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Surgery
Department
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Graphic Standards
Programming and Schematic Design
June 1999
Surgery Department
Table of Contents
Table of Contents
Function
Staff
Advantages of
Movable Modular Casework
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3
5
6
Functional Areas
7
Control Station
7
Pre-Operative Holding
8
Scrub Area
8
Operating Room
9
Cystoscopy
10
Substerile
11
Clean Core
12
Post-Anesthesia Care Unit
(PACU/Recovery Room)
13
Equipment Storage
14
Clean/Sterile Storage
15
Clean Workroom
16
Soiled Utility
17
Anesthesia Supply/Workroom
18
Satellite Lab
19
Satellite Pharmacy
20
Staff Lounge/Locker Room
21
Administrative Office
22
Functional Program
23
Bubble Diagram
24
Block Diagram
25
Preliminary Plan
26
Schematic Plan
27
Future Trends
28
Surgery Department 2
Surgery Department
Function
Function
The surgery department of a general
hospital is that area responsible for the
surgical procedures, or operations,
performed on hospital inpatients and/or
ambulatory outpatients. The ambulatory
surgery services may be in another
location within the hospital or in a
freestanding facility.
Because surgical procedures are
performed under the strictest sterile
techniques and infection control
concepts, the design of the department
and the flow of patients, staff, and
supplies must be rigidly controlled. The
surgery department includes a required
number of operating rooms, pre- and
post-anesthesia areas, technical support
functions, equipment and supply areas,
and administrative staff space.
SINGLE CORRIDOR
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Traffic Flow
The layout of the operating room
suite may be a single corridor plan
with operating rooms and support
services opening off the same
corridor.
Today the more commonly used
design combines a clean core with
peripheral corridors, sometimes
called the “racetrack” design.
Either type of plan will typically have
three basic zones of traffic flow.
Unrestricted Areas
The unrestricted area allows visitors or staff
attired in street clothing to enter the surgery
department. Their movement is limited to the
locker rooms, staff lounge, and from the
main entrance to the control station.
Semi-Restricted Areas
These areas are within the department and
beyond the control station, requiring
personnel to be attired in scrub suits or
dresses, shoe covers, and hair covers.
Restricted Areas
The most restricted areas of the department
are the operating rooms, the clean core, and
the scrub areas. A face mask must be worn in
these areas in addition to the scrub suit and
hair and shoe covers.
CLEAN CORE/PERIPHERAL CORRIDOR
Surgery Department 3
Surgery Department
Function
Flow of Patients
Flow of Supplies
Patients are brought to the surgery
department on stretchers from the patient
units. After notification of the control
station staff, patients are moved to a preoperative holding area to wait for the
available operating room. Medications
and/or intravenous fluids may be
administered while patients are in the
pre-operative holding area.
Traditionally, surgery departments stored
supplies and instruments in casework
cabinets within the operating rooms, in
corridors, and in clean supply rooms.
Supplies were then collected from
multiple areas and carried to the
appropriate operating room before each
surgical case. In some cases, supplies
were stored in rooms dedicated to a
specific type of surgical case.
Surgery procedures are scheduled for
predetermined times in specific rooms
with a minimal amount of turnaround
time between cases for cleaning and case
preparation.
Patients will then be moved to the
designated operating room, the
anesthesia administered, and the surgical
procedure performed.
Following surgery, patients are moved to
the post-anesthesia care unit where they
remain until responding and awake, and
are then returned to the patient unit.
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This system has proven to be time
consuming and inefficient. Turnaround
time, or the time between the close of
one surgical case and the beginning of
the next case, is critical in the productive
utilization and revenue generation of the
operating rooms.
Because the surgery department is the
primary user of sterile equipment and
supplies in the hospital, sterile processing
departments are now being located either
adjacent to or in a direct line above or
below the surgery department. Today, the
supplies and instruments for surgery are
centralized, reprocessed, and distributed
from the sterile processing department,
eliminating the costly duplication of
reprocessing equipment and reducing
both inventory and labor costs by
utilizing movable modular casework and
carts.
