Medical Construction & Design

MAY-JUN 2018

Medical Construction & Design (MCD) is the industry's leading source for news and information and reaches all disciplines involved in the healthcare construction and design process.

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52 Medical Construction & Design | M AY/ J U N E 2018 | MCDM AG.COM BY CINDY BECKHAM & ROSEMARY HWANG Healthcare organizations across the country are strug- gling to identify opportunities to save costs through im- proved operational effi ciency. Perhaps no healthcare area is more scrutinized through re- search and analytics than the surgery department. As one of the most labor-intense and costly areas in any healthcare environment, it makes sense to streamline processes, physi- cal design and staffi ng to limit downtime in this area. Research shows 1 that one minute lost in operating room utilization can cost as much as $20 per minute. Oddly though, one area that has little re- search to support operational improvement and cost savings in surgery is the impact of mechanical system design on operating room turnover time. When every minute counts for the physician, patient and visitors waiting for an operat- ing room to turn over, it makes sense to design heating, ven- tilation and air conditioning systems that support fl exibility and limit downtime. As hospitals look to en- hance fl exibility for advanc- ing and changing medical technology, surgery is also looking for ways to create fl exible environments to maximize operating room scheduling and allow proce- dures of varying complexity in any room. Operating room customization by procedure type is typical. Customization of heating, cooling and ventila- tion requirements by operat- ing room classifi cation based on procedure type can be identifi ed as a limiter to true operational effi ciency of the surgical environment. HVAC systems designed for fl exibility allow any OR to be used for any procedure type (excluding other specifi c infrastructure requirements) with reduced impact on the turnover time. Consider a traditional HVAC design requiring man- ual recalibration to achieve varying temperature and hu- midity needs in one OR. This recalibration can take as long as 60 minutes to accomplish. If each minute of time in this OR has a $20 value, this could cost as much as $1,200/day, $6,000/week and $312,000/ year. Now multiply this by an eight OR suite. An institution could be losing more than $2.5 million/year just waiting for a room to heat or cool. A more extreme example is when specifi c ORs are utilized only for specifi c procedures due to the limited fl exibility to control room conditions. These ORs could account for extreme revenue loss to the hospital over time. Finally, studies have shown the dura- tions of most surgeries are getting shorter, allowing more surgeries to be scheduled per day. By shortening OR turn- over time, using a combination of diff erent methods, a hospi- tal could regularly schedule an additional operation in each OR. Adding one additional sur- gery to the schedule each day could increase the revenue of the hospital by $500,000/year. Innovation in HVAC design thinking takes the identifi ed fl exibility limitations and reve- nue losses out of the effi ciency equation for hospital surgical departments and ambulatory surgery centers. Engaging various combinations of these strategies or any of the strate- gies independently will en- hance the overall performance and operational opportunity to improve throughput of the surgical department. Strategy #1: Automatic setpoint adjustment One such strategy is a system called advanced controls technology, which allows for operating room schedules to be incorporated into the HVAC control system. This solution allows the preset defi ned and required room temperature and humidity for a particular procedure type or physician preference to be changed automatically, with no manual calibration by staff . This self-adjustment in the HVAC system ensures each operating room is proac- tively customized, resulting in A transient computational fl uid dynamics model of a typical OR with a typical HVAC system and laminar airfl ow. ROOM TEMP AFTER 10 MINUTES OF COOLING KEEPING THE SAVINGS FLOWING Ways to reduce OR downtime through HVAC, mechanical system design

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