Areas and typologies of spaces in a surgical suite for pediatric patients

As we have already mentioned in other articles in previous editions of this blog, hospital centers that specialize in maternal and child patients require specific sensitivity and design, taking into consideration the patient’s profile (children and teenagers) and their families. In this article, we will discuss the most technical part of the new Surgical Block of the Hospital Sant Joan de Déu: on the program and typologies of surgical rooms.

The program: reception, intervention, support spaces and circulation

The Sant Joan de Déu Hospital’s new pediatric surgical block, located on the upper level of the surgical area, is divided into the following areas, which are complementary to one another:

Reception: Rainbow Space

The Rainbow space includes the patient reception and welcome area. It is organized into waiting areas, lockers and accompanying services.

Intervention: Intermediate and sterile zone

This area stands out for its natural light, which is essential for the activities that it hosts. This is where the surgery rooms and their support areas are located, such as sterile material preparation rooms, storage rooms, intelligent cabinets, medical offices or report rooms.

A unit with eight pediatric operating rooms was then established:

• Four high-tech surgery rooms: fetal, trauma, hybrid neurosurgery with magnetic resonance, and hybrid cardiology with hemodynamics.

• Four standard surgical rooms, one of which is equipped for gynecological procedures.

Along with support spaces and respective complementary services:

• Post-anesthesia recovery unit serving the surgical rooms with 10 boxes for reanimation.
• Sterilization center connected to the other hospital circuits in order to provide a complete service to the operating rooms. Again, natural light is essential in this area.

Circulation: Technical circulation area

Restricted access for medical staff, it belongs to the circuit for waste and dirty material. The technical equipment necessary for working in the surgery rooms is also located in such a way that maintenance can be done without coming into contact with the sterile areas of the block. This organization allows high efficiency, as maintenance can be performed from outside the unit, without having to enter the sterile areas. As this hallway is parallel to the facade, some niches are used to place storage elements, ensuring that circulation is not obstructed.

Types of surgical rooms

A double corridor surgical block was designed to comply with the strict regulations of the Catalan autonomous community:a sterile corridor and a technical circulation corridor, which ended up deriving in a battery with a hybrid scheme between the simple and the multiple, due to the difficulty of fitting the pieces together in terms of distribution. The proposal was fitted into the available space and, in the minimum space areas (4.50 meters), work points for the medical staff and Smart Cabinets (intelligent cabins for dispensing surgical material) were provided.

The technical panel of the surgical room has a structure that does not touch the floor and has all the control elements of the room: climate, light, signals, clock, stopwatch… achieving as a result an integrated design element within the surgical room.

The hybrid surgery room is a surgical suite equipped with advanced, high-quality diagnostic imaging devices, combining a range of interventional services (medical imaging such as MRI and CT) without the need to transport the patient. The MRI room is adjacent to the surgery room, connected through a door. The CT is portable or hanging by guides on the ceiling or floor in the same surgery room. These surgical rooms combine minimally invasive technologies with high quality imaging and communication in a single room. Usually, complex surgical procedures are performed in separate environments far away from the diagnostic imaging rooms, which makes the patient’s journey from the surgical service to obtain a new diagnosis with high quality images not very efficient and a risk for his or her own safety. The hybrid model encourages better patient care and optimal use of space, and incorporates all the aseptic conditions and features of an advanced operating room.

The advantages of a hybrid operating room could be summarized as the following:

• It supports the patient’s safety by minimizing the risk of movement between surgical room, radiology and ICU.
• The possibility of performing diagnosis and intervention at the same time.
• Fewer incisions, as it is a less invasive procedure, with better chances of long-term success.
• Patients recover more quickly and spend less time in the hospital.

In the case of the Sant Joan de Déu hospital, the two hybrid surgical rooms diagnose and provide treatment simultaneously during surgery. This allows to achieve more precision relative to the area to treat and to minimize the magnitude of the intervention in facilitating a better recovery. It also makes it possible to verify the result of an intervention and, when necessary, to continue operating. The procedure may take longer, but the patient’s benefit is significant.

The neurosurgical surgical suite is a hybrid with a 1.5T MRI. In this case, the MRI is not moved, but the surgical table is displaced. The MRI is set up as a submarine because it was designed to be used in outpatient cases, so it can be used by the hospital and has an independent access circuit.

The cardiology surgical room is a hybrid with an angiograph, in the same room, with an idea to perform tests and visualize the operation itself. In this case, the work area and the external control point must be directly related to the surgery room, since the equipment is controlled from the outside, although the surgery room has an enabled point to do so if necessary.

Useful links:

• Project sheet: Sant Joan de Déu Hospital Surgical Block
• Article: Co-creation, neuroarchitecture and technology in healthcare spaces for the pediatric patient. | Published in the Bloc Pinearq (January 2023)