The method of choice for the delivery of
surgical supplies and instruments is the
case cart system. Rather than instruments
and supplies for each operative case
being housed in casework and compiled
in the operating room, the sterile
processing department will assemble the
appropriate supplies and send them to
surgery as a specific case cart. This case
cart is stocked with all of the materials,
instruments, and supplies necessary for a
single designated surgical procedure,
with a cart prepared in advance for all
daily scheduled surgery cases. Thus the
turnaround times between cases can be
kept to a minimum. Case carts are also
supplied and kept ready for the most
frequently performed emergency cases.
In the clean core/peripheral corridor type
of plan, there is dual access to the
operating rooms with the clean supplies
and case carts flowing from the clean
central core into the operating room and
the dirty supplies and contaminated case
carts moving into the peripheral corridor
to the decontamination area. This type of
flow provides the best opportunity for
infection control, preventing the clean
and dirty supplies from crossing paths.
Surgery Department 4
Surgery Department
Staff
Staff
Surgery departments typically have two lines of authority – physicians and nurses –
and an administrative staff.
Physician Staff
Operating Room Staff
Administrative Staff
Chief of Surgery
OR Supervisor
Manager of Post-Anesthesia Care Unit
The chief of surgery (an MD or
DO) will oversee the physicians, the
surgical procedures, and/or the
administration of anesthesia, as well
as make recommendations
concerning the medical aspects of
the department.
An operating room supervisor or director of
surgical services is usually an RN with extensive
operating room experience and may have an
advanced degree in nursing, management, or
business. This position will be in charge of
nursing; responsible for such business aspects of
the department as budgets, inventory, scheduling,
and staffing; and responsible for balancing the
needs of administration, physicians, operating
room staff, and patients.
The manager of the post-anesthesia
care unit (PACU) is a registered nurse
(RN) with administrative responsibilities for the PACU. This person may
be a major decision maker or
influential in equipment and facility
decisions as they relate to this unit.
Chief of Services
The chief of services is an MD who
oversees a specialty service such as
orthopedics.
Chief of Anesthesiology
The chief of anesthesiology (an MD
or DO) is the administrative head of
the anesthesia department and
supervises the anesthesiologists,
nurse anesthetists, and anesthesia
technicians. This position manages
anesthesiology supplies, equipment,
and procedures.
Manager of Ambulatory Surgery
This person usually is a registered nurse (RN)
with or without an advanced degree; works with
one or more specialty services, such as
cardiovascular; and is influential in decisions
regarding supplies, equipment, policies, and
procedures for that specialty area.
This may be the operating room
supervisor or a separate RN manager
who reports to the administrator of
ambulatory services. Frequently, this
person supervises a patient holding
and recovery area separate from the
main surgery department and is
responsible for department staff and
budgets.
Circulating Nurse
Anesthesia Supervisor
This is a registered nurse (RN) who coordinates
activity in the operating room for a particular
surgical procedure, opens supplies for the scrub
nurse, assists with moving the patient, applies
dressings, etc.
The anesthesia supervisor makes
decisions on supplies, budgets, and
equipment purchases frequently in
conjunction with the chief of
anesthesiology. This person may be a
nurse anesthetist or technician.
Head Nurse/Clinical Nurse Manager
Scrub Nurse/Instrument Nurse
This registered nurse (RN) or surgical technician
maintains the sterile operating field, and
organizes and passes sterile instruments and
supplies to the surgeon.
Surgical Technician
Typically, this technician has completed a oneyear program in preparation for working in a
surgery department and is familiar with
instruments, surgical procedures, and sterile
techniques.
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OR Materials Manager
This position, many times found in
larger and/or teaching hospitals, may
report to the director of surgical
services, the director of sterile
processing, or the director of materials
management. This person is
responsible for ordering supplies and,
sometimes, instruments and
equipment.
Surgery Department 5
Surgery Department
Advantages of Movable Modular Casework
Advantages of Movable Modular Casework
Surgical departments may differ somewhat in square footage, method of operation, and staffing
based on the size of the hospital, type of hospital, and scope of patient services, but each will
have certain functional areas in common. The following pages describe the advantages of
movable modular casework, give a brief description of the functional areas of the surgery
department, and provide typical plan views of movable modular casework applications.
Movable Modular Casework
Materials Handling Components
Financial Advantages
Movable modular casework offers the
following major advantages and
differences when compared with fixed
casework or millwork:
Movable modular materials handling
components can be especially useful for
supporting effective and efficient delivery,
storage, use, and removal of the supplies used
in the surgery department.
