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.
Research studies over the past several decades have indicated the possible harmful effects on healthcare workers from low-level work-related exposure to any of more than 200 medications that are considered hazardous drugs. As a result, the United States Pharmacopeia (USP) — a nonprofit compendium of drug information — published the nation’s first standards on the handling of hazardous drugs from receipt to disposal. Chapter 800, titled “Hazardous Drugs — Handling in Healthcare Settings,” applies to all healthcare personnel who handle hazardous drug preparations and all entities that store, prepare, transport, or administer hazardous drugs, such as pharmacies, hospitals, clinics, and physician offices. Hazardous drugs include those used for cancer chemotherapy, antiviral drugs, hormones, and some bioengineered drugs. Most existing pharmacies will need to modify their workflow, space, and infrastructure to comply with USP 800 when it becomes effective on December 1, 2019.
Planning a surgery suite used to be fairly simple. General operating rooms were used for a wide range of procedures with dedicated operating rooms limited to cardiac surgery and orthopedics. Today, the question “How many operating rooms are needed?” is complicated by more stringent distinctions between operating rooms and procedure rooms, changing technology and increasing specialization, and the convergence of diagnostic imaging and surgical procedures. From a facility planning perspective, the number, size, and specialization of the operating rooms (ORs) is the single biggest factor contributing to the overall footprint of the surgery suite (and project cost). Moreover, the numbers and sizes of related patient care and support spaces are planned based on the number and types of ORs. And, from an operational standpoint, the number of ORs drives ongoing staffing and related operational costs.
Physician 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.
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 operating rooms (ORs) is determined, an estimate of the total footprint required for the surgical suite can be made using the rules-of-thumb in this post.
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 to the their designated entrance as possible. Innovations in design, technology, and financing, along with careful planning, can mitigate shortages and improve customer convenience. Because easy and convenient access is a prime indicator of hospital customer satisfaction, more U.S. hospitals are rethinking the expansive asphalt parking lot and dreary concrete parking structure.