a. Arrangement. Basic principles for efficient workflow are adhered to when
planning the arrangement of rooms within a surgical suite. For example, traffic must
move smoothly and without interruption into, through, and out of the suite. Those rooms
where support activities are performed are grouped conveniently and systematically
about the ORs, which are arranged in pairs with scrub rooms and sterilizing
facilities between them. (See figure 1-3). Proper arrangement of the rooms reduces
the flow of excess traffic, saves much unnecessary walking, and therefore conserves
time and effort.
b. Size of the Suite. Numerous factors are considered when estimating the
size of the surgical suite required for a hospital.
(1) The first of these is the operative load or the number of surgical cases to
be done per day. Some hospitals have more patients requiring medical care than
surgical care. In such a hospital, only a small operative section would be necessary.
Several operative procedures can be done per day in each OR, one case following
another, but all should be completed by the end of the usual day shift or shortly
(a) The average number of ORs needed is indicated by the number of
operative cases to be done daily divided by the number of cases that can be done daily
in one OR.
(b) Operative load can also be broadly interpreted to include the
amount of work to be done per day, outside of actual cases. There is a great deal of
preparatory work necessary for each surgical procedure as well as the routine tasks to
maintain the suite. If most supplies are prepared and sterilized in CMS, the OR suite
needs to maintain only a small preparation and sterilization area; otherwise, it may need
a large one.
(2) The second factor, the types of surgery to be done, is even more
specific. Some procedures such as cardiac surgery are very long and detailed,
requiring many hours of operative time; others, such as tonsillectomy, can be
accomplished in just 20 to 30 minutes. In the first instance, a single OR would be
engaged for the whole operative day with just one case; in the second example, eight or
ten such procedures could be done in the same length of time.
(3) The number and frequency of emergency cases are also considerations
related to the necessary size of the suite. The larger the troop area near a hospital, the
greater the number of accident and emergency cases that may have to be done. These
must be done immediately, meaning that other scheduled cases may have to wait until
after normal duty hours, unless provision has been made for an additional room.