The initial cost of movable modular
casework is competitive with fixed
casework or millwork. However,
the life cycle cost of movable
modular casework is far less than
fixed casework because of
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All movable modular casework
components can be easily rearranged
or reused by the end user, allowing
ongoing changes with new technology
and accommodate major procedural
changes as well as hour-to-hour
variations in activities.
Movable modular casework
components have been specifically
designed to meet the functional
requirements of surgery departments.
Components are sanitizable, and
every configuration can be
disassembled to easily clean parts.
Movable modular components can
quickly and easily be relocated to the
opposite wall in an operating room
when a specific procedure requires
that the operating table be turned
around.
A movable system accommodates the
increasing need to plan the majority
of operating rooms generically, rather
than dedicating them to a specific
procedure. Being able to move
procedure-specific supplies into a
generic operating room simplifies
scheduling and increases the
productivity of the department.
Additional components can be added
at any time.
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Components can be rearranged to suit any
needed configuration as static storage, either
wall-hung or freestanding.
The quick-delivery capability allows
specialized supplies to be stored in a central
location and transported to an operating room
on demand. Each component can become
mobile by combining it with a wheeled
component and used for transport as well as
storage.
Specific components appropriate for use in the
surgery department include
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Case carts.
L carts.
Crash carts.
Specialty procedure carts.
Lockers.
Supply carts.
Process tables.
Extra-deep modular shelving.
Modular Furniture Systems
·
Panel systems for administrative areas
offer the use of less space, the flexibility
to make changes easily, and increased
worker productivity.
·
The system provides cantilevered work
surfaces and efficiently arranged
workstations.
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Longer product life.
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Ability to install and
reconfigure with little
downtime.
·
Accelerated depreciation rate,
especially important to “forprofit” organizations.
Minimal maintenance cost.
Continual reuse of the
components for new or different
functions.
For preliminary budget purposes,
movable modular casework for a
surgery department has an average
price in the range of $248 to $372
per linear foot.
This range will be affected by the
density of overhead and undercounter storage components and the
type of support structure used
(wall-mounted versus panels).
Surgery Department 6
Surgery Department
Control Station
Functional Areas
Control Station
The control station is primarily a clerical
area located in a position to control
traffic into the surgery department.
Similar to a nurses station, it is the
communications center of the surgery
department. A control station may be
configured in a variety of shapes and
sizes depending on the size of the
department and the number of operating
rooms.
Movable Modular Casework and Furniture Systems Applications
A control station can be planned using freestanding frame and/or panel systems with
movable modular casework components and generally will require
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Computer support components.
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Marker board for posting daily
surgery schedule.
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Acoustical tiles to reduce noise in the
area.
File drawers.
Work tools and form trays to help
organize the large volume of paper
and forms.
A control station tends to differ from a
nurses station in that less people
generally work out of this area, and
usually there are no patient monitors
located here.
Surgeries are scheduled; patient charges,
records, and administrative functions are
maintained; and intra- and interdepartmental communications are
channeled through the control station.
Space should be provided for requisitioned items to be delivered or picked up
by other departments.
Plan View of a Control Station
A control station will range in size from
200 to 400 square feet.
20 linear feet work surface
72 linear feet overhead storage
224 filing inches
330 square feet
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Surgery Department 7
Surgery Department
Pre-Operative Holding, Scrub Area
Pre-Operative Holding
Patients arriving for surgical operations
are held in this area until the appropriate
operating room is ready. This area may
also be called pre-anesthesia as patients
may be given medications or intravenous
fluids under close observation of the
nursing staff.
Plan View of a Pre-Operative Holding
Area
A pre-operative holding area will range
in size from 300 to 700 square feet.
6 linear feet work surface
10 linear feet overhead storage
Movable Modular Casework Applications
A pre-operative holding area can be planned using movable modular casework and
may require
·
Small workstation for
filling out forms and
paperwork.
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Locker to hold patient care
supplies.
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L cart, procedure/supply
cart, or rail-hung C frame
storage unit placed near
each stretcher.
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Specialty procedure carts.
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Sink unit.
Extra-deep modular
shelving units.
Med prep/storage.
