How Many ORs? It’s Complicated

Surgery SuitePlanning a surgery suite used to be fairly simple. General operating rooms were used for a wide range of procedures and dedicated operating rooms were limited to cardiac surgery and orthopedics. At the same time, interventional radiologists and cardiologists created their own workplaces. Today, planning surgical and endovascular suites is complicated by the convergence of diagnostic imaging and surgical procedures, rapidly changing technology, increasing specialization, and strict distinctions between operating rooms and procedure rooms. From a facility planning perspective, the number, size, and specialization of ORs and endovascular procedure rooms is the single most significant factor contributing to the overall footprint of the suite (and project cost). Moreover, the numbers and sizes of related patient care and support spaces are driven by the number and types of operating/procedure rooms. More importantly, the number of operating/procedure rooms drives ongoing staffing and related operational costs.

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Sizing Imaging and Procedure Rooms

Imaging and procedure rooms fall into several size categories — small procedure rooms, typical imaging rooms, or larger specialty imaging rooms. Diagnostic equipment has generally become more compact over time. For example, equipment used for chest X-rays, mammography, ultrasound, and pulmonary and neurodiagnostic testing is compact and commonly mobile, requiring only a small procedure room. Most general radiographic and fluoroscopic equipment can be accommodated in a typical imaging room. Computed tomography (CT) units are also becoming more compact but require a contiguous control room. Magnetic resonance imaging (MRI) and interventional procedure suites require a larger footprint that includes the procedure room, control room, and adjacent space for equipment (or system) components. Imaging equipment may also require lead shielding, enhanced floor loading capacity, and other unique design features. The FGI Guidelines also classify imaging rooms based on different levels of patient acuity and intervention.

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Physician Offices and Outpatient Clinics: How Many Exam Rooms?

Patient With DoctorPhysician offices and outpatient clinics typically consists of a patient intake area with space for reception, check-in/check-out, and waiting; exam/treatment space with a number of identical exam rooms, several office/consultation rooms, and one or more special procedure rooms; and associated clinical and administrative support space. Physician office space may be located in a medical office building (either freestanding or connected to a hospital), co-located with diagnostic and treatment services in a comprehensive ambulatory care center, or part of an institute or center organized along a specific service line — such as a Sports Medicine Center, Heart Center, or Cancer Center. Planning space for physician offices (also referred to as physician practice space) and outpatient clinics begins with determining how many exam rooms are needed and two different approaches are commonly used.

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Estimating Diagnostic Imaging Space Based on the Number of Procedure Rooms

Sometimes a preliminary space estimate is needed to evaluate location alternatives, conduct a feasibility study, or develop a preliminary cost estimate for construction or renovation. Once the number of procedure rooms is determined, an estimate of the total footprint required for the diagnostic imaging suite can be made using the range of DGSF (DGSM) per procedure room shown in this post.

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Rethinking Parking Lots and Structures

When it comes to parking, hospitals seem to never have enough. At the same time, customers ― whether patients, staff, or visitors ― always want to park as close as possible to the their designated entrance. Because easy and convenient access is a prime indicator of hospital customer satisfaction, U.S. hospitals are rethinking the expansive asphalt parking lot and dreary concrete parking structure. Innovations in design, technology, and financing, along with careful planning, can mitigate shortages and improve customer convenience. Now with a global pandemic, parking lots and structures are also being called into action as part of an organization’s emergency response strategy.

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Factors Affecting the Size of a Surgery Suite

The hospital surgery suite has undergone revolutionary change over the past several decades. For a long time, the focus has been on shifting surgery to a lower-cost outpatient setting. This has been replaced with a focus on lowering both the costs and risks of surgery with the ongoing migration from invasive to less-invasive surgery or noninvasive procedures. Minimally-invasive, image-guided, robotic, and telesurgery ― along with intraoperative imaging techniques ― continue to replace traditional surgical procedures. Aside from the economies of scale achieved with larger surgical suites, the biggest single factor contributing to the overall footprint of the surgery suite is the size and specialization of the individual operating rooms (ORs). Other factors include the proportion of outpatient surgery performed in the suite, and the type of patient care spaces provided, as well as the efficiency of the surgical suite layout.

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