Design of cardiac surgery operating rooms and the impact of the built environment

Abstract

This chapter is intended to provide a common language to enable both medical and design professionals to improve their dialog and collaborative work processes when designing pediatric cardiac care settings. This approach will help provide knowledge that can be applied to new construction or renovation of cardiovascular operating rooms and cardiac catherisation laboratories. It is not uncommon during the course of healthcare facility design for numerous people to use common terms that have different meanings for each person and community, and then be surprised to later discover that their conversations were about different meanings that led to a different understanding and mindset. Within the context of this chapter, the term “hybrid (surgical) room” is used to describe a procedure room designed and intended for either “open” or “closed” procedures, or both. They may be built for use by specific sub-specialists, or they may be shared by diverse users. This is a prime example of the necessity to clarify the operational, technological, cultural and political strategies explicitly prior to design inception and master planning. This chapter is not only about architectural design and planning, although that is its primary focus. Its underlying message is that the design of cardiovascular surgical procedure rooms or suites - regardless of how innovative they are or how much advanced medical technology they contain - will likely only be successful if they are closely aligned with the evolving changes in models of care, medical practices, local culture, politics and a concern for safety and high reliability of care. Cardiovascular spaces must also be designed with strategies that enable them to constantly evolve and be prepared for future changes in care models and technology requirements. Traditional boundaries - both physical and virtual - between surgical and non-surgical specialists, as well as within surgical and interventional sub-specialties are eroding with the emergence of hybrid interventionalists. The chapter encourages the development of a new design ethos and practice to be considered: One in which the commonalities - instead of the differences - of traditional surgical and interventional environments form the building blocks of facility design for tomorrow’s cardiovascular procedures.