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routinely pushing the boundaries of the possible beyond all precon-
ceived limitations. The key will be to find ways to align innovation
with the human realities of cost, quality and outcome.
The effort is well underway.
Finding the sweet spot, the perfect balance between humans and
machines, is one of the goals behind "OR 360," a joint effort by Cedars-
Sinai Medical Center in Los Angeles and the U.S. military to design and
implement their joint vision of the future.
"Our focus is on the way humans interface with technology," says
Bruce Gewertz, MD, surgeon-in-chief and chair of the hospital's
department of surgery. "Lighting, sound, the environment, teamwork
— the whole overall system is what determines the outcome of a pro-
cedure. People tend to think it's the surgeon who accounts for 99% of
everything, but we now understand that it takes a village. To succeed,
the village has to be in sync, it has to have the tools it needs, and it
has to have the environment it needs."
But the environment can't be static, since different procedures
require different amounts of space. That's why in Cedars-Sinai's vision,
even the walls will be movable, allowing the size of the OR to be tai-
lored to the volume of equipment and the number of people a given
procedure requires. "With each piece of equipment comes 1.2 people,"
says Dr. Gewertz. "With more complex procedures, you can have 25
people in the OR. You can have the best teamwork in the world, but if
the space is too small or too big — if you have to push 2 buttons that
are 8 feet apart — your efficiency is going to be hindered."
Once the room size is optimized, movement should be fluid and
unencumbered, which calls for wireless technology and the ability to
get everything out of the way when it's not being used. "Currently, all
of those pieces of equipment have wires coming down and tubes that
impede people from doing what they need to do," says Dr. Gewertz.
L O O K I N G A H E A D
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