Operating room design using agent-based simulation to reduce room obstructions

This study seeks to improve the safety of clinical care provided in operating rooms (OR) by examining how characteristics of both the physical environment and the procedure affect surgical team movement and contacts. We video recorded staff movements during a set of surgical procedures. Then we divided the OR into multiple zones and analyzed the frequency and duration of movement from origin to destination through zones. This data was abstracted into a generalized, agent-based, discrete event simulation model to study how OR size and OR equipment layout affected surgical staff movement and total number of surgical team contacts during a procedure. A full factorial experiment with seven input factors - OR size, OR shape, operating table orientation, circulating nurse (CN) workstation location, team size, number of doors, and procedure type - was conducted. Results were analyzed using multiple linear regression with surgical team contacts as the dependent variable. The OR size, the CN workstation location, and team size significantly affected surgical team contacts. Also, two- and three-way interactions between staff, procedure type, table orientation, and CN workstation location significantly affected contacts. We discuss implications of these findings for OR managers and for future research about designing future ORs.

Automated summary

This study aims to improve the safety of clinical care in operating rooms by examining the impact of the physical environment and procedure characteristics on surgical team movement and contacts. Using video recordings and a simulation model, the study analyzed how OR size, layout, and other factors affect surgical team contacts. The results showed that OR size, CN workstation location, and team size significantly influenced surgical team contacts, as did interactions between staff, procedure type, table orientation, and CN workstation location. The findings have important implications for OR managers and future research on OR design.