THEATRE DESIGN
floor maps of their surgical suites so that we could measure OT size. For each surgical procedure, the university hospitals were grouped according to the directors’ answer, i.e. ‘satisfied’ or ‘dissatisfied’. We then calculated the average OT size with which the OT directors were satisfied or dissatisfied for each procedure.
Results: Calculated OT size for each surgical procedure
Using our model, the OT sizes measured 36, 48, 64, 80, 90, and 100 m2
for minimum
OT (Fig. 3), standard OT (Fig. 4), ideal OT (Fig. 5), OT for cardiac surgery (Fig. 6), OT for specific surgery (Fig. 7), and OT for multi- subspecialty surgery (Fig. 8), respectively.
Validity of our model
Based on actual equipment usage, the average area apportioned to routinely used equipment measured 11.87 m2 temporarily used equipment 1.52 m2 result, the average OT size was 78.46 m2
, and to
. As a ,
with an overall ratio of 0.17. (Table 2). The calculated ratios of the equipment were 0.14, 0.19, 0.14, 0.12, 0.19, and 0.11 for the minimum OT, standard OT, ideal OT, OT for cardiac surgery, OT for specific surgery, and OT for multi-subspecialty surgery, respectively.
Practicality of our model
The OT directors of all 43 university hospitals answered the questionnaire. The average unsatisfactory/satisfactory OT sizes were 40.1/47.3, 52.4/65.9, 41.3/56.5, 53.4/75.5, 54.2/74.3, 44.1/62.8, 46.7/66.3, 46.8/59.6, 45.5/58.4, 52.1/66.8, 44.3/66.5, 41.3/50.6 and 46.9/55.2 m2
for lens
surgery, brain tumour surgery, head and neck surgery, CABG, thoracic/ abdominal aortic aneurysm surgery, lung cancer surgery, oesophageal cancer surgery, hepatobiliary/pancreatic surgery, colorectal surgery, spinal surgery, arthroscopic surgery, OBGY surgery, and urological surgery, respectively. (Table 3)
The OT sizes that did not satisfy the OT directors appeared to be close to the recommended minimum sizes in the 2018 FGI guidelines.6
On the other hand, the
calculated OT sizes in our model were almost identical to those with which the directors were satisfied.
Discussion
presented a detailed basic concept to determine the minimum requirements of OT space for the first time. Although the 2018 FGI Guidelines also adopt the concept of total combined area, the circulating pathway and movable equipment zone were
AUGUST 2019
Our results demonstrated that OT size could be determined by summation of the areas occupied by equipment, healthcare workers, their movement/practice, and traffic pathway. The 2014 FGI Guidelines for Design and Construction of Hospital and Outpatient Facilities1
90 m2 Figure 7. Three types of OT for specific surgery.
defined in a different way from ours. In addition, neither the exact figures of equipment footage nor the detailed alignment of the elements in the OT were provided. The OT size was not stratified according to the number of healthcare workers or the requirements for surgical equipment. As a result, the final formula of our model was
distinctive from the previous one. When considering the optimal OT size, there are so many standards to adhere to that it is difficult to understand the rationale easily. The Surgical and Endovascular Service Design Guide7
provides room
templates to overcome these complexities, but it is still difficult to understand how
WWW.CLINICALSERVICESJOURNAL.COM I 37
Table for specimens
2.0 m 6.0 m 2.0 m
Standard-sized operating theatre
Table for specimens
2.0 m 90 m2 6.0 m 2.0 m
Rear table for surgical instruments
90 m2
Table for specimens
2.0 m 6.0 m 2.0 m
Standard-sized operating theatre
C-arm X-ray machine
Rear table for surgical instruments
X-ray monitor Cell saver
Cardiopulmonary bypass
Standard-sized operating theatre
C-arm X-ray machine
X-ray monitor
Navigation machine
Surgical
Rear table for surgical instruments
microscope Cell saver
Navigation machine
8.0 m
1.0 m
8.0 m
1.0 m
8.0 m
1.0 m
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