our airflows are so well designed," says Arthur Brito, AIA, CAU,
EDAC, LEED AP BD+C, WELL AP, an associate principal and senior
vice president and healthcare practice leader at architecture and
design firm HKS in Miami, Fla.
"We conducted a simulation study and found contamination in the
OR was less related to the number of door openings and more to the
number of people in the OR," says Anjali Joseph, PhD, EDAC,
endowed chair in architecture + health design and research at
Clemson (S.C.) University's College of Architecture, Arts and
Humanities. Ultimately, the more crowded your OR typically is, the
more space you should build.
Still, keeping the OR doors closed during surgery is good practice.
One way to reduce door openings is to increase visibility into the
rooms. "The reason you want to look in is to understand what stage
the case is in," says Bryan Langlands, AIA, FACHA, EDAC, LEED GA,
principal and medical planner with architecture, planning and design
firm NBBJ in Seattle, Wash.
The obvious way to avoid "pop-ins" is to include windows in OR
designs, so staff can easily check the status of a case. Avera
McKennan Hospital in Sioux Falls, S.D, is in the process of renovating
14 ORs originally built in the early 1980s. "One thing that's been very
helpful is we put large windows in the doors," says Mary Leedom, RN,
MS, NEC, an assistant vice president for perioperative services. "I
believe that's minimized traffic in our rooms."
The storage dilemma
You don't want people constantly leaving the room during surgery to
get supplies, but you also don't want clutter. Should you have more
storage in the OR to prevent door openings? It's a difficult choice.
Dr. Joseph recommends any OR storage be seamless and integrated
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