospital and indeed the whole

Just before the COVID-19 lockdown kicked in the UK – 5 engineers, Chris Copper, Adam Pannell, Liam Wattis, Shaun Megee and Robbie Cooper from GE Healthcare UKI, were working on mobile MR installation for InHealth in the Netherlands.

“Could we just stop installations, service and maintenance in the middle of a pandemic?

Of course not.”

Dan Moss, Region Service Sales Manager, GE Healthcare UKI

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“I would like to say on behalf of the radiology staff, the General Hospital and indeed the whole Island of Jersey how immensely grateful we are to John [Sinclair] and John [Breen], for the way in which they conducted themselves both professionally and with some humour considering the short timeframe they had to install our second scanner.”

Angus Fitchet from CT Scanning, Jersey General Hospital

The CT scanner, Revolution EVO, in the relocatable in Jersey General Hospital dedicated to COVID-19.

Island of Jersey how immensely grateful we are to John and John, for the way in which they conducted themselves both professionally and with some humour considering the short timeframe they had to install our second scanner. We now have resilience and a scanner to dedicate to COVID-19 patients. They even found time to replace a part on another scanner (our main RevolutionTM CT)” said Angus Fitchet from CT Scanning, Jersey General Hospital.

was sent to InHealth in the UK. InHealth work in more than 300 hospitals and community based medical centers all over the UK and provides MRI service among others for mobile, relocatable or fixed sites .

In another part of Europe and just before the borders closed, five service engineers took on a job in the Netherlands and worked until the last minute to get InHealth’s mobile MR trucks ready to use.

As the pandemic was taking its hold, the team wanted to get the job done borders were closing, there were no places to eat, and scheduled flights reducing. They made sure the MR’s were in the best position possible, before getting home on the last flights to their families. After the installations, the mobile MR trucks

Working from home just wasn’t an option for the engineers out in the field doing the

”The last thing you want is an unscheduled event where the system might be down for a couple of days, when the customer is scanning for COVID-19.”

“Our engineers did a fantastic job during a very hectic time and are true heroes.”

Dylan James, Director of Service, GE Healthcare UK

actual maintenance and making sure that the doctors had scanners working properly at their disposal. But how do you visit a hospital for installation or maintenance work in the middle of a pandemic, avoiding being infected or risking infecting others?

Dylan James, Director of Service at GE Healthcare in UK, explains: “Obviously, when something as unexpected and unknown as this happens, there is a lot of stress in the beginning.

Many customers didn’t have time, really, to contact us and let us know what to expect. So sometimes we didn’t know what their need was before arriving on site. We had to be prepared for that and to be able to react quickly – while at the same time making sure that our engineers were properly protected and that they felt safe.”

“Some customers said: ‘We don’t have time for you to come and do periodic maintenance right now’ and we would then find another arrangement for that site. But we also made it clear that from

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a technical perspective, the best way to achieve maximum uptime is regular and preventative maintenance. The last thing you want is an unscheduled event where the system might be down for a couple of days, when the customer is scanning for COVID-19. In the end, we didn’t miss a single service.”

“The picture could be changing by the hour.”

Hospitals still needed to be served and their equipment covered more than ever during the Corona crisis in order to optimize uptime and allow them to look after their patients.

One key factor for ensuring this is the availability of comprehensive and detailed information.

“The situation was complex: we often found very different demands at the different hospitals and sites. The feedback from our field engineers was that every hospital and every department did something different.

So, we asked our service managers from all over the UK to gather as much information as possible in order to paint a picture of what we were seeing and how we could react to the demand and

situation. The picture could be changing by the hour.”

“Our engineers did a fantastic job during a very hectic time and are the true heroes of all this. They are the kind that thrive on making sure that our systems in the hospitals are working properly in a very difficult time. And the more information we can give to our engineers, the better they can perform.

An important learning that I take with me is to focus more on information and communication – how to get, collect and distribute more relevant information to the relevant people more quickly. We did well, but we should still try to do better,” says Dylan James.

“At the end of the day, this is a story about a massive team effort, about delivering and collaborating.”

Dylan James, Director of Service, GE Healthcare UK

“At the end of the day, this is a story about a massive team effort, about delivering and collaborating. The way our service teams adapted personally – going from a 20-30 people strong team in the service center to being dispersed out to their houses while serving customers and making sure we didn’t drop the ball.

