Surgery is safer and patient recovery quicker when medical teams inform operating room design. Deerns and the design team let this ethos lead for the new hybrid OR at Jeroen Bosch Hospital.
Deerns and EGM architects are designing a new hybrid operating room (HOR) at the Jeroen Bosch Hospital, which was originally one of the first hospitals in the Netherlands to have an HOR. With the X-ray tripod -at the end of its lifecycle, the ideal opportunity arose for refining the design and improving the layout of the existing HOR, thereby improving medical processes and user experience.
Charles Mahieu, Senior Consultant Health Care and Hospital Logistics at Deerns, is once again involved in the design phase and gives a glimpse into the process. “The final design aligns with the principles of high-quality equipment and smart room design that facilitate future-proof healthcare. Together with EGM and Roubos OK Expertise, we are designing the new HOR and supervising the process. In the preliminary phase, we conducted a feasibility study, in which we investigated both the technical and functional feasibility with various layouts.”
Merging Radiology and Surgery
Twelve years ago, the Jeroen Bosch Hospital was one of the first hospitals in the Netherlands to have a hybrid operating room (HOR). An HOR combines the sterile environment of a high-care OR with high-quality imaging equipment, combining open surgical and endovascular techniques, thereby providing safer treatment for high-risk patients.
Unpacking the initial HOR design Mahieu says, “When we designed the new hospital, the hybrid OR was still an a new concept evolving into state-of-the-art technology. Consequently, the request to fit a hybrid OR into the design was only discussed at the end of the execution phase. An HOR requires more equipment and consequently more space and we had to drastically change the layout. It all worked out well and we are still very proud of that outcome.”
Medical team tests design
The new HOR will replace an existing orthopaedic OR with ancillary rooms, and will be a lot more spacious than the existing one. This offers new opportunities for efficiency according to Ina Roubos of Roubos OK Expertise, “We are setting up smarter logistics for patient route and the supply and removal of sterile materials thereby increasing ease of use and saving time.”
The design team involved the OR staff in the early stages of design process. Ina explains how the design is tested with a model created at full scale and with careful consideration of work processes: “We recreated the new design, including all the built-in components, from a polystyrene X-ray arch, imitation surgical booms through to the operating table.”
" Together with the OR team, we tested the workspace as well as the walking and sight lines. Armed with this information of the user experience we refined our design even further.
Vascular surgeon Olivier Koning is looking forward to the technological innovations, “In the new hybrid OR, we can count on improved 3D reconstruction and workflow in the imaging system through the integration of ultrasound and IVUS. An additional new feature are two large screens on either side of the patient.”
With a view to reducing energy consumption the hybrid OR is designed as an air class 1 operating room in accordance with the new FMS guideline. This makes it possible for the air supply system to be more energy-efficient and maintenance-friendly. An additional advantage is that air circulation takes place throughout the room, increasing the workspace around the operating table. At the same time, various air handling units are being upgraded and equipped with direct drive fans.
Here’s where Care comes First
Joost Bonnier, project manager at EGM architects, continues, “Even though the OR project is complex the design should never be at the expense of patient care. Consequently there are several preconditions prior to implementation such as guaranteeing accessibility and availability of the hospital and its facilities. We draw up clear agreements and protocols for the execution of the project, such as the short shutdown of construction work during an emergency operation. Care always comes first.”
With the final design of the hybrid OR completed, construction starts in 2024. “The hospital will continue to offer the same high-quality care during the renovation,” Jeroen continues. The existing HOR and surrounding operating theatres will remain operational during the implementation period.”
“We involved the Emergency Department early on in the process because our work is adjacent to the ambulance response route. By transporting the construction staff and materials via a construction hoist on the outside façade, we can maintain the hospital operations and keep the area clean.”
Joëlle de Ronde, OR assistant at the Jeroen Bosch Hospital highlights what she is looking forward to the most in the transition from the existing to the new HOR. “In today’s HOR, we owe our gratitude to our equipment, which is a great support in our daily specialist work. Twelve years on we are now using far more advanced equipment. I expect that the new hybrid OR will mainly improve the user experience, and even more so with the bespoke design tailored to our needs.” She explains how early engagement of the OR staff contributed to this outcome: “We were able to think along about the design so that the OR set-up works for all of us. The new HOR will provide better well-being for both staff and patients, the people for whom we are re-designing in the first place.”
