When Cedars-Sinai Medical Center partnered with the U.S. Department of Defense (DOD) on a simulation center to address trauma care workflow and procedures, they didn’t just think outside the box—they replaced it.

“If you really want to simulate, you shouldn’t start with a predetermined box,” says Carlos Amato, principal/western region healthcare market leader, architecture, for CannonDesign. Instead, the team replaced traditional walls and ceilings with movable parts and pieces that can flex and adapt to various needs, under both civilian and military settings.

Called “OR 360,” the project is funded by $3.8 million in DOD grants and comprises academic offices, flexible research areas, and collaborative shared spaces on one floor of a three-story building in L.A.

Dr. Bruce Gewertz, surgeon-in-chief at Cedars-Sinai, says simulation spaces traditionally look just like the functional spaces they’re mimicking. Here, though, the OR suite has built-in flexibility thanks to its moving walls and pieces of equipment attached to ceiling tracks, allowing constant transformation.

“We’re trying to see if we can gain efficiencies with larger or smaller spaces,” he says. “Using clinically relevant scenarios, we can try out different net square footage and designs to see if emergency care and complex operative procedures can be accomplished in smaller spaces.”

For example, research teams can change the proportion and dimension of the room as well as move or remove walls, while panels can be changed out with transparent or opaque pieces to help determine design preferences.

For the ceiling, the team worked with equipment vendors to design a trolley system that would allow equipment—such as IVs, lights, or monitors—to move around surgical teams rather than be clustered in work areas. Unnecessary or out-of-date equipment can then be removed without requiring a total overhaul of the space. The ceiling grid system isn’t vendor-specific, so any company’s product can be brought in for a test-run.

Amato says project allows users to ask a bunch of “what if” questions to fuel new designs and ways of working in trauma care. The most successful lessons and research gleaned from the process are expected to be used in future Cedars-Sinai spaces and programs.

“It allows them to do things they couldn’t do in another simulation space,” Amato says.