Flevo Hospital
At the Flevo Hospital in Almere, the Netherlands, Kieback&Peter has integrated a smart automation solution for surgery. © Kieback&Peter

Operating theaters – like those of the Flevo Hospital in Almere, the Netherlands – are the beating heart of surgical medicine. The largest clinic in the province of Flevo treats more than 100,000 patients annually. In order to provide these patients with the fastest and best possible state-of- the-art medical care, the five existing operating theaters were fully modernized in 2018 and four new operating theaters were added. To better prevent infections during the operation, a unique ventilation system with two zones creates a highly sterile atmosphere around the operating table. Numerous control and monitoring systems ensure that no equipment fails during an operation and all technical functions are documented. For the complex task of automating the ventilation and air conditioning of the new operating theaters, an open and redundant communication system is required. Once again, the Flevo Hospital tasked Kieback&Peter with the technical integration of this highly sensitive environment.

Name of the operation: Operating theaters of the future

The automation of the four new operating theaters in the Flevo Hospital proves once again that experience is often the key to success. The Dutch branch of Kieback&Peter is gathering experience with the Dutch market since 2001. They have already created smart solutions in other areas of the clinic. This time, they integrated the technical systems for the new operating theaters into the existing control technology: Neutrino BMS is the management system software from Kieback&Peter which runs on a server in the surgical equipment room. The software visualizes all system components and conditions in the five existing operating theaters and four new operating theaters on a PC workstation with flat screen. Facility managers at the hospital are trained in how to use Neutrino BMS. If required, they can set target specifications via the intuitive graphical user interface. All of the integrated technical systems of the new operating theaters are actually regulated from two main information centers: Every two operating theaters have a control cabinet, which houses the flexible and powerful DDC4200 controllers from Kieback&Peter. The controllers use cables to continuously communicate with the Neutrino- BMS and field devices – actuators and sensor – located at 800 physical data points, and thus ensure appropriate regulatory actions. To guarantee the reliability required, both the controllers and the field devices of the two information centers work redundantly, in other words they duplicate each other. If, for example, an air pressure sensor or a damper actuator fails in the ventilation system, the respective twin component takes over the work, and the system immediately reports the fault to the facility management team. The DDC4200 controllers also work in duplicate for maximum safety.

Efficiently clearing the air

Der Operationssaal des Flevo-Krankenhauses
In order to guarantee the cleanest atmosphere around the operating table, the innovative Opragon air distribution system is supplied with the required air quality and quantity by the Kieback&Peter automation solution. ǀ © Kieback&Peter

The assignment handed out to Sander Kroon by the Flevo Hospital hinged on complete reliability and nothing less than perfection. Sander Kroon is the account manager for the Flevo Hospital and was responsible for the complete sales process. He and his team of technicians and engineers had to develop a complex automation solution for the four new operating theaters. One of the most difficult tasks was to control the ventilation and air conditioning of the treatment rooms using the unique Opragon surgical ventilation system from a third party: Using special, non-mechanical ceiling outlets, the system is designed to blow pure air into the rooms and distribute it in such a way that surgeons have a highly sanitized atmosphere in their working area. The air temperature should also be 1.5 degrees Celsius cooler than the surrounding secondary zone. The Kieback&Peter team was tasked with providing a smart system to supply and monitor the required air quality. All relevant data and values had to be displayed to the OR team in real-time via the third-party Bender OR monitoring system. In addition, the entire system should work redundantly: If a component fails, a replacement system should spring into action immediately. A further challenge was to store important data for each operation centrally in a tamper-proof manner in accordance with the FDA 21 Compliance Requirement, Section 11. Kieback&Peter launched the project in May 2018. The acceptance process was scheduled to take place as early as December 2018 — a tight timescale for such a big challenge.

Calibrated for maximum control quality

Numerous calibrated field devices are supplied by Kieback&Peter to ensure that the Opragon ventilation system with its innovative ceiling outlets and floor extraction points always maintains the required air quality and quantity. Among other things, the field devices maintain the relative humidity of the supply air at a constant 55% and ensure the required temperature difference of 1.5 Kelvin between the operating zone and surrounding zone. Before an operation can begin, the system checks whether all components can work without disruption and gives the surgeons the go-ahead. The doctors can use the Bender surgical control monitors, which are connected via BACnet, to keep a constant overview of the operating status of their systems.   


In order to record all important operational data, Kieback&Peter has installed an additional, separate building management system, Neutrino BMS. This is networked with its own information center where the digital information from all nine old and new operating theaters converges and is stored centrally. The system is tamper-proof in accordance with FDA 21, Section 11. This makes it possible to verify at any time how all technical systems have functioned during an operation. Kieback&Peter’s team of experts did such a good job that the smart system worked flawlessly and in accordance with all requirements just in time for the handover date.

From the control cabinets, the flexible and powerful DDC4200 controllers from Kieback&Peter orchestrate the regulatory actions of actuators and sensors in the new operating theaters.

Flevo Hospital, Almere – Technology at a glance:

  • Integration of ventilation and air conditioning in a single system
  • Real-time monitoring using the Neutrino BMS building management software
  • Global standard BACnet used for communication at the management and automation levels                             
  • 3 information centers with 5 DDC4200 automation stations
  • 800 physical data points