And the way that the engineers worked day in and day out throughout the whole peak. I think it just demonstrates the level of dedication our teams have. “

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When big CT scanners come in a box, easy to unpack and ready to use

“At that time, everybody was asking themselves what to expect, how many patients would need a CT scan and how long the COVID-wave would be exactly”

a CT scan and how would the COVID wave last, and if the hospitals would be able to cope with the demand,“ recalls Guillaume Fusari, Imaging Modality Manager at GE Healthcare in the UK and Ireland

CT-in-a-box installed at St Helens and Knowsley Teaching Hospitals NHS Trust in the UK.

Most people that have seen or been examined in a CT scanner will recognize that it is not exactly the type of machinery that comes to your doorstep, delivered in a box. It seems far too big, bulky and heavy – and it needs X-ray to function.

“In order to be prepared, the NHS set up a series of temporary field hospitals, named Nightingale hospitals, to provide cover for the projected increase in patients. These hospitals were set up in very different places, in the middle of nowhere in the countryside and in conference centers.

But they all needed a mobile CT solution to be placed close by, on a lawn or in a car park, that could be turned on and be ready for use. The same was true for many existing hospitals that simply had no room for installing an additional CT scanner.”

But ‘CT-in-a-box’ was in fact the name of that type of mobile and ready-to-use CT solution requested by NHS England in the middle of March 2020 when the COVID-19 pandemic hit UKI. And GE Healthcare soon began to deliver mobile CT units, 18 of them in total, the first one in April. And in fairly big ‘boxes’.

“At that time the NHS, like everybody else, was asking themselves what to expect, how many patients would need

“We all felt we were doing this effort for the patients affected by COVID.” Paul Kennedy, Director of Project Management, GE Healthcare Northern Europe

“The initial weeks leading into the COVID-19 outbreak created uncertainty about how to continue to offer outpatient radiology services in a way that was safe.

Somerset Foundation Trust was offered an opportunity to acquire an additional CT scanner and we chose GE. The decision was taken to site the scanner at Bridgwater Community Hospital (BCH).

This was the first time we’ve sited a CT scanner in the community, but GE and

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community estates team worked together to quickly plan for the scanner’s arrival.

Within only a few weeks the scanner was sited and became operational. This facility has meant that we can offer CT scanning away from the acute hospital which has given some anxious patients additional reassurance. The scan box itself provides a scan room size to rival most departmental scanners and has allowed us to maintain scanning, independent from the main Radiology department.

The GE installation team worked hard to get the scanner installed as quickly as possible and were able to make all necessary adjustments to tailor the box to the needs of Somerset FT,” said Adam Turner, Operational Manager of Radiology at Taunton & Somerset NHS Foundation.

“It was a learning process for everyone involved.”

A CT scan combines a series of X-ray images taken from different angles around a patient’s body and uses computer processing to create cross-sectional

images of the bones, blood vessels and soft tissues inside the body. As such, CT-scans are very helpful, if not essential, for the diagnosis and the management of patients with suspected or known COVID-19 infection .

The first agreement with the NHS stated that GE Healthcare should have delivered all 18 CT-scanners by end of June. But as the COVID situation developed during the first months, the NHS decided to push parts of the delivery.

”The scan box itself provides a scan room size to rival most departmental scanners and has allowed us to maintain scanning, independent from the main Radiology department.”

Adam Turner, Operational Manager of Radiology at Taunton & Somerset NHS Foundation.

“It was a learning process for everyone involved,” explains Paul Kennedy, Director of Project Management at GE Healthcare in Northern Europe. As head for the GE project managers who manage customer facing installation projects, Paul was ultimately responsible for designing the packaged and mobile CT-solution that would fit the best with NHS’s needs. Not surprisingly, the NHS decided for the fastest model to implement.

Inside the CT in a box at St Helens and Knowsley Teaching Hospitals NHS Trust.

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“The first ‘boxes’ delivered weren’t the same as the last ones.”

“As the NHS was learning more about COVID, they came back to us with additional requirements, for example about safety standards, things like infection control and hygiene procedures, and so we tweaked the design of the boxes. We also kept expanding the original boxes with things like ramps and patient waiting areas. So, the fact that the NHS was slowing down a bit in terms of when they needed all the CT scanners gave us time to keep improving the box-concept and the overall design.

The first ‘boxes’ delivered were not the same as the last ones.”

The ongoing refinement of the CT-in-a-box concept also involved the pre-installation work needed for setting up a CT scanner, like taking care of connection to electricity and water: “We knew that if we threw these kinds of problems at the NHS, it could go 18 different ways and eventually slow down the pace of installations. And so, the box-concept, meant that we could deliver a mobile and ready-to-use CT quickly – going beyond delivering just the CT itself,” adds Paul Kennedy.

