“Hybrid OR” is a popular buzzword for those planning a renovation or adding new-built OR space. I know because I’ve just been involved with such a project.
We recently added 10 new ORs at Saratoga Hospital in Saratoga Springs, NY, while renovating older ORs. Our situation is somewhat unusual. Because Saratoga Hospital is the only acute care hospital in our county, our ORs must support a broad range of surgical specialties. At the same time, we’re close enough to larger cities like Albany and New York City that our patients can travel there for surgery. In addition, our population swells significantly during summertime, as Saratoga Springs is a popular vacation destination for visitors from major East Coast population centers. Our challenge, as we planned our new construction project, was to make sure we could support our community and visitors, attract medical staff, and be financially strategic in our investment.
The first thing our multi-disciplined OR planning team realized was that we had two divergent goals. We needed maximum OR scheduling flexibility and the ability to provide the state-of-the-art visualization technology required to fulfill our mission as a center of excellence. As we analyzed these goals, the team realized we needed “hybrid” functionality. Every OR had to be able to accommodate image-guided surgery using surgical video cameras, C-arms, and ultrasound. Our surgeons needed access to PACS and the EMR. And, from a patient care perspective, we wanted our nursing staff inside the OR, not chasing down equipment.
“Hybrid” can refer to flexible use and to architectural design. Since usage of “hybrid” varies depending upon the institution, it’s important to make sure everyone has a common understanding of the term when discussing “hybrid OR” projects with colleagues. At Saratoga, we defined hybrid as flexible OR space, designed specifically for today’s advanced medical devices and for the visualization capabilities needed for MIS. Each of our 10 new ORs features a built-in visualization system whose displays are suspended from ceiling booms. We have anesthesia booms, as well, to provide gas machine placement flexibility if we have to flip a room. Our new ORs can also accommodate our multi-discipline surgical robotic program used for GYN, general, and urology surgeries. We have the ability to schedule any type of surgery inside any of the ORs.
To make the most strategic use of our space, we currently are repurposing an area in the older section of our facility to support surgeries that don’t require as much floor space. Prior to the new-built OR project; we had purchased a floor-mounted boom system, which provided turnkey video integration. When designing the new ORs, we chose ceiling booms but opted for the previous vendor’s video integration system because it was flexible and familiar. For the newly repurposed space, we relocated the floor-mounted boom system, called a NuBOOM, from an older, dedicated MIS room to a flexible room where GI/ERCP will be conducted.
Many organizations rightly consider single-specialty cardio ORs with built-in bi-plane imaging systems to be “cardio hybrid ORs.” Similarly, organizations refer to “neuro hybrid ORs” with built-in MRI. Both types of ORs are hybrids because they are capable of image-guided and traditional open surgery. At Saratoga Hospital, we do not have cardio or neuro hybrid ORs. These capabilities are available within a reasonable distance, in Albany and New York City, so we didn’t include them in our strategic plan.
Sharman Lisieski is the Director of the Operating Room/Post Anesthesia Care Unit at Saratoga Hospital since 2002.