An Introduction to Operating Room Design

Building a new operating room is a complex process that involves balancing needs of facility staff with construction costs, while also looking forward to future healthcare trends. To make planning and construction go smoothly, it helps to consider every possible variable at the outset of the growth process. Often, this includes an evaluation of current practices.

Evaluate the Current Operating Room

Before officially embarking on the facility planning process, it’s necessary to take stock of how existing operating room space is utilized. Are there any navigation or bottlenecking issues in the current operating room?

During this process, identify and consult with staff members to collect their feedback. This not only includes the surgery team, but also those in radiology, administration, laboratory, and beyond.

Set Goals for the New Project

What will be the focus of the new operating room? Does the facility plan to integrate or expand its imaging capabilities? Will the new space require more room for specialized procedures, which can require a larger surgical staff?

To begin the planning and design phases, several factors must be taken into account. These can easily be broken down into the room’s size, orientation and layout, and supporting systems. Further designs for accompanying spaces are also key.

Room Size

In its 2014 Operating Room Requirements Guidelines, the Facility Guidelines Institute recommends that the minimum inpatient operating room size be no less than 400 square feet. Operating spaces designed for specialized procedures generally require more staff, and are recommended to be at least 600 square feet.

Estimated Industry-Standard Operating Room Sizes

Determining the size of any operating room requires factoring in the above estimates, while also accommodating for future changes. The room will need to be optimized for the various equipment, supplies, staff, and general work flow.

Common Operating Room Equipment

See a full list of potential OR equipment >>

Room for expansion

Whether facility expansion is necessitated by regulatory changes, or as the side effect of a rapidly growing practice, the expertly-planned OR can adapt and grow if needed.

One contingency plan for growth, outlined in the American Society of Anesthesiologists’ Operating Room Design Manual, is to plan for “soft space” around an OR. If increasing the size of an existing OR space is unavoidable, a facility can use the adjacent space to expand without eliminating critical systems.

A less drastic option from the ASA would be to rely on modular furnishings and partitions that can easily be changed. This would allow more flexibility than using more traditional millwork or other permanent structures.

Room Orientation and Layout

Current space expectations in today’s operating room

A crucial part of planning the layout of any operating room is arranging all of the necessary equipment while accounting for all of the daily tasks performed there. A few of these tasks, including patient transfer, sterile equipment setup, and using a mobile C-arm during procedures, take up a sizeable amount of space. A modern OR needs to be able to accommodate all of these, while still maintaining space for all surgical staff to move efficiently through each procedure.

Estimated Equipment Space Requirements

• Nitrous Oxide Machine – 4ft x 4ft – right side head of table
• Anesthesia Machine – 3.5ft x 3.5ft
• Anesthesia Cart – 2ft x 5ft (single) 2ft x 7ft (double)
• Transesophageal Echocardiograph (TEE) 4ft x 2ft
• Rapid Infusion Machines – 2ft x 2ft
• Airway Cart – 3ft x 2ft
• Robotic Surgery – 5ft x 5ft at foot of table
• Robotic Surgery Control Console – 6ft x 6ft behind or at the side of the anesthesia machine.

Space Saving Solutions

An easy way to make sure there is enough maneuvering space in a smaller operating room is to center the design around the surgical table. Larger rooms offer more flexibility for positioning the operating room table, because there will always be enough space to move around the perimeter.

In modern operating room design, ceiling mounted booms have allowed operating room designers to negotiate around limited floor space. It isn’t uncommon to see wide range of equipment and system ports located on booms that can be positioned easily for a variety of procedures.

While ceiling mounted surgical lights and video screens are the most natural fit for surgical booms, facilities may choose to mount endoscopy towers, anesthesia systems, medical gas systems, data jacks, suction ports, and more.