OPERATING THEATRES
Detailed 3D visualisation, DWG, and BIM drawings, should be completed for the new hybrid theatre, crosschecked, and approved by each equipment supplier.
From design to implementation The duration of any hybrid OR project strongly suggests the need to have continuity of involvement by the stakeholders who participated and were most closely involved in making the planning decisions. At this point in the process, successful installation relies on confirming the room configuration, equipment specifications, and exact placement of all the hybrid OR technology. Detailed 3D visualisation, DWG, and BIM drawings should be completed for the new hybrid OR, crosschecked, and approved by each equipment supplier, to help avoid unanticipated installation issues. In traditional ‘stick-built’ construction, last-minute alterations can result in expensive changes and unacceptable delays. For this reason, many hospitals have chosen modular stainless steel wall panels that facilitate any required modifications without affecting installation scheduling. Limiting the number of suppliers involved in supplying equipment and technology has, equally, proven to minimise the potential for connectivity and installation issues that can delay the commissioning of the project.
Need for an installation schedule Regardless of the number of suppliers, a mandatory installation schedule is key to ensuring that everyone and everything is on site when required. In addition, in-depth discussion should take place between project leaders and suppliers to establish best practices in determining the optimal sequence of installation steps and areas of concern, and the key areas where collaboration is required among multiple vendors and specialists to successfully interface hardware and software. Finally, an effective training plan for the staff that will use the new theatre can reduce the time it takes for them to adapt to new equipment, and, for example, different working practices, as well as increasing staff confidence, satisfying regulatory requirements, and
Many hospitals are installing multiple modalities of imaging systems for intraoperative imaging for planning, guidance, and final check-up, without having to reposition the patient.
meeting internal performance standards. Getinge also recommends that key users are identified to facilitate knowledge transfer to all current and future staff members.
Conclusions
The planning and commissioning of a hybrid operating theatre requires the active participation of a diverse group of stakeholders and consultants whose decisions contribute to the effective and seamless interaction of all the selected hardware and software platforms. Limiting the number of solution- oriented vendors can lower the risk of failure, prevent compromised performance, and eliminate delays, by reducing the inherent inefficiencies of multiple service and maintenance interfaces. Meanwhile, 3D modelling of the hybrid OR, including the placement of equipment and staff (to scale), helps stakeholders to visualise workflows and relative positioning of multiple elements in the hybrid environment.
An increasing number of hospitals are installing multiple modalities of imaging
Julian Grimaldi
Julian Grimaldi, MBA Biomed Eng, is a graduate biomedical engineer who specialises in operating theatre design. Senior business manager, Hybrid OR, for Getinge in Germany, he has a Masters degree in Business Administration. Born in Buenos Aires, Argentina, he undertook his university degree there, and first became involved in operating theatre design early in 1995. His career subsequently continued in Spain, where he completed his Master’s degree.
Joining Getinge (formerly Maquet) in 2007 in Spain to develop a project department, he also served as a Professor on the Master’s for Hospital Architecture course at the Universidad CEU in San Pablo. In 2013 he joined the international organisation for Getinge Surgical Workplaces in Rastatt in Germany, working in the Hybrid Department. Alongside his business responsibilities for Western Europe, Latin America, the Middle East, and Africa, he is in charge of developing architectural concept solutions for Hybrid Surgical Rooms – from single to multiple rooms – for different imaging equipment and modalities.
June 2018 Health Estate Journal 51
systems (angio, CT, MRI) to handle intraoperative imaging for planning, guidance, and final check-up, without having to reposition or transport the patient.
The placement of the theatre table in relation to the imaging system, laminar flow alignment and coverage, positioning of the room ceiling supply unit, and surgical lighting, merit particular attention during the planning process, to ensure ergonomic and collision-free utilisation across multiple disciplines and procedures. User and application training is also fundamental in reducing the time it takes a surgical team to adapt to a new theatre facility and in increasing staff confidence, while satisfying regulatory requirements and meeting internal performance standards.
Bibliography
This article is based on Roadmap to the Hybrid suite (white paper) – Optimizing the Planning Process for designing and Commissioning the Single Discipline, Multidisciplinary, and Multi Modality Hybrid OR, GSW-BR-10001016-EN-1.
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