The integrated project delivery (IPD) approach toward hospital design and construction has gotten a lot of attention lately,as project teams have become much more attuned to the fact that working collaboratively typically produces much better results than working in separate silos.

That very same shift towards integration is also being paralleled in the hospital facility itself, particularly the operating room (OR) environment, where there is a fast-emerging trend afoot in the development, growth, and demand for the hybrid OR.

A surgery suite that incorporates single or bi-plane angiography imaging equipment and can also include MRI or other diagnostic imaging equipment, the hybrid OR allows surgeons to transition from minimally invasive to open surgical procedures as conditions may develop without having to move the patient from a procedure area (i.e.,cardiac cath lab) to an OR.

And just like the owner-architect-builder team has adopted a more integrated approach for the betterment of the project, hospitals have followed a similar course.

Within the last decade or so, the once classic separation of OR departments from diagnostic/radiologic departments has morphed into adjacent space with some shared support space to the current trend of an integrated OR space. It’s not so much a change in technology that is driving this, but rather a change in the philosophy of better space utilization, better patient care, improved outcomes, simplified service delivery models AND a willingness of different physician groups to eliminate old silos of service and join their counterparts in moving healthcare forward.

Call it IPD for healing the patient.

Based on our recent work on hybrid OR projects for Banner Health at Good Samaritan Hospital in Phoenix and other projects across the country, there are a couple of things owners should think about as they consider a hybrid OR for their facilities.

Get Educated: The entire staff—that means everyone associated with using the space—needs as much education as possible. The hybrid OR is a new development; new rooms are being completed every day and put into use, and the staff feels like they are going to Disneyland but are not certain what to do when they get there.

Field trips to existing hybrid ORs or manufacturer showrooms, or distance learning, can be helpful, but always beware of salesmanship. Different specialties also have different requirements (and wishes), and a hybrid OR is not “one size fits all.” It is helpful for the user team to have a staff champion who can enlist others to get involved during the design phase.

Participation: Everyone on the team should participate in the early and detailed planning of the room and selection of equipment, with the design team and equipment planners. Identification of, and agreement on, equipment is essential prior to the end of design development documents, so that project-specific data sheets can be drawn by equipment suppliers and the details incorporated into construction documents.

Caution: most suppliers will NOT supply these project specific sheets until a purchase order is received.

Whether it’s an OAC team or physician groups, an integrated approach that includes input from all project stakeholders at the appropriate times not only offers improved outcomes but also ultimately results in better patient care.


Gerry DeWulf is a project executive for DPR Construction, a forward-thinking national general contractor and construction manager that specializes in technically complex and sustainable projects for the healthcare, advanced technology, life sciences, higher education and corporate office markets. With 41 years of construction management and general contracting experience, DeWulf has extensive skill in estimating, value engineering and project supervision. As one of DPR’s healthcare specialists, DeWulf has played an instrumental role in many of DPR’s recent healthcare projects including Banner Health’s Banner Maricopa Health Center in Maricopa, Ariz., Palomar Pomerado Health Foundation’s Palomar Medical Center West in Escondido, Calif., and two new Hybrid ORs for the University of Arizona Health Network.

For more information about DPR Construction, visit Gerry DeWulf can be contacted at