Future of Modular Operation Theatre
According to Bhavesh Bhatt, Country Head, Medifa Healthcare Group, the evolution of technology is chiefly responsible for the growth of modular OT segment. He shares his insights on the OR of the future and how go about making the right choices. Excerpts of the interview
Q: Modular OT is becoming increasingly popular; what are the reasons for this and the benefits of adopting it over traditional OT?
The evolution of technology is chiefly responsible for the growth of modular OT. The introduction of Hybrid OT , large-screen tele medical diagnostic and monitoring equipment became indispensable with time. Initially, the equipment were embedded in the walls of the OT and this made the maintenance of the equipment a huge concern for the staff. Concealed power line and medical gas pipes had problem with conventional OTs where failure / breakdown would result in OT shutdown, resulting in OT shortage and loss of revenue. Hence introduction of truly modular OT made it easy to install , use, maintain, and expand. Although a brick-less room was not a good idea for many, but the flexibility of the modular OTs won over the critics and users alike. Modular OT are upgradable and easy to maintain.
Q: What are the most important aspects to consider when designing a new modular OT [from a functional, design, and efficiency standpoint]? How does this enhance workflow and ergonomics?
Workflow is paramount while designing a modular OT design. We may have the best medical equipments in the OT , but personally I emphasize on the importance of work flow. Today hospitals perform huge number of surgeries hence the patient movement from semi- sterile to sterile zone is crucial. However, mobility of the clean and dirty goods, entry and exits of the patient , clinical staff and OR staff and ability to adjust for different surgical needs is what makes an ideal and efficient modular OT design.
Q: Since developing a new OR is an expensive option, what factors should be taken into account to maximize the return on investment [ROI] OR are high functional area and the most important aspect to consider is the ease of operation and patient safety.
In my opinion we should not look from a ROI standpoint, it should not matter as it is a long term infrastructural investment. What’s more important is to focus on uptime and keep low cost of maintenance. As the OR is future-proof, even if requirements change, there is no need to invest a lot in reconstruction in the future, this is where you save costs.
Q: How quickly can a modular OT be built? What effect does it have on project timelines and budgets? Modular OT cannot be built in a blink once you have decided on the project.
Although it doesn’t need as much time as a brick and mortar construction would need. However, the planning and architecture is where the real task begins and that is the key. Then comes the collaboration with the HVAC , electrical ,Med Gas and other utility services. Post this the equipment like OT lights, Pendant, tables needs installation. In fact, upgrading of the OT & equipment is very flexible and quick, the panels are easy to install or modify later as per the need of the OT environment . That’s where the time & cost is saved. But everything boils down to situation, space, and ergonomics.
Q: Can you tell us about modular OT retrofitting to accommodate new or changing OR requirements? Is the OR facility flexible enough to meet future changes?
For a new and spacious OR a modular system is the best option as it is highly flexible and the substructure can be easily modified to accommodate new OR equipment meeting new design layout. This is the biggest advantage. And secondly when it comes to accommodating retrofitting’s, let me tell you, a modular OT can be easily created and converted into a hybrid OT by merging two different OTs. The procedure is effortlessly time-saving and the best part is that you don’t have to shut down the regular functions during the merger.
Q: What are the new fabrication materials that are being employed in modular OT development? How can they provide a more sterile atmosphere and superior built performance? Comment on the Modular OR’s long-term viability
The wall material is one of the many components of the modular OR system and I believe steel is the finest material for OR walls. It is simple to maintain, long-lasting, colorable, and sterilizable. Maintaining a sterile environment requires an effective laminar flow with a high-quality HEPA filter which is important. However, there are other OT wall material choices like as glass, SMS and HPL, all of which have their own advantages and disadvantages. Due to the modular design and factory coated panels, it requires less maintenance and hence is very cost effective in the long run. Additionally, panels can be changed separately in a short period of time. Another overlooked problem is switching off air conditioning when OT is not in use. This causes condensation resulting in rusting and equipment damage
Q: Comment on the importance of aesthetics and introducing appealing colors and patterns into the OR environment to reduce stress.
Aesthetics and natural light percolation is very important and it has a positive impact not only on surgeons and OT staff but also has impact on patient wellbeing. We always plan to introduce sealed window, offer Printed wall elements to get lively working environment with appealing colors in OT have proven to alleviate the stress arising from long work hours in the OT. Induction and recovery rooms can also be attractively designed with patterns and pleasant colors so that patients fall asleep and wake up as relaxed as possible.
Q: Include the other major components of the modular OT that must be carefully chosen for maximum OR efficiency.[ integrating other critical components]
There can be no compromise on any component of the OT. Every single thing is important. Right from walls, Ceiling , Doors, antistatic flooring, ambient lights, control panels and windows, everything has a significant role. Minimizing joint in the OT is extremely important to ensure there is no air leakage, also maintaining the temperature is key to avoid condensation in the OR. Missing anything can reduce the functionality of the OT to a major extent.
Q: What are the key considerations when planning and developing a modular OT that incorporates important technology aspects [Hybrid, Digital] ?
Hybrid and Digital OT are two different concepts. Digital OT is still not being efficiently incorporated in India. There are many reasons for that ,one is that medico-legal regulations are still in the formative stage. Integration of Data collection, sortation, and storage procedures are time-consuming too we have some time to reach there yet. However we can integrate large displays, Data monitors and PACS PC in the modular wall quickly. In the Hybrid OT the focus is more on integrating the imaging modality and surgical discipline along with technologies pertaining to endoscopy procedures, trolley and insufflators. Hybrid OT is very futuristic and it has significant outputs where surgical programs like cardiovascular ( TAVI), endovascular ( EVAR), Neuro, Spine, Onco,Trauma and many procedures can be performed. For sure Hybrid OR can be digital also.
Q: How do you anticipate the future of Modular OR Build & Technology?
The future is full of opportunities and has a great potential to grow exponentially. Modular OT are highly efficient and flexible in nature, key features that are paramount are upgradation and technology, choosing a right OR partner offering all solutions under one roof is equally important. But yes, we also need specialized workflow architects, investors, and people who are ready for the transition. Robotics and Hybrid will truly bring in revolution in the OR practice in future.