OR Design Toolkit


CIRCULATION ZONE

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OR Design Toolkit / Circulation Zone

Circulation Zone

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Sufficient circulation area to accommodate the flow of all surgical team members. equipment, and supplies supports reduced potential for hazards such as slips, trips, and falls.

DESIRED OUTCOMES/CITATIONS

Improve movement and flow              

Peer-reviewed (empirical study)

Joseph et al., 2018
Joseph, A., Khoshkenar, A., Taaffe, K. M., Catchpole, K., Machry, H., & Bayramzadeh, S. (2018). Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room. BMJ Qual Saf, bmjqs-2018.

Best Practice report (non peer-reviewed)

Lee, 2015
Lee, K. (2015). Designing The OR Of The Future. Healthcare Design Magazine. Available at https://www.healthcaredesignmagazine.com/trends/construction-engineering/designing-or-future/?hilite=%27designing%27%2C%27Future%27

Peer-reviewed (best practice, design guidelines, or literature review report)

FGI Guidelines, Hospitals, 2018
Facility Guidelines Institute. (2018). 2018 FGI Guidelines for Design and Construction of Hospitals. Washington, D.C.: Facility Guidelines Institute.

Peer-reviewed (best practice, design guidelines, or literature review report)

FGI Guidelines, Hospitals, 2018
Facility Guidelines Institute. (2018). 2018 FGI Guidelines for Design and Construction of Hospitals. Washington, D.C.: Facility Guidelines Institute.

Reduce disruptions              

Peer-reviewed (empirical study)

Joseph et al., 2018
Joseph, A., Khoshkenar, A., Taaffe, K. M., Catchpole, K., Machry, H., & Bayramzadeh, S. (2018). Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room. BMJ Qual Saf, bmjqs-2018.

Peer-reviewed (empirical study)

Bayramzadeh et al., 2018
Bayramzadeh, S., Joseph, A., San, D., Khoshkenar, A., Taaffe, K., Jafarifiroozabadi, R., ... & RIPCHD. OR Study Group. (2018). The impact of operating room layout on circulating nurse’s work patterns and flow disruptions: A behavioral mapping study. HERD: Health Environments Research & Design Journal, 11(3), 124-138.

TYPE OF STRATEGY

People Task Technology Built Environment

Unobstructed circulation pathways support reduced work flow challenges that can lead to potential hazards such as surgical errors, slips, trips, and falls by increasing access to supplies, equipment, and communication devices during the procedure.

DESIRED OUTCOMES/CITATIONS

Improve movement and flow              

Peer-reviewed (empirical study)

Ahmad et al., 2016
Ahmad, N., Hussein, A. A., Cavuoto, L., Sharif, M., Allers, J. C., Hinata, N., ... & Guru, K. A. (2016). Ambulatory movements, team dynamics and interactions during robot‐assisted surgery. BJU international, 118(1), 132-139.

Peer-reviewed (empirical study)

Palmer et al, 2013
Palmer, G., Abernathy, J. H., Swinton, G., Allison, D., Greenstein, J., Shappell, S., ... & Reeves, S. T. (2013). Realizing improved patient care through human-centered operating room designa human factors methodology for observing flow disruptions in the cardiothoracic operating room. The Journal of the American Society of Anesthesiologists, 119(5), 1066-1077.

Peer-reviewed (best practice, design guidelines, or literature review report)

Brogmus et al., 2007
Brogmus, G., Leone, W., Butler, L., & Hernandez, E. (2007). Best practices in OR suite layout and equipment choices to reduce slips, trips, and falls. AORN journal, 86(3), 384-398.

Peer-reviewed (empirical study)

Bell et al., 2008
Bell, J. L., Collins, J. W., Wolf, L., Grönqvist, R., Chiou, S., Chang, W. R., ... & Evanoff, B. (2008). Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees. Ergonomics, 51(12), 1906-1925.

Peer-reviewed (empirical study)

Neyens et al., 2018
Neyens, D. M., Bayramzadeh, S., Catchpole, K., Joseph, A., Taaffe, K., Jurewicz, K., ... & Group, R. O. S. (2018). Using a systems approach to evaluate a circulating nurse's work patterns and workflow disruptions. Applied ergonomics.

Peer-reviewed (empirical study)

Joseph et al., 2018
Joseph, A., Khoshkenar, A., Taaffe, K. M., Catchpole, K., Machry, H., & Bayramzadeh, S. (2018). Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room. BMJ Qual Saf, bmjqs-2018.

Reduce slips, trips, and falls              

Peer-reviewed (best practice, design guidelines, or literature review report)

Brogmus et al., 2007
Brogmus, G., Leone, W., Butler, L., & Hernandez, E. (2007). Best practices in OR suite layout and equipment choices to reduce slips, trips, and falls. AORN journal, 86(3), 384-398.

Reduce disruptions              

Peer-reviewed (empirical study)

Joseph et al., 2018
Joseph, A., Khoshkenar, A., Taaffe, K. M., Catchpole, K., Machry, H., & Bayramzadeh, S. (2018). Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room. BMJ Qual Saf, bmjqs-2018.

TYPE OF STRATEGY

Task Built Environment

Locating the anesthesia zone to avoid encroachment of unrelated circulation into the anesthesia zone supports anesthesia task completion without disruption and interference from unnecessary traffic.

DESIRED OUTCOMES/CITATIONS

Improve movement and flow              

PSLL (case studies, RIPCHD.OR books)

PSLL High Fidelity Mock-up Simulations, December 2018
PSLL High Fidelity Mock-up Simulations (December 2018). Orthopedic High Fidelity Mock-up Simulations Focus Group. Charleston, SC.

Reduce disruptions              

PSLL (case studies, RIPCHD.OR books)

PSLL High Fidelity Mock-up Simulations, December 2018
PSLL High Fidelity Mock-up Simulations (December 2018). Orthopedic High Fidelity Mock-up Simulations Focus Group. Charleston, SC.

TYPE OF STRATEGY

Task Built Environment
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