DownloadNote - The PPT/PDF document "Operating room" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Presentations text content in Operating room
Slide1Slide2
Operating room
design & operation
Andy Yosten
September
15, 2015
Slide3
agenda
Introduction
Codes & Standards
Operation Room (OR) Design Practices New Technology & Strategies
Slide4
Understand latest changes to codes and standards for operating roomsDiscuss current operating room design practicesIdentify new technologies and how they affect operation strategies
Learning objectives
Slide5
Facilities Guidelines Institute (FGI)Guidelines for Design and Construction of Health Care Facilities (2010)Incorporated ASHRAE 170 -2008 for all HVAC requirementsASHRAE/ASHE Standard 170 – 2008Ventilation of Health Care Facilities
Codes & standards
Slide6
Recent Changes
Facilities Guidelines Institute (FGI)Guidelines for Design and Construction of Health Care Facilities (2014)Incorporated ASHRAE 170 -2013 for all HVAC requirementsASHRAE/ASHE Standard 170 – 2013Ventilation of Health Care FacilitiesIncorporates all addenda thru November 2013
Codes & standards
Slide7
Recent Changes
Humidity levelsReturn/exhaust grille locationOperating room classificationOR vs procedure roomSpace requirements
Codes & standards
Slide8
Evolution of the Operating room
Slide9
1900 – Roosevelt Hospital NYC
Library of Congress Prints
Slide10
1950 – Northfield, Minnesota
Slide11
2000 – Bethesda, Maryland
Slide12
2015 – Parkland Hospital
Slide13
User requirementsSpecialized proceduresRoom size and layoutLightingEquipment layoutBoomsImaging equipment
Design considerations
Slide14
Room size and layoutLightingEquipment layoutBoomsImaging equipment
HVAC Design Process
Slide15
Primary diffuser array shall extend a min. of 12 in. beyond footprint of tableNo more than 30% of diffuser array shall be used for non-diffusers such as lights, gas columns, ect.
Hvac Design process
Slide16
Air Curtain vs Laminar Flow
Design process
Laminar
Flow
Large volume of sterile air
Minimize entry of bacteria into sterile field
Constant volume can help with patient comfort
Air
Curtain
Dome-like sterile procedure area by increasing air velocity at the perimeter
Sterile field is washed with a slow moving column of air
Slot diffusers used to direct away down and away from the patient creating a boundary
Slide17
Operating
Room
Design Practices
Slide18
Primary diffuser array coordinationPlacement of lightingLocate columns and boomsImaging equipment supportsReturn air locations
HVAC/room Layout
Slide19
Pressure: + 0.01 in. wc Maintain positive pressure to all adjoining spaces at all times
Pressure relationships
Slide20
Patient comfortSurgeon and personnel comfortControl of pollutantsAbility to quickly raise and lower temperatureHumidity control
Temperature requirements
ASHRAE 170 -2013
Slide21
Best practicesSurgeon preferenceSetback controlHVAC design strategy
Primary diffuser array to provide concentrated airflow over patient and surgical teamAirflow: Unidirectional, downward with average velocity of 25 to 35 cfm/ft2At least two low sidewall grilles at opposite corners installed approximately 8 in. Above floor
Particulate control
Slide25
NFPA 99 Health Care Facilities Code (2012) – Smoke purge systems are not requiredMost recently language existed in NFPA 56A (2005) and previous editions of NFPA 99CMS requirements
Download this presentation
DownloadNote - The PPT/PDF document "Operating room" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Presentations text content in Operating room
Operating room
design & operation
Andy Yosten
September
15, 2015
Slide3agenda
Introduction
Codes & Standards
Operation Room (OR) Design Practices New Technology & Strategies
Slide4Understand latest changes to codes and standards for operating roomsDiscuss current operating room design practicesIdentify new technologies and how they affect operation strategies
Learning objectives
Slide5Facilities Guidelines Institute (FGI)Guidelines for Design and Construction of Health Care Facilities (2010)Incorporated ASHRAE 170 -2008 for all HVAC requirementsASHRAE/ASHE Standard 170 – 2008Ventilation of Health Care Facilities
Codes & standards
Slide6Recent Changes
Facilities Guidelines Institute (FGI)Guidelines for Design and Construction of Health Care Facilities (2014)Incorporated ASHRAE 170 -2013 for all HVAC requirementsASHRAE/ASHE Standard 170 – 2013Ventilation of Health Care FacilitiesIncorporates all addenda thru November 2013
Codes & standards
Slide7Recent Changes
Humidity levelsReturn/exhaust grille locationOperating room classificationOR vs procedure roomSpace requirements
Codes & standards
Slide8Evolution of the Operating room
Slide91900 – Roosevelt Hospital NYC
Library of Congress Prints
Slide101950 – Northfield, Minnesota
Slide112000 – Bethesda, Maryland
Slide122015 – Parkland Hospital
Slide13User requirementsSpecialized proceduresRoom size and layoutLightingEquipment layoutBoomsImaging equipment
Design considerations
Slide14Room size and layoutLightingEquipment layoutBoomsImaging equipment
HVAC Design Process
Slide15Primary diffuser array shall extend a min. of 12 in. beyond footprint of tableNo more than 30% of diffuser array shall be used for non-diffusers such as lights, gas columns, ect.
