Resources for OR Design & Construction

If you’re designing new operating rooms, equipment planning is a critical part of the project, whether it entails new construction or remodeling of existing space.

The opportunity to build an OR suite doesn’t come often, and planning for new technology is complex. For that reason, teams often look for expertise from an equipment planning consultant. One of the planner’s significant roles is to provide the vision and guidance for technology aspects of the project. Equally important is an equipment planner’s role in creating a process for decision making on medical equipment planning issues. The planner should be brought in as early as possible to coordinate and participate in these decisions to help avoid conflicts between equipment and other aspects of design.

Vision is essential. Whether the project involves new construction or renovation, the planning and design team will want to reexamine the flow of patients and supplies and determine how surgical procedures are changing. Which specialties are growing or declining? Which procedures does the facility expect to increase or decrease? What technologies will make certain procedures less invasive? Which will be done in an outpatient setting?

Equally important is coordination. A planner coordinates equipment-related issues with all parties, including the surgical team, architect, contractor, facilities engineers, and others. For example, an OR has many technologies that generate heat. How will these affect the heating and air conditioning system? Also important are structural issues. What supports will be needed for equipment and utilities? Because many new technologies rely on information systems, what coordination is needed with the rest of the hospital’s information network?

If you’re planning a minimally invasive surgery (MIS) OR, you may plan to install equipment booms that involve a variety of services and vendors. Equipment planning must consider all of these parties. In one situation, an OR project was headed by a well-known MIS surgeon who had some good ideas about equipment planning. As the team started to draw up plans, they realized they had started without consulting with the anesthesiologists. Leaving out a potentially vital team member can have costly implications on design and construction plans and budgets.

A planner also coordinates current equipment inventory with new equipment needs. In an MIS OR, for instance, can you use existing electrosurgical units or will you need to upgrade? To what extent will you standardize equipment?

Questions to ask any equipment planner

Key questions to ask when selecting an equipment planner include:

• What is the planner’s level of expertise? How much experience does the planner have with projects similar to yours?
• What resources does the planner rely on? How does the planner monitor new and emerging technology and assess its efficacy?
• Does the planner have agreements with certain vendors? Is the planner free to consider other vendors as well?

What is surgical services director’s role?

Surgical services leaders should be closely involved in all phases of design and construction. They bring an important clinical perspective because they will use the suite every day. They should not hesitate to provide input and ask questions.

They and their staff know what works well in the current ORs and what they want to change. They understand how equipment is used and how it affects the workflow. They have experience with various brands of equipment and know about service, reliability, ergonomics, and educational issues.

Equipment planning process

Here is how an equipment planner is involved in the design and construction process:

• Early in the project, meet with clinicians, the architect, and administrators to gain a vision of the new space and how it will be used.
• Consult with the architect as the architect develops a space program, which is a "blueprint" of how the space will be organized.
• Develop a preliminary equipment budget. ECRI uses its own database, which has templates for equipment for various types of rooms, for example, an orthopedic OR.
• Inventory current equipment and recommend how it should be allocated to the new facility based not only on its physical condition, but whether it will meet long-term future needs.
• Consult with the architect during design development as more detailed drawings are made. Meet with clinicians to make more specific decisions about equipment needs and refine templates into formal room layouts. Begin to zero in on manufacturers and models while monitoring the budget. Consider issues such as weight, utility and information technology demands.
• Continue to consult with the architect before construction documents are prepared so decisions can be made about fixed equipment, which may require structural support.
• Develop detailed equipment lists that include new and existing equipment. Compile specific technical information on equipment, for architect and contractor planning. Coordinate with other members of the design team to review drawings and plans.
• Assist in the hospital decision-making and procurement process, including coordinating requests for proposal, vendor negotiations, time lines for delivery, and acceptance testing.
• Continue to be a resource for the hospital’s team, the architect, and contractor as phases of the project are completed.

Operating room construction or renovation is a complex and detailed process, involving close coordination and long-term planning. Ultimately, a good equipment planner can make the difference between a confused, over-budget project, and one that fulfills the exciting original vision of your new OR suite.

Reprinted from OR Manager newsletter, December 2002. Copyright 2002. OR Manager, Inc. ormanager.com. All rights reserved.