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Realizing Improved Patient Care through Human-Centered Design in the Operating Room (RIPCHD.OR)

The Realizing Improved Patient Care through Human-Centered Design in the Operating Room (RIPCHD.OR) learning lab uses a socio-technical approach incorporating human factors engineering and evidence-based design principles to create an optimal ergonomically sound operating room that results in improved patient and staff safety. A multidisciplinary team comprised of human factors and industrial engineers, architects, environment and behavior researchers, medical equipment planners, anesthesiologists, nurses and quality and patient safety experts from Clemson University and the Medical University of South Carolina (MUSC) have worked collaboratively to develop, test (through iterative design cycles), implement and evaluate various OR design solutions. Some of the concepts developed as part of this learning lab are being implemented in two new ambulatory surgery centers built at the Medical University of South Carolina (MUSC) in Charleston.

Sponsor: Agency for Healthcare Research Quality

Project period: 2015 to 2020

Three highly interrelated and integrated patient safety focused projects related to key aspects of OR suite design have been undertaken over the course of the RIPCHD.OR project

Project 1: Unmasking of anesthesia-related alarms and communications This work extends what is known about alarms, interruptions, and distractions in the operating room by examining them from a systems perspective. Project 1 involves several phases with the goals of: 1) developing and evaluating systems design methods that account for masking affect tasks within the OR environment and 2) exploring interface design as a means to mitigate the effects of masking.

Project 2: Traffic flow and door openings in the OR This project focuses on understanding factors impacting traffic flow in the OR suite. Using a systems approach, the flow of supplies, equipment, information and people in the OR is being studied and the factors impacting traffic flow and distribution are being analyzed to develop solutions that minimize door openings and flow disruptions in the OR.

Project 3: Integrated OR suite design This project provides the overall framework for integrating the work of this learning lab. This project is developing an overall framework and methodology for designing an ergonomic and human-centered operating room that will improve patient and staff safety and outcomes in the OR. The project team for OR suite design has worked closely with the other project cores to determine optimum procedure room configuration, orientation and intra-room zoning that supports the performance of the surgical team, improves workflow within the team, enhances visibility of work and team members, minimizes distractions of team members and reduces risk of surgical site infections.

AIM 1: Formally structure the RIPCHD OR learning lab and establish laboratory infrastructure and team management.

AIM 2: Develop a systematic approach to evaluating the impact of people, tasks, tools and technology and the built environment in developing ergonomic and human-centered operating room design solutions.

AIM 3: Develop evidence and recommendations related to the use of advanced displays and multimodal displays for anesthesia tasks to mitigate the masking of important signals.

AIM 4: Develop process design recommendations to support key OR flows (OR team members, supplies, patient, equipment, information) that impact patient safety outcomes such as surgical site infections and surgical errors.

AIM 5: Develop an evidence-based framework and methodology for designing operating rooms that achieve the desired patient and staff safety outcomes.