2 L carts
1 procedure cart
475 square feet
Scrub Area
Scrub areas are placed strategically
outside operating rooms. If the surgical
suite is designed with the clean core/
peripheral corridor plan, the scrub sinks
are best located in the peripheral
corridor.
Surgical scrub sinks are generally
ceramic or stainless steel with foot or
knee controls. It is helpful to place
shelves above the sink to hold scrub
brushes and masks.
Movable Modular Casework Applications
Depending on the design of the scrub
area, scrub brushes and masks can be
housed in modular shelving hung on rail,
on wall strips above the sinks, or in railhung C frame storage units with drawers
beside the sinks.
Plan View of a Scrub Area
8 linear feet overhead storage
(2 feet per sink)
50 square feet
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Surgery Department 8
Surgery Department
Operating Room
Operating Room
An operating room is the area where
surgical procedures are performed under
strict sterile techniques.
Operating rooms may be dedicated to
specific procedures such as cardiovascular, neurological, orthopedic, or
ophthalmic procedures. Special supplies
and equipment are moved in and out as
needed.
Operating rooms may also be generic and
used for many different procedures
which will maximize the use of the space.
Movable Modular Casework Applications
An operating room can be planned using movable modular casework components.
Movable modular casework can be relocated to the opposite wall when a specific
procedure requires that the operating table be turned around.
L carts or procedure/supply carts used for
Lockers used for
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Monitoring equipment.
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Prep and dressing.
Process tables used as
Anesthesia carts.
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Anesthesia supplies and equipment.
Suction and cautery equipment.
Stainless steel case carts which can also
be used as a back table.
General supply storage.
Backup supplies.
Specialty procedure carts.
Administrative/computer workstations.
Back table for instruments.
Operating rooms should have positive
pressure ventilation systems, with
controlled temperature and humidity, to
prevent corridor air from entering.
The general layout of the OR should
place the work surface for the circulating
nurse near the entrance door and the
movable modular casework on the wall at
the foot end of the table depending on the
head orientation of the patient.
Little or no built-in casework should be
used in the operating room for
sanitization purposes and because
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Built-in casework inhibits change.
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It increases the floor space needed.
It is difficult to sanitize.
It increases construction costs due to
the need for soffits and recesses.
Rather than using wall strips, horizontally mounted rail with rail-hung
components are appropriate for hanging
work surfaces for documenting or
charting. Rail-hung shelves or CST units
are suitable for overhead storage.
Plan View of an Operating Room
An operating room will range in size
from 400 to 600 square feet.
4 linear feet work surface
4 linear feet overhead storage
1 locker for anesthesia supplies
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3 lockers for backup supplies
1 L cart
1 anesthesia cart
case carts as required
528 square feet
Surgery Department 9
Surgery Department
Cystoscopy
Cystoscopy
Because of the nature of the procedures,
this should be a separate procedural
room that may or may not open off the
clean core.
While similar to an operating room, it
differs in some aspects. It will include a
sink and may include a flushing floor
drain. The room requires space for a
large quantity of irrigating fluids and a
large supply of catheters.
This room needs to be lead lined and
should be adjacent to an x-ray control
room.
Movable Modular Casework Applications
A cystoscopy room can be planned using movable modular casework components and
may require
·
Bulk supply carts for medical/
surgical supplies.
·
Cantilevered sink units or sink base
cabinets.
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L carts for prep supplies or special
procedures.
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Extra-deep modular shelving units.
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Bulk supply carts or lockers with
wire shelves for storing fluids.
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Cantilevered work surfaces.
NOTE: Anytime components are hung
from the wall, care must be taken not to
compromise the lead lining.
Plan View of a Cystoscopy Room
A cystoscopy room will range in size
from 250 to 400 square feet.
4 linear feet work surface
4 linear feet overhead storage
2 bulk supply carts
1 L cart
287 square feet
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Surgery Department 10
Surgery Department
Substerile
Substerile
Substerile rooms are workrooms, usually
located between two operating rooms.
They most frequently contain the “flash”
sterilizer and the blanket/solution
warmer, as well as storage of clean
supplies and equipment.
Movable Modular Casework Applications
A substerile room can be planned using
movable modular casework components
and may require
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Heavy-duty work surface at stand-up
height.
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Modular shelving units and flipper
units, if closure is desired.
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Lockers to hold supplies.