“It was some crazy weeks and weekends in March and April.”

Meanwhile it was Stephen Cropper UKI Imaging Sales Director responsibility for driving the communication with

It was some crazy weeks and weekends in March and April. It could only happen because our people and team were so committed and dedicated.”

in terms of speed and scale this was definitely something I’ve never come across before.”

“I think we all felt we were doing this effort for the patients affected by COVID.”

The concept of delivering a CT scanner in ‘a box’ originates from GE Healthcare in China where the first outbreak of Guillaume Fusari, COVID-19 was seen. But that didn’t Imaging Modality Manager, mean that is was a simple copy-paste GE Healthcare UKI to a European context.

NHSE for weeks and even over nights and weekends and Guillaume Fusari’s responsibility to build and maintain a strong communication with the customer. He and Steve worked as duo to balance the expectations of the NHS with GE Healthcare’s supply chain and specialists. It wasn’t a period with a regular 9-5 job.

“It was some crazy weeks and weekends in March and April. It could only happen because our people and team were so committed and dedicated,” says Guillaume and is seconded by Paul: “I agree. This period and this kind of request, I can’t think of anything that we have responded to as quickly and as creatively as to this before. We often get asked to come up with solutions for different needs and scenarios, but

“We needed to go out and find the right local European providers and suppliers in order to build the complete systems. Excellent teamwork made it possible for us to succeed, for sure.

But if I should point out one particular important individual, it would Francois Meignan. He was simply fantastic in helping us work with the vendor and operationalize the design and production locally in France. He was a great support throughout the whole project, it would have been difficult without him,” Paul Kennedy says and continues: “No doubt the amount of work was phenomenal for a period, but it was the same for all of us. In the middle of a crisis, we felt we needed to do this – for ourselves, for the company, for the NHS. But in the end, we were doing this for the patients affected by COVID.“

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Ramping up: How to build and deliver 4 years’ worth of patient monitors in a few months

“Unprecedented must be the word of the year.”

‘Out of the ordinary’ does not entirely capture what began on a Tuesday afternoon in the middle of March 2020, when the Department of Health in Britain approached GE Healthcare with an urgent request for ventilators and patient monitors to secure proper care for COVID-19 patients in light of the rapidly evolving pandemic. In the treatment of severely ill patients, monitors are an important tool for doctors to see how effectively the patient is getting oxygen, how well the lungs are working, in addition to monitoring other key vital signs.

“It was just unprecedented, that’s what it was. Looking back, I think unprecedented must be the word of the year,“ says Hannah Horsfield, the Channel Manager for patient monitoring at GE Healthcare in the UK and Ireland. She normally takes orders from hospitals for about 20 or perhaps 30 patient monitors at a time. But this time was different.

“I got a phone call on a Tuesday morning if I could come in a conference call with the Department of Health that same afternoon. They asked if we could commit to delivering 300 ventilators and thousands of monitors within weeks, and my heart stopped a bit. That figure was ten times bigger than a normal request.

But then again, it was nothing compared to the 5,175 monitors in total that we ended up having delivered by end of July, only 3.5 months later. In some ways, it felt like years.”

”’We were looking at around 150,000 parts that had to come together in exactly the right way.”

Bev Grandon, Accessories Modality Manager, GE Healthcare UKI

GE Healthcare and GE Aviation joined forces to ramp up production of patient monitors to meet the demand in the UK and Ireland from March to June 2020.

GE Aviation raised its hands and put its plant and engineering team at GE Healthcare’s disposal.

“5,175 monitors – it’s a figure, that will never leave us, I think. “ “5,175 monitors – it’s a figure, that will never leave us, I think. To put it into perspective, it is about 4 years’ worth of monitors delivered in just a few months.

It was from the start of the process, that a lot of us started to have sleepless nights,” Hannah recalls.

Planning began immediately, and, just as fast, questions piled up in front of her and her immediate colleagues in charge of the unprecedented task, Tim Barraclough, Modality Leader for patient monitoring in the UK and Ireland, and Bev Grandon, Accessories Modality Manager in the UK and Ireland.

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In just 4 weeks, the GE Aviation plant in Cheltenham was completely transformed into a production site for patient monitors.

“We had to think of a new and contact-free way to deliver the monitors because of the risk of infection – normally, we set up the monitors on site in the hospitals. How could we package the monitors including the roll standers in a way that was easy for hospital staff to unbox, set-up and, most importantly, be ready to use in the best and most lean way? But the biggest challenge of them all was – where could we find the manpower and the facilities for ramping up production this much in such a short time,” says Tim Barraclough.