Hvac Design process
Slide16Air Curtain vs Laminar Flow
Design process
Laminar
Flow
Large volume of sterile air
Minimize entry of bacteria into sterile field
Constant volume can help with patient comfort
Air
Curtain
Dome-like sterile procedure area by increasing air velocity at the perimeter
Sterile field is washed with a slow moving column of air
Slot diffusers used to direct away down and away from the patient creating a boundary
Slide17Operating
Room
Design Practices
Slide18Primary diffuser array coordinationPlacement of lightingLocate columns and boomsImaging equipment supportsReturn air locations
HVAC/room Layout
Slide19Pressure: + 0.01 in. wc Maintain positive pressure to all adjoining spaces at all times
Pressure relationships
Slide20Patient comfortSurgeon and personnel comfortControl of pollutantsAbility to quickly raise and lower temperatureHumidity control
Temperature requirements
ASHRAE 170 -2013
Slide21Best practicesSurgeon preferenceSetback controlHVAC design strategy
Air changes requirement
ASHRAE 170 -2013
Slide22Filtration
ASHRAE 170 -2013
Slide23FGI Guidelines (2010)
30% - 60% RHFGI Guidelines (2014)20% - 60% RHCMSMust document changeMonitor humidityEquipment Considerations
Humidity control
Slide24Primary diffuser array to provide concentrated airflow over patient and surgical teamAirflow: Unidirectional, downward with average velocity of 25 to 35 cfm/ft2At least two low sidewall grilles at opposite corners installed approximately 8 in. Above floor
Particulate control
Slide25NFPA 99 Health Care Facilities Code (2012) – Smoke purge systems are not requiredMost recently language existed in NFPA 56A (2005) and previous editions of NFPA 99CMS requirements
Smoke evacuation
Code excerpt: ASHRAE
170 -
2013
Slide26Integrated operating room “Smart OR
”
Hybrid operating roomIntegrated ceiling solutionsUltra-clean operating room
New technologies & OR Strategies
Slide27Combine patient-specific data will intelligent devices to support real time decisions
Support trends in robotic surgery technology
More space requiredControl room
New technologies
& OR
Strategies
Integrated Operating Room “Smart OR”
Slide28Hybrid Operating Room
CT scanners, MRI scanners, fixed C-Arms
Larger surgery team of 8 to 20 people More space requiredControl room Vibration considerations
New technologies & OR Strategies
Slide29Fully integrated ceiling system
Slide30Ultra clean Surgical suites
Slide31Best Practices
Dedicated AHU
Coils in series
Humidifier location
Energy efficiency – DOASBoom location – laminar flow sterile field
Hvac design
Slide32Scheduled modes – “unoccupied setback”
Integrated optimizationFactorsStaff usageExisting conditionsCost
Setback strategies
Slide33Operating room
design & operation
Andy Yosten
September
15, 2015
Slide34Slide35