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.
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.
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.
Endoscopy procedures — using a rigid or flexible scope to examine the interior of a hollow organ or cavity in the body — may involve the upper gastrointestinal tract (GI endoscopies), large intestine (colonoscopies and sigmoidoscopies), lower respiratory tract (bronchoscopies) and the urinary tract (cystoscopies) along with a variety of other specialized procedures. Endoscopy procedures generally take 30 to 45 minutes. Patients are usually given intravenous sedation and may recover for up to an hour after the procedure. Recovery time has been reduced significantly in recent years due to the use of shorter-acting sedatives.
Removing as much of a brain tumor as possible during neurosurgery can make a critical difference in preventing recurrence. Philips has introduced a new MR-OR intraoperative neurosurgery solution based on its Ingenia MR system that allows a neurosurgeon to quickly perform a magnetic resonance imaging (MR or MRI) scan to check the results of a resection during the surgery and remove additional tumor mass if necessary — without first closing the patient’s skull. This reduces the number of repeat surgical procedures, shortens hospital stays, and improves neurosurgery success rates.
According to Joint Commission safety experts, wrong-site surgeries and procedures happen as many as 40 times each week in U.S. hospitals. In Rhode Island, state health officials have issued a consent decree for the 719-bed Rhode Island Hospital in Providence to begin using cameras in the operating room after five wrong-site surgeries occurred there between 2007 and 2009. Each of the hospital’s 379 surgeons must be recorded on video during two of their procedures each year and they don’t know when those times might be. The randomly assigned cameras have been streaming operations live so they can be seen in real time by an observer in another room. No digital or print records are kept.