By Akshay Sangolli and Mark Vaughan
Behind many successful surgeries lies complex medical equipment and a team of skilled professionals. The operating rooms (ORs) where these procedures occur are equally complex, fast-paced, and demanding. They call for flexibility and careful planning in their design. As hospitals reevaluate their post-pandemic utilization and needs, the perioperative environment requires adaptable ORs that can respond to changing demands.
Planning considerations
When designing a modern OR, there are several factors to consider: efficient workflow, standardization, and quality and safety.
- Efficient workflow. Streamlining workflows within the OR is like organizing a well-choreographed dance where everyone knows their steps. Experienced designers will simulate full-scale ORs to evaluate workflows with doctors and nurses, helping inform design and facilitate communication between surgeons, anesthesiologists, nurses, and support staff. Workflow design requires thoughtful, hands-on planning to use resources and space efficiently and safely while supporting patient care.
- Standardization. Because hospitals typically have multiple ORs, standardization is important as it supports consistency in how each room is set up and organized. Doctors and nurses know where to find the equipment and supplies they need when they move between ORs. This consistency can save time and may help reduce errors, an important consideration for patient safety. Standardizing OR design also helps hospitals manage equipment and supplies consistently across rooms. Additionally, designing universal ORs with standardized layouts and room set-ups can support scheduling flexibility and OR utilization.
- Quality and safety. Operating rooms are a fundamental part of the hospital environment, and supporting a safe experience for patients, surgeons, and staff is essential. Patients trust surgical teams with their well-being, while surgeons depend on carefully managed and well-equipped environments to perform procedures as intended. Prioritizing safety while maintaining a sterile environment and procedural accuracy helps reduce risks and supports patient care.
While these factors are important, it’s also necessary to understand the nuances and complexities of modern ORs. For example, general ORs differ from urology or orthopedic ORs. Each has different needs, including specialized equipment, support systems, and safety requirements. Designers must assess ORs individually and understand their goals before design begins.
Incorporating innovative technologies
The healthcare sector has historically been slower to embrace new technologies due to concerns about high implementation costs, uncertainty about patient benefits, regulatory hurdles, and data privacy. COVID-19 prompted a substantial disruption, particularly with the widespread adoption of telemedicine, which accelerated the shift toward digital patient care approaches. However, healthcare innovations have become more prevalent in recent years, especially in areas such as artificial intelligence (AI), augmented reality, and robotics, with many of these technologies supporting patient and staff experience.
" }UNC Health’s North Carolina Surgical Hospital aims to support precise and efficient care with its modern operating rooms.
One significant development is the integration of advanced imaging modalities, including MRI, CT scans, and intraoperative ultrasound. These technologies allow surgeons to visualize procedures in real time. Robotic-assisted surgery has become more common in the OR and allows surgeons to use robotic instruments during complex procedures, particularly in confined spaces or delicate areas. Various surgical instruments can be connected to robotic arms, allowing surgeons to manipulate graspers and other equipment remotely. Remote connectivity technologies have also played a growing role in healthcare, especially following the COVID-19 pandemic. Through telepresence and video conferencing solutions, specialists can remotely participate in surgical procedures, providing real-time guidance and insight to on-site teams. These techniques also make it easier to share medical images, patient data, and surgical plans.
The implementation of hybrid operating rooms has also seen substantial growth due to these advancements and the increasing demand for integrated surgical solutions. Hybrid ORs combine traditional surgical facilities with advanced imaging and diagnostic capabilities, allowing for a wider range of procedures. For example, UNC Health’s North Carolina Surgical Hospital, a seven-story, 375,000-square-foot building located in Chapel Hill, has recently added 26 new surgical suites that accommodate equipment designed to support the patient experience.
Four of these ORs are hybrid rooms that accommodate imaging technology and equipment, helping surgeons perform certain procedures using in-room imaging rather than traditional surgical approaches. For example, surgeons can make small incisions and use in-room imaging to perform delicate repairs on abdominal aortic aneurysms or bulges in the artery below the heart instead of the large chest incision used in traditional surgery.
Patient and staff experience
Thoughtful design plays a role in shaping patient and staff experiences within a medical facility by incorporating welcoming spaces that encourage comfort and emotional well-being. Hackensack Meridian Health, a not-for-profit healthcare organization based in New Jersey, is one example of designing for the patient experience.
" }Intraoperative MRI between two Neuro ORs at the Hackensack University Medical Center’s Helena Theurer Pavilion combines a traditional surgical environment with advanced imaging and diagnostic capabilities.
The Helena Theurer Pavilion is a nine-story surgical and intensive care tower on the Hackensack University Medical Center campus in Hackensack, New Jersey. The goal was to create an environment that supports patient and family comfort while creating an efficient workflow for staff. By organizing vertical circulation and separating staff elevators from patient elevators, the design helps with wayfinding and keeps staff organized within the complex. The perioperative platform includes 24 ORs distributed across two adjacent floors and 72 prep/recovery spaces. The surgical suite integrates modern technology, including an intraoperative MRI. Additionally, the dual-purpose surgical suite includes separate areas for inpatient and outpatient procedures, supporting efficient use of resources, particularly the intraoperative MRI, even when it is not being used for surgery.
Future-proofing and flexibility
Flexibility and future-proofing are important considerations when designing operating suites to support teams of specialists, accommodate future technological advances, and prepare for tomorrow’s unknown challenges.
By incorporating flexibility into the design, ORs can more easily integrate emerging technologies and adapt to evolving surgical procedures. Similarly, future-proofing can support an operating room's longevity and help reduce the frequency of significant renovations or equipment replacement.
" }Hospitals must future-proof by expanding infrastructure to meet the rising demands for neurosurgery in the coming decade.
Inherent in the process, designers need to consider scalability, compatibility with emerging industry standards, investments in durable equipment, and establishing processes for ongoing evaluation to identify emerging trends and opportunities for improvement.
Designing modern ORs requires careful planning, flexibility, and foresight. Current knowledge of healthcare technologies and equipment helps hospital ORs adapt to future innovations and the dynamic needs of medical professionals and patients.
A version of this blog was originally published by Page, now Stantec.
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