Taaffe Kevin, Joseph Anjali, Khoshkenar Amin, Machry Herminia, Allison David, Reeves Scott T
From the Department of Industrial Engineering, Clemson University, College of Engineering, Computing and Applied Sciences.
Clemson University, School of Architecture, Clemson, South Carolina.
J Patient Saf. 2021 Dec 1;17(8):e1833-e1839. doi: 10.1097/PTS.0000000000000693.
There is a pressing need to improve safety and efficiency in the operating room (OR). Postsurgical adverse events, such as surgical site infections and surgical flow disruption, occur at a significant rate in industrial countries where a considerable portion of such complications result in death. The aim of the study was to identify an ideal room design that improves the flow of staff members using risk and safety performance measures.
Operating room designs were compared by using computer simulation modeling to analyze traffic flow inside an OR. The study was conducted in two phases. A historical data set was first created based on surgical flow data obtained from 23 video observations of actual surgical procedures. A detailed simulation-based model was then developed.
As room size increases, staff members have more available space to maneuver in the room, resulting in more distance walked but far fewer undesirable contacts. An angled table orientation is preferred with the circulating nurse workstation at the foot of the OR table, as it provides more space for staff to move across the room without increasing the number of contacts. Furthermore, when the nurse workstation is near the wall, staff members experience fewer undesirable contacts.
Simulation modeling was used to assess the impact of OR layout alternatives on three performance metrics, and the medium-sized OR prototype performs well across the metrics. Future research will consider the relative influence of several factors on traffic-based safety and efficiency performance metrics, resulting in a more predictive simulation design model.
迫切需要提高手术室（OR）的安全性和效率。在工业国家，术后不良事件，如手术部位感染和手术流程中断，发生率相当高，其中相当一部分此类并发症会导致死亡。本研究的目的是通过风险和安全性能指标来确定一种能改善工作人员流动的理想手术室设计。
通过计算机模拟建模比较手术室设计，以分析手术室内的交通流量。该研究分两个阶段进行。首先根据从23次实际手术过程的视频观察中获得的手术流程数据创建一个历史数据集。然后开发一个基于详细模拟的模型。
随着手术室面积的增加，工作人员在室内有更多的活动空间，这导致行走距离增加，但不良接触显著减少。手术台呈一定角度摆放，巡回护士工作站位于手术台脚部时更为可取，因为这样可为工作人员在室内移动提供更多空间，同时又不会增加接触次数。此外，当护士工作站靠近墙壁时，工作人员的不良接触更少。
使用模拟建模评估了手术室布局方案对三个性能指标的影响，中型手术室原型在各项指标上表现良好。未来的研究将考虑几个因素对基于交通的安全和效率性能指标的相对影响，从而产生一个更具预测性模拟设计模型。
