A sensor-based framework for layout and workflow assessment in operating rooms.

Due to their large sizes and impediments to personnel workflows, integrating robotic technologies into the existing operating rooms (OR) is a challenge. In this study, we developed an ultra-wideband sensor-based human-machine-environment framework for layout and workflow assessments within the OR. In addition to providing best practices for use of the framework, we also demonstrated its effectiveness in understanding layout and workflow inefficiencies in 12 robotic-assisted surgeries (RAS) across 4 different surgical specialties. We found avoidable movements as the circulating nurse covers at least twice the distance of any other OR personnel before the patient cart (robot) is docked. OR areas of congestion and undesirable personnel-pair proximities across RAS phases that impose extra non-technical skill challenges were determined. Our findings highlight several implications for the added complexity of integrating robotic technologies into the OR, which can serve as drivers for objective evidence-based recommendations to combat RAS OR layout and workflow inefficiencies.

Associations of Surgical Team Communication With the Layout of Physical Space: A Network Analysis of the Operating Room in a Military Medical Center.

AIM: To examine how the spatial topology of the operating room (OR) within the medical center impacts surgical team communication. BACKGROUND: Understanding the complex association between surgical team communication and the OR's spatial network location is critical to patient safety. Effective surgical communication is associated with fewer adverse events and medical errors. METHODS: We employed a cross-sectional, quantitative, case study, and network-centric study design. We studied the population of 204 clinicians in a large military medical center (36 perioperative nurses, 34 surgical technicians, 62 anesthesia providers, and 72 surgeons), focusing on surgical teams with cases completed within duty hours. Data were collected from December 2020 to June 2021 using an electronic survey. Spatial network analysis was done using electronic floor plans. Statistical analysis was done with descriptive statistics and linear regressions. The outcomes were general and task-specific communication, and team-level variables were aggregated from scores for all team members. Spatial effects were assessed with network centrality (degree, Laplacian, and betweenness). RESULTS: The individual-level survey response rate was 77% (157 of 204). Data were collected on 137 surgical teams. On a 5-point scale, general and task-specific communication ranged from 3.4 to 5.0 and 3.5 to 5.0, respectively (for both, median = 4.7). Team size ranged from 4 to 6 individuals (median = 4). Surgical suites with higher network centralities were associated with significantly lower communication scores. CONCLUSIONS: The OR's spatial network location has important impacts on surgical team communication. Our findings have design and workflow implications for ORs and even surgical care in combat zones.

Using a systems approach to evaluate a circulating nurse's work patterns and workflow disruptions.

The physical environment affects how work is done in operating rooms (OR). The circulating nurse (CN), in particular, requires access to and interacts with materials, equipment, and technology more than other OR team members. Naturalistic study of CN behavior is therefore valuable in assessing how OR space and physical configuration influences work patterns and disruptions. This study evaluated the CNs' work patterns and flow disruptions (FD) by analyzing 25 surgeries across three different ORs. The OR layouts were divided into transitional and functional zones, and the work of CNs was categorized into patient, equipment, material, and information tasks. The results reveal that information tasks involve less movement than other types of work, while across all ORs, CNs were more likely to be involved in layout and environmental hazard FDs when involved in patient, material, or equipment-related tasks compared to information tasks. Different CN work patterns and flow disruptions between ORs suggest a link between OR layout and a CN's work. Future studies should examine how specific layout elements influence outcomes.

Layout design of operating area in Model 920 hospital ship / 医疗卫生装备

Objective To research the location,composition,zoning,flow and combination form of medical system of Model 920 hospital ship, and to provide theoretical support for the design of the hospital ship. Methods The layout of medical system of the hospital ship was constructed based on the theories of ship engineering design,hospital architecture design and naval health service as well as the requirements for height and internal environment of medical system.Results The mode combining multi corridor and single column was used to design 8 operating rooms and accessories in the midship of No.01 deck.Conclusion The multi-corridor single-column combination operating area occupies less ship space resources and the surgical treatment of wounded and sick patients is efficient, which is suitable for the platform of the ship and is worthy of reference for the design of the medical system of the large-scale rescue platform on the sea. [Chinese Medical Equipment Journal,2018,39(5):39-43]