Specialty
Neurosurgery
A head injury from the road is the case Indian neurosurgery sees most, and it arrives out of hours, through casualty, needing a scan, a theatre, an anaesthetist and an intensive care bed at the same time. Each of those four is held by a different desk, and the case is assembled by a registrar on a telephone.
The delay is between departments, and it is where the outcome is decided.
Nobody in the chain is slow. The chain has no shared state.
Casualty knows the patient. Radiology knows the scanner. The theatre knows the list. Intensive care knows the beds. None of the four can see the other three, so the case is coordinated by whoever is willing to keep ringing.
Eliminate the coordination that runs on a telephone and a registrar's memory. Nexus holds the digital twin of the hospital: the rooms, the equipment, the teams and the roster, so a theatre and a bed are objects with a state rather than an answer somebody has to go and get.
Impact and action
Before the theatre.
- The scan is requested by phone, the porter is found by hand, and the report is read on the radiology workstation.The request is one order with a live state, and the completed study returns to it and opens in the record.ForgeAtlas
- Theatre availability, the anaesthetist on call and the intensive care bed are three separate enquiries.All three are resources in the digital twin of the hospital, with schedules and a duty roster, so who is on and what is free is a fact rather than a call.Gate
In the theatre.
- Cranial fixation, dural substitutes, shunts and navigation consumables are written on a sheet and priced afterwards.Each is issued against the case as it is used, and the charge is placed by the order that used it.ForgeVault
The unit.
- The handover into critical care is spoken, and the neurological baseline it establishes is the one everything afterwards is compared to.The handover runs as a defined procedure with its own steps and a live board showing every case on it.Cadence
- Ventilator settings and intracranial pressure sit on the machines, and the chart holds an hourly sample of them.The devices connect over one managed outbound link, and their output attaches to the patient.Westron
The medico legal case.
- A road traffic case carries statutory obligations that gate both discharge and the claim, and they are tracked on a register in another room.Those steps run inside the same procedure the clinical work runs in, and an outstanding one is flagged as overdue before discharge.CadenceVigil
Four departments, one case, one state.