L carts or procedure/supply carts.
Process tables.
Casework sink unit.
Plan View of a Substerile Room
A substerile room will range in size from
75 to 200 square feet.
8 linear feet work surface
8 linear feet overhead storage
1 locker for supplies
162 square feet
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Surgery Department 11
Surgery Department
Clean Core
Clean Core
In a double-corridor plan, clean and
sterile supplies are stored in the clean
core, a large internal corridor adjacent to
and opening into all operating rooms.
Movable Modular Casework Applications
A clean core can be planned using movable modular casework components and may
require
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This area is accessible only to those in
surgical attire.
The area may allow for freestanding or
built-in sterilizers, blood refrigerator, and
freestanding or table-top warming
cabinets.
Small workstation for paperwork
with work surface, overhead storage,
undershelf lighting, and drawers.
·
Lockers for holding supplies or as
specialty carts.
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Case carts.
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Procedure/supply carts.
Bulk supply carts.
Regular and extra-deep modular
shelving units.
Plan View of a Clean Core
A clean core will range in size from
150 to 200 square feet per operating
room.
8 linear feet work surface
2 lockers per operating room
1 case cart per operating room
1125 square feet
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Surgery Department 12
Surgery Department
Post-Anesthesia Care Unit
Post-Anesthesia Care Unit
(PACU/Recovery Room)
This area is usually adjacent to the
operating room and generally near the
critical care units. Patients are brought to
this area after surgery to recover from
anesthesia and regain stable vital signs.
After patients are stable, they are
transferred to a patient unit or, in the case
of outpatient surgery, patients are moved
to secondary recovery before being
discharged.
Movable Modular Casework Applications
Movable modular casework components appropriate for use in the post-anesthesia
care unit include
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Nurses control station.
L carts or rail-hung C frame storage
units with drawers for supplies for
each patient.
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Lockers for linen and medical
supplies.
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Cantilevered sink units.
Dictation area.
The space is usually in an open area with
patients separated by cubicle curtains or
modular panels. Those patients who need
to be isolated are kept in a separate
isolation recovery room.
The layout of this space generally
includes a medical headwall for each
patient stretcher, a nurses control station
with physicians’ dictation space, a
medication preparation area, an area for
supplies and equipment, and handwashing sinks.
Plan View of a Post-Anesthesia Care Unit
A post-anesthesia care unit will range in size from 100 to 350 square feet per bed.
54 linear feet work surface
lockers as required
46 linear feet overhead storage
L carts as required
40 filing inches
procedure carts as required
1 C frame storage unit per bed
bulk supply carts as required
2772 square feet
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Surgery Department 13
Surgery Department
Equipment Storage
Equipment Storage
There is a large amount of equipment
that needs to be stored for use in the
operating rooms and a variety of ways
of storing this equipment. Peripheral
corridor alcoves or single-corridor
alcoves can be planned for stretcher
storage, a single large room for general
equipment storage, and/or specific
smaller rooms for specialty equipment
storage such as orthopedic, cardiac
surgery, etc.
Movable Modular Casework Applications
An equipment storage area can be
planned using movable modular
casework components and may require
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Extra-deep modular shelving units
and/or lockers with shelves to keep
smaller items off the floor.
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Cantilevered work surfaces.
Wire carts.
Much of this equipment must be
accessible to electrical outlets to
maintain battery charges.
In addition to needing floor space for
housing large equipment, overhead
shelving can be used so equipment can
be placed underneath for maximum use
of space.
Plan View of an Equipment Storage Room
An equipment storage room will range in
size from 150 to 400 square feet.
4 linear feet work surface
32 linear feet storage
1 locker
220 square feet
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Surgery Department 14
Surgery Department
Clean/Sterile Storage
Clean/Sterile Storage
Clean/sterile storage areas differ in each
surgery department depending on how
supplies are distributed to the department
and the layout of the department:
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Supplies may be sent to this area on
a replenishment and/or exchange
system from general stores and/or
sterile processing.
Case carts may be partially or
entirely assembled in this area, or
case carts may be sent to this area
from sterile processing.
Movable Modular Casework Applications
A clean/sterile storage area can be planned using movable modular casework
components and may require
·
Process tables to stage supplies for
packing case carts (if assembled
here).
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Regular and extra-deep modular
shelving units.
