As the trend toward minimally invasive procedures gains ground, interest in hybridoperating rooms (ORs) – which are essentially fixed angiography systems of various configurations in an OR with various display monitor options – should likewise continue to build steam. And heightened interest in hybridORs isn’t confined merely to the practitioners of cardiothoracic or vascular procedures. Neurosurgery, spine surgery, and orthopedics are also image-guided procedures, and minimally invasive kidney removal and liver resection rely on imaging more heavily than ever before.
Demand for hybridORs is clear. Less obvious, though, are the complications hospitals encounter when planning and implementing these rooms. Hospitals typically face three major challenges:
Failure to involve all stakeholders – Every stakeholder in an organization – not just cardiothoracic and/or vascular surgeons, but also radiologic technologists, anesthesiologists, nurses, architects, planners and facilities representatives, along with imaging, lights/boom, and video integration vendors – should attend hybrid OR joint planning sessions early on to ensure that everyone is playing in the same room, so to speak. These joint planning sessions can ensure that workflow in the hybrid OR is not hampered due to the inability of the fixed angiography system to, for example, coexist with the room’s lighting systems.
Inadequate or nonexistent education and training – Surgeons working in a hybrid OR must be as adept in imaging techniques as interventional cardiologists and interventional radiologists. They need to educate themselves in the use of hybrid OR systems and the ability to perform all kinds of advanced imaging techniques. Indeed, the hybrid OR involves highly collaborative efforts since it is host to a mix of imaging and OR techniques. For these reasons, every medical professional who is slated to use the hybrid OR should receive some form of specialized user training prior to working in the OR. Unfortunately, some hybrid OR users schedule patients while they are still learning how to navigate their new room – a practice that simply does not work.
Failure to designate dedicated staff – All hybrid ORs should have dedicated staff. Some hospitals share the nursing staff and technologists with other ORs and interventional rooms. Institutions with large staff may see fairly long gaps between “turns” in the hybrid OR. As a result, some staff members may forget how the system operates or fail to recall nuances of the system/room/workflow. Continuity with the staff is necessary so that systems operation and workflow become second nature.
Armed with this insight during the early stages of planning, hospitals can help ensure minimal procedural complications and limited internal trauma as they roll out their hybrid ORs.