“The kitting system they built looked like a supermarket.”

The answer was to come flying in from an unexpected corner of the GE family, when GE Aviation in Cheltenham raised its hand and put its plant and engineering team at GE Healthcare’s disposal. In just 4 weeks, the aviation plant was completely transformed into a production site for patient monitors, to meet the excessive units’ production, as well as the production of corresponding accessories. In Tim’s recollection, he has never experienced anything quite as lean and as effective.

“At first, it seemed a little far-fetched.

But it quickly turned out to be the best decision we made and without their help, we would have never been able to

do it. It’s that simple. They put together a whole production line to get monitors assembled and configured, attached to a roll stand, packed with the right accessories, on to a pallet and then out of the door. The kitting system they built looked like a supermarket, they walked through with a shopping list and picked the items they needed and packed an accessory kit that fit to each particular monitor configuration. It was just amazing to see.“

“We were looking at 150.000 parts in total.”

Bev Grandon, responsible for the different types of accessories that went with each monitor, was at first hesitant if it would all work out well.

“To be honest, I didn’t think it was possible.

On the accessories side I thought it would be close to undoable, not just because of the complexity but also because of the sheer quantity of the task. In total we were looking at around 150,000 parts that had to come together in exactly the right way.

But the way the people from GE Aviation set about structuring the build processes from the first end to the last, the way they were thinking lean all the way through, soon convinced me that we were safe hands. I have really learned a lot and being part of this has been the highlight so far

“When you are in the middle of a pandemic, in a lockdown, desperate to get parts, hit by roadblocks left, right and center, when you finish work late at night – you get tired. But when you turn on the news and hear about the latest deaths and numbers of infected, it motivates you. When you know that we are helping somebody’s mum or dad, people will do what it takes.”

Hannah Horsfield, Channel Manager, Patient monitoring, GE Healthcare UKI

in my career. It’s has been a privilege to be part of and I’m pretty sure everyone involved feels the same way.”

“What we did in week 10 was so different to what we did in week 1.”

“Absolutely, we have learned so much from each other,” agrees Hannah. “In GE Healthcare, our skills set is knowledge

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about the product, about the patient, about what we need to deliver to the Department of Health. Aviation’s knowledge is about how you plan large scale production, and how you deliver something successfully in a lean way and with consistency.”

“It was inspiring to watch the things they considered. Like the way they measured the distance between the base of the roll stand and the basket so that each roll stand was built with a consistent height.

We never really thought of such a thing before. When we go onsite, we get things out of the boxes and start building.”

“This machine, if you like, that Aviation built for us kept getting better and more efficient throughout the period. We were all constantly evaluating what we were doing, and we kept refining each little process. I remember a serial number that had been labeled the wrong way which meant that we had to undo a billing. To prevent that from happening again, the Aviation guys put a macro in the excel form.”

“We were constantly making those tweaks. Simple things you might say, but

”It quickly turned out to be the best decision we made and without Aviation’s help, we would have never been able to do it.”

into lockdown without notice and made the chase for parts all the more stressful.

“Everyone was stressed to their eyeballs, all day, every day. But we never fell out, we got on. And perhaps the most important thing we learned is how much collaboration and a positive team spirit really mean. If one Tim Barraclough, Modality team couldn’t get parts that we needed, Leader, Patient Monitoring, we knew they had tried their best and that GE Healthcare UKI it wasn’t their fault. We didn’t play blame games, we kept a good tone all the way, and I am convinced that got a lot more out of people than if we were banging on they add up. And that is why, what we did the tables shouting - I need it now,“ Tim in week 10 was so different to what we concludes, as Hannah adds another and did in week 1.” perhaps equally important factor.

“We kept upbeat, and that got a lot more out of people.”

In the end, the combined forces of GE Healthcare and GE Aviation were delivering hundreds and hundreds of monitors every week. The effectiveness of the production opened the floor up in terms of planning and enabled the team to better foresee coming roadblocks and to take action accordingly. During the whole period it was a constant challenge getting all the parts needed. Suppliers around the world went

“This was serious, and we were in unique position to make a difference. When you are in the middle of a pandemic, in a lockdown, desperate to get parts, hit by roadblocks left, right and center, when you finish work late at night – you get tired. But when you turn on the news and hear about the latest deaths and numbers of infected, that motivates you and you want to work your backside off. When you know that we are helping somebody’s mum or dad, I think most people will do what it takes.”

GE Healthcare and GE Aviation, UKI worked together to build and deliver 5,175 patient monitors in less than four months.

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