The incidence of adverse events such as surgical site infections and surgical errors are a huge problem in the operating room (OR) due to the high vulnerability of the patient and the complex interactions required between providers of different disciplines and a range of equipment, technology and the physical space where care is provided. Two to five percent of all patients who undergo an operation will develop a surgical site infection leading to significant mortality and morbidity. Distractions and interruptions are major causes of medical errors during surgery and often lead to serious patient harm. While significant efforts to improve patient safety have been focused on enhancing skills and training for surgical staff, little effort has been directed at the environment in which healthcare provider work. The overreaching goal of the proposed 'Realizing Improved Patient Care through Human-Centered Design in the OR' (RIPCHD.OR) learning lab is to develop an evidence-based framework and methodology for the design and operation of a general surgical operating room to improve safety. RIPCHD.OR will use a multidisciplinary human-centered approach incorporating evidence based design, human factors and systems engineering principles. Clemson University will collaborate with the Medical University of South Carolina (MUSC) and the Health Sciences South Carolina (HSSC) to develop the RIPCHD.OR learning lab. The design, process and technology solutions that emerge from this learning lab will be implemented and tested in the new MUSC Ambulatory Surgery Center in Charleston, SC. Three highly interrelated and integrated patient safety focused projects related to key aspects of OR suite design will be undertaken over the course of four years: Project 1: Unmasking of anesthesia related alarms and communications Project 2: Understanding traffic flows and door openings in the OR Project 3: Integrated OR suite design

Public Health Relevance

Many older operating suites remain operational today. These ORs are poorly equipped to handle the equipment, technology, processes and people that a modern OR needs to accommodate. With research in OR design lagging far behind the advances in technology, new ORs are for the most part modifications to outdated OR designs and are often built with little consideration to human factors and ergonomics criteria. As a result, the operating room environment is inherently unsafe for patients as well as clinicians.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Center Core Grants (P30)
Project #
5P30HS024380-04
Application #
9557463
Study Section
Special Emphasis Panel (ZHS1)
Program Officer
Rodrick, David
Project Start
2015-09-01
Project End
2019-08-31
Budget Start
2018-09-01
Budget End
2019-08-31
Support Year
4
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Clemson University
Department
Miscellaneous
Type
Schools of Arts and Sciences
DUNS #
042629816
City
Clemson
State
SC
Country
United States
Zip Code
29634
Joseph, Anjali; Bayramzadeh, Sara; Zamani, Zahra et al. (2018) Safety, Performance, and Satisfaction Outcomes in the Operating Room: A Literature Review. HERD 11:137-150
Bayramzadeh, Sara; Joseph, Anjali; San, Dee et al. (2018) The Impact of Operating Room Layout on Circulating Nurse's Work Patterns and Flow Disruptions: A Behavioral Mapping Study. HERD 11:124-138
Neyens, David M; Bayramzadeh, Sara; Catchpole, Kenneth et al. (2018) Using a systems approach to evaluate a circulating nurse's work patterns and workflow disruptions. Appl Ergon :
Taaffe, Kevin; Lee, Brandon; Ferrand, Yann et al. (2018) The Influence of Traffic, Area Location, and Other Factors on Operating Room Microbial Load. Infect Control Hosp Epidemiol 39:391-397
Bayramzadeh, Sara; Joseph, Anjali; Allison, David et al. (2018) Using an integrative mock-up simulation approach for evidence-based evaluation of operating room design prototypes. Appl Ergon 70:288-299
Catchpole, Ken; Neyens, David M; Abernathy, James et al. (2017) Framework for direct observation of performance and safety in healthcare. BMJ Qual Saf 26:1015-1021
Ibrahim, Andrew M; Dimick, Justin B; Joseph, Anjali (2017) Building a Better Operating Room: Views from Surgery and Architecture. Ann Surg 265:34-36