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Lockers to store clean/sterile supplies
or to be used as case carts.
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Specialty procedure carts.
Stainless steel case carts.
Space for wire carts to hold sterile
linen, bulky supplies, and instrument
trays.
Plan View of a Clean/Sterile Storage Area
A clean/sterile storage area will range in size
from 225 to 400 square feet.
lockers or wire carts as required
bulk supply or wire carts as required
279 square feet
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Surgery Department 15
Surgery Department
Clean Workroom
Clean Workroom
This area is used for assembling,
wrapping, and sterilizing specialty and/or
delicate instruments that are kept within
the department.
If central supply does not support the
reprocessing function for surgery, this
space will need to be large enough to
accommodate the necessary assembly
and sterilization functions.
Movable Modular Casework Applications
A clean workroom can be planned using movable modular casework components
and may require
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Cantilevered work surfaces for
assembling instrument sets.
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Modular shelving units, L carts, and
lockers for supply storage.
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Large process tables for wrapping
instrument sets.
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Cantilevered sink unit.
Wire carts for staging assembled
trays.
Plan View of a Clean Workroom
A clean workroom will range in
size from 125 to 750 square feet.
12 linear feet work surface
10 linear feet overhead storage
1 L cart
133 square feet
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Surgery Department 16
Surgery Department
Soiled Utility
Soiled Utility
Used linens, instrument sets, and
equipment are placed in soiled utility
immediately after surgery. This room
may hold case carts, lockers, wire carts,
trash containers, and soiled linen that
have been used in the operating rooms
until they are returned to central supply.
If the surgery department processes its
own instrument sets, this room may
function as the decontamination area and
must be large enough to accommodate
washing and decontaminating equipment.
Surgery departments processing their
own instruments may also require
stainless steel sinks (with double and
triple bowls) and a counter for washing
instruments and utensils.
Movable Modular Casework Applications
A soiled utility room can be planned
using movable modular casework
components and may require
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Process tables or heavy-duty work
surfaces for receiving soiled items.
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Modular shelving units and/or
lockers with shelves to hold cleaning
supplies.
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Horizontal rail to hold lockers
awaiting return to central supply.
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Cantilevered sink unit.
Plan View of a Soiled Utility Room
A soiled utility room will range in size
from 200 to 400 square feet.
16 linear feet work surface
20 linear feet overhead storage
1 locker for supplies
case carts
220 square feet
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Surgery Department 17
Surgery Department
Anesthesia Supply/Workroom
Anesthesia Supply/Workroom
Anesthesia will have a workroom with an
area for washing equipment and
maintaining/testing anesthesia machines.
Movable Modular Casework Applications
Sometimes a second room or area is
provided to hold anesthesia supplies.
Anesthesia supply carts are generally
replenished from this room, and at the
end of the day, these carts may be parked
and secured here.
The anesthesia supply room may require
The anesthesia workroom may require
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Lockers and modular shelving units
for supply storage.
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Work surfaces or process tables to
receive and clean equipment.
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Locked drawers and cassettes for
medication storage.
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Bulk supply carts.
Small administrative area with work
surface, seating, file storage,
tackboards, space for computer,
overhead storage for manuals and
binders.
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Cantilevered sink unit.
The anesthesia workroom and supply room can be planned using movable modular
casework components.
Specialty procedure carts.
Extra-deep modular shelving units.
Plan View of an Anesthesia Supply/Workroom
An anesthesia supply/workroom will range in size from 250 to 500 square feet.
16 linear feet work surface
42 linear feet overhead storage
328 filing inches
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5 lockers
bulk supply carts as required
470 square feet
Surgery Department 18
Surgery Department
Satellite Lab
Satellite Lab
The surgery department may have a
satellite lab for STAT testing of tissues
and for creating and reading frozen
section slides.
Movable Modular Casework Applications
A satellite lab can be planned using
movable modular casework components
and may require
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Heavy-duty work surfaces and/or
process tables for automated
instruments.
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Wall strips, modules, or support
panels to hold work surfaces and
overhead storage.
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Tackboards.
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Cantilevered sink unit.
File storage.
Flipper units, C frames, lockers, and
L carts for storage.
Plan View of a Satellite Lab
A satellite lab will range in size from
150 to 400 square feet.
