The use of a hybrid OR—a single room that’s fully equipped to merge imaging and surgery—has been show to lower mortality rates and reduce complications and time spent in the hospital, according to Terry Miller, BSEE, executive vice president for Gene Burton & Associates (GBA; Franklin, Tenn.). There are currently about 100 U.S. hospitals with hybrid OR capabilities, and it’s projected that that number will grow 15 percent every year over the next decade. “Everybody’s doing it, everybody’s talking about,” Miller says, “and no two projects are alike.”

Miller and his GBA colleague Lynne Ingle, RN, MHA, CNOR, project manager, talked about the unique needs of these spaces at ASHE PDC in their session, “Hybrid Operating Rooms: The Challenge for Planning, Design, and Construction.”

The equipment—the imaging system in particular--drives the design, Miller said, and the exact type of technology specified determines everything. The booms and lights must adapt accordingly. While the size of a traditional OR is around 600 to 700 square feet, he suggests a minimum of 1,000 square feet for a hybrid OR, plus space for an equipment room and control room. The preferred size is 1,200 square feet, taking into account these separate rooms.

“The size, shape, and ceiling height of the room are all affected,” Miller said. In addition to the number and size of the equipment pieces needed, hybrid ORs must also accommodate two teams of clinicians, bridging two separate disciplines. “There can easily be up to 26 people in that room at one time,” he said.

Miller points to a trend toward super-high-definition displays in the 56-inch range, as well, which also affects the design of the room. Monitor arms, wall-mounted  monitors, the router/control, video docks, and more must all be considered with these more sophisticated (and larger) displays.

Ingle discussed the teamwork necessary to make a hybrid OR installation successful and recommends a very thorough discussion with the owner to determine how it defines a hybrid OR, the hospital’s goals, what’s driving the function of the space and what sorts of procedures are expected to be performed there, and the all-important budget.

In assembling the team, she said, you want not only all the clinicians affected (including the anesthesia teams, which are sometimes overlooked), but also the IT staff, administration, architects, and construction professionals. Above all, she said, “Vendors, vendors, vendors. The vendors providing the equipment are absolutely critical to the process.”

Site visits to existing hybrid ORs are another necessary component to success, Ingle said, to get feedback on what works, what challenges they’ve found, and what changes they’ve made. Those who conduct the site visits need to document everything and bring it all back to the bigger planning team.