Impact of Surgical Table Orientation on Flow Disruptions and Movement Patterns during Pediatric Outpatient Surgeries

Abstract

(1) Background: The surgical table within a typical ambulatory surgery operating room is frequently rotated and placed in different orientations to facilitate surgery or in response to surgeon preferences. However, different surgical table orientations can impact access to different work zones, areas and equipment in the OR, potentially impacting workflow of surgical team members and creating patient safety risks; (2) Methods: This quantitative observational study used a convenience sample of 38 video recordings of the intraoperative phase of pediatric outpatient surgeries to study the impacts of surgical table orientation on flow disruptions (FDs), number of contacts between team members and distance traveled; (3) Results: This study found that the orientation of the surgical table significantly influenced staff workflow and movement in the OR with an angled surgical table orientation being least disruptive to surgical work. The anesthesia provider, scrub nurse and circulating nurse experienced more FDs compared to the surgeon; (4) Conclusions: The orientation of the surgical table matters, and clinicians and architects must consider different design and operational strategies to support optimal table orientation in the OR.

Keywords: flow disruptions; layout; movement; operating room; pediatric surgery; surgical table.

Figure 1

Multiple connections between the patient and OR equipment making surgical table rotations complicated and challenging.

Figure 2

Location and type of zones in the ORs.

Figure 3

Floor plans of the four ORs observed with zones demarcated (refer to Figure 2 for legend). All floor plans are shown with surgical tables in orientation B.

Figure 4

The four different surgical table orientations observed in the ORs in this study (a) Table position A, (b) Table position B, (c) Table position C, and (d) Table position D. These figures show the different surgical table orientations in OR 1. Refer to Figure 2 for legend.