43 linear feet work surface
65 linear feet overhead storage
1 locker (optional)
332 square feet
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Surgery Department 19
Surgery Department
Satellite Pharmacy
Satellite Pharmacy
A satellite pharmacy may exist in the
surgery department. This decentralization
of the pharmacy function allows for more
rapid response to the needs of the patient.
The space will vary in size but will
usually contain a small drug picking area,
sink, refrigerator, computer, printer, label
printer, and controlled substance storage.
Some satellite pharmacy areas may have
a small laminar flow hood.
Movable Modular Casework Applications
The same movable modular casework components used in the main pharmacy are
appropriate for the satellite pharmacy, allowing for continual flexibility and change in
the space and may include
·
Medication locker or transfer cart.
·
Cantilevered work surfaces.
·
Double-locking drawers for storing
controlled substances.
·
Extra-deep modular shelving units.
·
Dispensing rail.
·
Cantilevered sink unit.
The satellite pharmacy is staffed,
stocked, and serviced by the primary
pharmacy department.
Modular carts are appropriate for the
transfer of medications to the satellite
pharmacy.
Plan View of a Satellite Pharmacy
A satellite pharmacy will range in size
from 120 to 250 square feet.
18 linear feet work surface
28 linear feet overhead storage
80 drug bins average
1 locker
1 medication cart
140 square feet
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Surgery Department 20
Surgery Department
Staff Lounge/Locker Room
Staff Lounge/Locker Room
A staff lounge is used primarily for
coffee breaks, snacks, and as a place for
staff to rest from the pressures of patient
care. Space should be provided for a
refrigerator, microwave oven, and large
coffee maker.
Staff locker rooms, usually adjacent to
the staff lounge, are provided for male
and female staff to change from street
clothing into surgery attire. Clothing
lockers, toilet facilities, and showers are
provided.
Movable Modular Casework and Furniture Systems Applications
This environment should be easily cleaned and offer a warm, enjoyable atmosphere.
Staff lounges may require
·
·
Wall strips with work surface and
overhead storage or heavy-duty
storage work surface with C frame
and drawers for a coffee maker and
supplies.
·
Tackboards for displaying
information.
·
Lockers or wire carts for surgical
attire – dresses, suits, caps, shoe
covers.
Tables and seating.
·
Base cabinets for storage.
Plan View of a Staff Lounge/Locker
Room
A staff lounge/locker room will range in
size from 125 to 250 square feet.
10 linear feet work surface
10 linear feet overhead storage
2 lockers
175 square feet
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Surgery Department 21
Surgery Department
Administrative Office
Administrative Office
Each surgery department will have
unique requirements for its administrative areas. Generally the following
positions will require an administrative
office:
Movable Modular Casework and
Furniture Systems Applications
·
·
·
·
·
·
·
·
Cantilevered work surfaces.
·
Work surfaces with keyboard
drawers or trays to accommodate
computers and printers.
·
Overhead storage, flipper units,
display shelves, and marker boards
for displaying information.
·
·
Task lights and personal lights.
Operating room supervisor.
Director of surgery.
These areas may be furnished with
modular furniture systems and seating.
These offices may need
Director of anesthesiology.
Chief surgical residents.
Clinical nurse managers.
Operating room materials manager.
Tool bar with accessories for paper
handling.
Freestanding, under-work surface, or
wall-attached drawers and files.
Plan View of an Administrative Office
9 linear feet work surface
12 linear feet overhead storage
20 filing inches
100 square feet
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Surgery Department 22
Surgery Department
Functional Program
Functional Program
Number
Department Area
Square Feet
Movable Modular Casework
Control Station
Pre-Operative Holding Area
Scrub Areas @________ sq. ft.
Operating Rooms @________ sq. ft.
Orthopedic Operating Room
Orthopedic Equipment Storage Room
Cystoscopy Room
Substerile Room
Clean Core
Post-Anesthesia Care Unit
Primary Recovery
Secondary Recovery
Isolation Recovery
Patient Toilet
Medication Area
Clean Holding Room
Soiled Utility Room
Equipment Storage Room
Clean/Sterile Storage Area
Clean Workroom
Soiled Utility Room
Anesthesia Supply/Workroom
Satellite Lab
Satellite Pharmacy
Staff Toilets @________ sq. ft.
