Operating Room Design: “The Devil is in the Details”

297 No perfect operating room (OR) exists and many, if not most, surgeons have complained about their workplace at one time or another. But just imagine if you had complete control over the design of your operating room and could fashion it as you pleased. What would you change? Where would you begin? Certainly, many surgical sales-persons would like to sell their product, but would that product be right for the patient, right for you the surgeon, right for the nurses, right for administration, and right for the payers who ultimately fund hospital activities? Importantly, does the OR design change represent your needs, or, in fact, does that change represent your wants? Philosophizing about what represents an optimal operating room turns out to be easier than actually designing one. In reality, it is not just the surgeon who is concerned with an operating room. Many constituents are intensely interested in the OR, and these constituents frequently have different agendas. With modern, complex operating rooms, great attention must be paid to the " details. " A huge problem can lurk in just neglecting one small detail, and with operating room design " the devil is in the details. " 1 Technology has driven operating room design since the earliest times. That technology may have been " low tech, " such as access to prevailing light or proximity to patient floors. Or it may have been " high tech, " such as machines that sterilize instruments or devices that administer anesthesia. In either case, technology was utilized to benefit patient care and empower the surgeon to perform interventions not possible in any other setting. In today's age, technology has continued to determine operating room design. Voice activated controls, robotic devices, and incorporation of the developing science of ergonomics has changed how we think about operating rooms. Operating rooms constructed in the 20th century are different from those designed at the end of the 19th. And those of the 21st century promise to be very different from those of the preceding century. For instance, " low tech " areas, such as the physical plant and basic surgical instruments, have garnered intense study. It is recognized that patient flow through a system is important and that the integration of patient flow with the processes of preoperative care, operating room transfer , and postoperative recovery is important for the expeditious , cost-efficient management of a …