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SURGERY DESIGN


Tetsuo Hotta –Clinical Professor, MD at Niigata University Medical and Dental Hospital


A new concept of operating room stratification


To improve the efficiency of the operating rooms a new concept of stratification of operating room unit has been developed at the Niigata University Medical and Dental Hospital. The unit is called the Quad Core Operating Rooms (QCOR) which is flatly arranged as four operating rooms and a central cross passage.1 Stratification of the unit also makes good use of limited space. This article examines the theoretical effects of stratification of QCOR to shorten the walking lines of operative nurses. Isolation of each line of surgeon, patient and medical instruments is also considered.


As illustrated in Figure 1, each unit is composed of four operating rooms arranged like a four-leaf clover. It also has a front room for instrument preparation and storage


OCC DW OR CEV PR OR DW OCC


OR PR


DW


OCC CEV


Operating Room Preparation Room Dumbwaiter


Outer Collection Collider Collection Elevator


SRR ARR SEV


Surgeons’ Ready Room


Anesthesiologists’ Ready Room Staff Elevator


PEV & DEV Private and Device Elevator NS


Nurse Station


Figure 1: Quad Core Operating Rooms (one unit). Each operating room is 10 x 9 m in outer size, and 9 x 6 m in inner size.


IFHE DIGEST 2015 OR NS PR OR


between the two facing operating rooms. On the same floor are a nurse station and preparation rooms for surgeons and anesthesiologists. Stratification of the unit is easily


constructed, and the numbers of operating rooms are increased by multiples of four (Fig. 2). If a larger room, such as a hybrid room, a CAT scan room, or an MRI room is needed, it can be obtained by connecting two facing rooms, as shown in Figure 3. Elevators and supply dumbwaiters are vital


to make this system function well. There are four elevators for the staff, for the patients and medical devices, and for collection of contaminated instruments. Two dumbwaiters are also installed in the preparation rooms, as shown in Figure 1. As illustrated by the arrows in Figure 4,


supply and collection can be independently separated by the supply dumbwaiter and


SRR


ARR SEV


PEV & DEV PEV & DEV


‘In our QCOR, a large room can be easily constructed without change of the general shape by connecting two facing rooms.’


outer circumferential corridor with the collection elevator. The line of people is also isolated from the instrument passage by the private elevator.


Theoretical examination Moving distance of nurse: The walking line


of nurse is obviously and undoubtedly shorter than that of flatly arranged operating rooms. In 1,254 m2


three floors, but the longest distance of the line is same 19 m (Fig. 5). On the other hand, in flatly arranged operating rooms, it reaches 53.5 m (Fig. 6). It lengthens according to the numbers of operating rooms in the flat


operating rooms set up. Carring of heavy medical devices: Even a


heavy device can be easily carried by the elevator and a short carrying distance.


Tetsuo Hotta


Tetsuo Hotta graduated from Niigata University School of Medicine in 1981, following which he became a resident in the Department of Orthopaedic Surgery, Niigata University Hospital. In 1992 he gained a MD, PhD post-graduate school at Niigata University School of Medicine. In 1992 he became a Fellow in the Department of Orthopaedic Surgery, Niigata University Hospital.


In 1995 he became Assistant Professor, Department of Orthopaedic Surgery, Niigata University Hospital and in 2001 became Associate Professor, Department of Operative Medicine. He is also the current President of the annual meeting of JSMI (Japanese Society of Medical Instrumentation).


operating rooms, we need


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