Can Operating Room Design Make Orthopedic Surgeries Shorter, Safer, and More Efficient?: A Quasi-Experimental Study

Area of Science:

• Orthopedic Surgery
• Healthcare Facility Design
• Surgical Workflow Optimization

Background:

• Prolonged surgery duration negatively impacts patient experience, increases complication risks, and wastes resources.
• The physical environment of the operating room (OR) can influence workflow efficiency and personnel movement.
• Minimizing disruptions and unnecessary movements in the OR is crucial for improving surgical care.

Purpose of the Study:

• To investigate the impact of operating room (OR) design on orthopedic surgery duration.
• To identify specific OR design features that contribute to reduced surgery times and enhanced safety and efficiency.
• To address the knowledge gap concerning the relationship between OR physical environment and surgical outcomes.

Main Methods:

• Conducted unobtrusive observations of 70 unilateral total knee or hip replacement surgeries.
• Compared surgical durations, environment-related disruptions, and circulator movements in two differently designed ORs.
• Utilized computer-based forms to collect data and controlled for confounding factors like surgery type.

Main Results:

• Significantly shorter surgery durations were observed in a larger OR with greater clearances and optimized layout.
• The better-designed OR was associated with fewer workflow disruptions and personnel movements (p < .001).
• Strong correlations were found between surgery duration, disruptions, and movements (r = .576–.700, p < .001).

Conclusions:

• The physical design of the operating room plays a critical role in supporting safe and efficient surgical care.
• Innovations in OR design can lead to substantial improvements in surgical workflow and patient outcomes.
• Further research and design advancements are recommended to optimize OR environments for enhanced surgical delivery.