Janitor’s Closet
Subtotal
Modular Furniture Systems
Staff Lounge/Locker Room
Administrative Offices @________ sq. ft.
Subtotal
TOTAL NET SQUARE FEET
Net-to-Gross Conversion Factor
X
TOTAL GROSS SQUARE FEET
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Surgery Department 23
Surgery Department
Bubble Diagram
Bubble Diagram
The bubble diagram of the surgery
department demonstrates typical
departmental relationships and
interaction between areas. Necessary
adjacencies within the department
become clear.
SECONDARY
RECOVERY
PRE-OP
HOLDING
CONTROL
PACU
STAFF
LOUNGE/
LOCKERS
PERIPHERAL
CORRIDOR
ANESTHESIA
SCRUB
SOILED
HOLDING
OPERATING
ROOM
CLEAN
WORKROOM
SUBSTERILE
CLEAN CORE
CLEAN
HOLDING
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Surgery Department 24
Surgery Department
Block Diagram
Block Diagram
The block diagram demonstrates the adjacencies and relative sizes for the areas within
a typical surgery department. Evaluation of the work flow and materials flow from the
bubble diagram has determined this initial general layout.
The size of each area is determined by combining the typical movable modular
casework plans for each identified function. Traffic patterns are developed, and an
overview of the general work process can be evaluated.
SECONDARY
RECOVERY
PRIMARY
RECOVERY
CLEAN CORE
CYSTOSCOPY
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Surgery Department 25
Surgery Department
Preliminary Plan
Preliminary Plan
The preliminary plan clarifies the surgery
department space requirements by
showing the location of all the fixed
walls and open areas and identifies
entrances, exits, and exact traffic
patterns.
SECONDARY
RECOVERY
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PRIMARY
RECOVERY
Surgery Department 26
Surgery Department
Schematic Plan
Schematic Plan
The schematic plan shows all of the
specific movable modular casework,
modular furniture systems, and materials
handling components appropriate for a
typical surgery department.
SECONDARY
RECOVERY
PRIMARY
RECOVERY
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Surgery Department 27
Surgery Department
Future Trends
Future Trends
Facilities
Procedures and Services
Layout
Because of the increase of outpatient
surgeries, the number of off-site surgical
outpatient facilities has grown over the
past ten years. Currently, however,
hospitals are constructing more on-site
outpatient surgical suites than
freestanding surgery centers. This trend
is due to surgeons’ preference for using a
hospital setting with its backup resources
and equipment rather than a remote
location and patient preferences for a
hospital setting. The percentage of
outpatient surgical procedures will
continue to rise.
There will be new and increasing
numbers of procedures for the regulation
of waste products from the operating
rooms, of which approximately fifteen
percent is infectious.
New technology and new procedures will
continue to impact the need for larger
operating rooms to accommodate the
necessary equipment. These larger
operating rooms will still need to remain
flexible in function as well as being able
to adapt to continual change.
Surgery departments require constant
renovation to keep pace with new
technologies, practices, and equipment.
Implementation and expansion of
information systems will be seen
throughout the hospital with computer
capabilities and technology becoming
standard equipment in each operating
room. The increased use of computer
systems will be accompanied by the use
of bar code technology for a variety of
applications.
Innovations in medical technology will
continue to have a profound effect on the
types and variety of surgical procedures
performed.
Advances in technology will center
around cardiac surgery, organ
transplants, and new laser and
endoscopic procedures.
Space must be provided for the storage
of the constant influx of new equipment
used in surgical procedures.
Future surgery departments must
continue to fine tune sterile storage and
materials handling procedures and
planning to provide the most costeffective systems, including space
allocations for case cart and exchange
cart systems.
The disposal of waste materials from the
surgery department will have an impact
on future planning. There is an emerging
trend for surgery departments to return to
reusable supplies, particularly operating
room linen and instruments, because of
the rising costs of medical-waste
disposal. This will affect not only waste
removal, but the clean storage areas of
the surgery department, and the delivery
system of the central sterilizing
department.
The nursing care emphasis on “patientfocused” care will promote changes in
planning to allow greater patient privacy
and comfort within the surgery
department.
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Surgery Department 28
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or call (800) 628 0058.
©
1999 Herman Miller, Inc., Zeeland, Michigan
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