THEATRE DESIGN
Identifying the best theatre size for different surgeries
In this article, Hiroshi Yasuhara MD, OR Medical director at The Surgical Center at the University of Tokyo Hospital, presents what he dubs ‘a universal model for estimating the appropriate size for new operating theatres’.
The design and architecture of operating theatres (OTs) have, over the years, developed, alongside the emergence of new surgical procedures and technologies. The design of an operating theatre is influenced not only by the surgical disciplines that were prevalent at the time it was built, but also by the type of patients seen, and even the historical background of the hospital. Above all, an operating theatre’s size is one of the key factors to impact on its performance and the quality of surgery undertaken.2–4 More recently, a number of administrative regulations and standard guidelines for healthcare facilities have been established, and have become a key factor in determining OT size. HBN 26 in the UK5 recommended that a standard inpatient OT should have an area of 55 m2
. On the
other hand, the 2018 FGI Guidelines for Design and Construction for Hospitals state that a standard operating room (OR) requires an area of 37.2 m2
, and that an OR
for image-guided surgery – which requires additional personnel and/or large equipment – should have an area of 55.7 m2
However, the rationale behind these guidelines has not really been clarified.
2.0 m .6 Abstract
The 2014 Facility Guidelines Institute (FGI) guidelines include a method to calculate the minimum size of operating theatres (OTs).1
However, the rationale behind the
outside of the circle were designated to the traffic space. Routinely used medical equipment was included in the model beforehand, together with the operating table, part of which was included later as being within the patient’s area. The shape of the OT was set as square as possible. Ordinary surgery was considered to be performed by a surgeon, first/second assistants, an anaesthesiologist/assistant, and an assistant/circulating nurse.
guidelines has not been clarified. The purpose of this study was to create a universal model for the design and structure of operating theatres. Our major assumption was that OT size can be calculated by adding together the areas occupied by medical equipment, healthcare workers, and their traffic pathway. The area designated to healthcare workers was set as a circle with a 2 m diameter, compatible with a human’s height according to the ancient model of the ideal human body. The remnant corners of the 2 m2
Questionnaire issued
Using our model, the proposed sizes of OTs measured 36, 48, 64, 80, 90 and 100 m2 for the minimum OT, standard OT, ideal OT, OT for cardiac surgery, OT for specific surgery, and OT for multi-subspecialty surgery, respectively. In the next stage of our research, the proposed model was evaluated through contact with the operating theatre directors at national university hospitals nationwide. We sent them a questionnaire to determine their satisfaction with the size of theatres presently used for 13 representative types of surgery. They were asked to provide the floor maps of the surgical suites, so that we could measure the sizes of the operating theatres for each type of surgery. The calculated sizes of the operating theatres arrived at using our model were were almost identical to those of the theatres that the directors were satisfied with and accustomed to. The questionnaire’s results demonstrated that the proposed model could be used to estimate the appropriate size of an operating theatre with a high degree of success.
This article, entitled ‘Appropriate sizing of operating theatres with high satisfaction’, was first published in the December 2018 issue of Healthcare Facilities, the magazine of the Institute of Healthcare Engineering Australia (IHEA). HEJ thanks the author, the magazine’s publisher, Adbourne Publishing, and the IHEA, for allowing its reproduction, in slightly edited form, here.
2.0 m
Area of healthcare worker’s traffic
Vitruvian man
Area of human’s body and movement
Area of human’s body and movement
Figure 1. A model of the ideal human body, and a two-dimensional square designated to its movement and traffic space. February 2019 Health Estate Journal 23
2.0 m
1.8 m
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