Healthcare Design - February 2019 - 41

When these types of rooms were first introduced, they averaged 700-800
square feet, says Zambo, whose firm works with Cleveland Clinic. But over
the years, they've increased to nearly 1,200 square feet at some facilities, he
says. The jump in size helps designers balance sterile space requirements
while accommodating an ever-growing lineup of technology and equipment such as monitors, lead shielding for imaging equipment, light and
medical gas booms, and a C-arm medical imaging device that can rotate
around the procedure or operating table. Facilities also must make room
for the control room itself, where staff operate equipment and capture and
record images, as well as space for clinicians on standby in case emergency
surgery becomes necessary.
These larger, tech-laden rooms require significant structural reinforcement in the ceiling and floor to support the equipment as well as be flexible
enough for future changes. For an endovascular hybrid room retrofit, Zambo says designers installed a 40-inch diameter mounting plate to support
the weight of the floor-mounted equipment, which was equivalent to the
weight of an SUV. "It's not easy," Zambo says. "We try to build in the flexibility to handle the weight of the equipment while making it easier for [the
client] to retrofit the room in five or seven years when the equipment may
change."
Looking ahead, he says some facilities are also looking to bring in more
robotics while others are testing the idea of a simulation component in the
hybrid suite, allowing a surgeon to review images and do a simulated procedure prior to the actual surgery to become familiar with a patient's anatomy.
FORECASTING FUTURE CARE

HED (WVU); TODD WILLIAMS, SHOOTING STAR PHOTOGRAPHY (BOSTWICK)

While healthcare providers have one eye focused on what new procedures and technologies they can bring in-house today, they've got another focused on how to extend services into communities. For example,
Garon says WVU has been creating a spoke-and-wheel model, aligning
with strategic partners at satellite hospitals and clinics throughout West
Virginia to provide consultations, office visits, and follow-up visits while
sending surgeries and complex issues to the medical center. "We understand that not everyone can come here, so if we need to go out to them

A B OV E : Designed

by Bostwick Design
Partnership, this minimal
hybrid room, which is for
less complex procedures,
has fewer OR lights
and monitors than a
traditional hybrid room.
B E L OW: The interventional
center at WVU Heart and
Vascular Institute houses
hybrid rooms where
surgery, catheterization,
electrophysiology, and
advanced procedures can
be performed.

through telemedicine or opening clinics, we've
done that," Garon says.
There's also a push to move more cardiac
care into the outpatient environment-an effort that's currently hampered by licensing
requirements in some states requiring certain
diagnostic and interventional procedures to
be performed in the inpatient environment.
The biggest opportunity exists for heart catheterization, a procedure that's done for diagnostic and interventional purposes. "Once we
get cath outside the hospital, allowing this to
be a convenient, outpatient-focused, interventional discipline, it will redefine the cardiac center of excellence," says Kevin McCausland, senior programmer and medical planner
at CO Architects (Los Angeles). "It will be
smaller, and it will be in the community."
Many designers also expect technological
advancements, such as artificial intelligence and
smartwatch-based monitors, to impact future
cardiac treatment, allowing for more realtime symptom management that helps avoid
escalation to what were traditionally emergency
situations, says Tom Chessum, principal at CO
Architects.
Garon also anticipates continued growth and
research in noninvasive care and technology.
"If we can take care of someone without having
to open their chest or make a huge incision in
their leg, that's better for the patient, it's better
for the organization in terms of length of stay,
and the patient and family can go home sooner," she says. 
Anne DiNardo is executive editor of Healthcare
Design. She can be reached at A N N E . D I N A R D O @
EMERALDEXPO.COM.
MORE ONLINE: Learn how the project team
for West Virginia University Health System's
Heart and Vascular Institute transformed a planned
bed tower into a cardiac center in 15 months. Visit
HCDmagazine.com/cardiac-wvu to read the article.

FEBRUARY 2019

http://www.HCDmagazine.com/cardiac-wvu

Healthcare Design - February 2019

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