Academy of Architecture for Health

Have you experienced a trend in Cardiac Cath suites adding a hybrid OR to support EVAR and TAVI procedures? 

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Michael Scherbel AIA
Plunkett Raysich Architects LLP
Milwaukee WI
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Yes. There is a great argument for changing the Cath team to an Open Heart OR team if the planned protocol switches mid procedure from Catheter to Open Heart. The Cath labs do not have the required room for the team or the equipment. Moving the Patient to a different Room (if it is available) is not always the best choice. There are a few photos at our website of a Hybrid Room. 
It was a very difficult and timely project to coordinate. Good luck

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Daniel Klute AIA
GMA ARCHITECTS
Eugene OR
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Original Message:
Sent: 08-04-2014 10:39
From: Michael Scherbel
Subject: Hybrid OR

Have you experienced a trend in Cardiac Cath suites adding a hybrid OR to support EVAR and TAVI procedures? 

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Michael Scherbel AIA
Plunkett Raysich Architects LLP
Milwaukee WI
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Yes.  The question is where should it be; within the OR restricted area, supported by OR services, or with the Cath Labs?

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Heather Lewis AIA
Manager, Architectural Services
University of Michigan Hospitals & Health Services
Ann Arbor MI
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Original Message:
Sent: 08-04-2014 10:39
From: Michael Scherbel
Subject: Hybrid OR

Have you experienced a trend in Cardiac Cath suites adding a hybrid OR to support EVAR and TAVI procedures? 

-------------------------------------------
Michael Scherbel AIA
Plunkett Raysich Architects LLP
Milwaukee WI
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I have done several hybrid OR's in both Cath Lab and OR Suites.  Since the Hybrid OR can be used as both a Cath Lab and OR, then the Cath Labs are becoming OR's.  I see the future as OR Suites stay the same while Cath Lab Suites become Cardiac OR Services similar to an OR Suite but supported by Cardiac Staff.  These departments would be adjacent to each other with common support services.

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Michael Clark AIA
Director Of Design
H&H Design-Build
New Albany IN
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Original Message:
Sent: 08-06-2014 08:23
From: Heather Lewis
Subject: Hybrid OR

Yes.  The question is where should it be; within the OR restricted area, supported by OR services, or with the Cath Labs?

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Heather Lewis AIA
Manager, Architectural Services
University of Michigan Hospitals & Health Services
Ann Arbor MI
-------------------------------------------


Original Message:
Sent: 08-04-2014 10:39
From: Michael Scherbel
Subject: Hybrid OR

Have you experienced a trend in Cardiac Cath suites adding a hybrid OR to support EVAR and TAVI procedures? 

-------------------------------------------
Michael Scherbel AIA
Plunkett Raysich Architects LLP
Milwaukee WI
-------------------------------------------

The Cath Lab of today should be within the OR restricted area, supported by OR Services.
The Cath Lab of tomorrow should be within the OR restricted area, supported by OR and Cath Lab services or in their own Cath Lab restricted space that meets the same requirements as an OR Suite.  
In other words, Cath Labs are moving toward being used as OR's with a million dollar piece of equipment in them.
Ask the Cardiologist if cardiology work is done better in two rooms or is it better in just one.

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Michael Clark AIA
Director Of Design
H&H Design-Build
New Albany IN
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Original Message:
Sent: 08-06-2014 08:23
From: Heather Lewis
Subject: Hybrid OR

Yes.  The question is where should it be; within the OR restricted area, supported by OR services, or with the Cath Labs?

-------------------------------------------
Heather Lewis AIA
Manager, Architectural Services
University of Michigan Hospitals & Health Services
Ann Arbor MI
-------------------------------------------


Original Message:
Sent: 08-04-2014 10:39
From: Michael Scherbel
Subject: Hybrid OR

Have you experienced a trend in Cardiac Cath suites adding a hybrid OR to support EVAR and TAVI procedures? 

-------------------------------------------
Michael Scherbel AIA
Plunkett Raysich Architects LLP
Milwaukee WI
-------------------------------------------

Agreed, assuming you mean "semi-restricted" zone. We aren't officially building hybrid ORs, except in a few special locations, but all our Cath Labs (and most IR suites, incidentally) are designed as ORs, at least partly because the State of CA requires us to do so (don't start...).  We go beyond the minimum Cath requirements, however, in terms of area and anesthesia support, and all we'd really need to do to make them "hybrid" is add decent OR lights. And figure out how to make the table work for both PCI and open surgery, and all the other problems that come along with hybrids, etc etc, but we'll build that bridge when we get to the river.

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S. Ross Bogen AIA
Prinicpal Architect/Planner
Kaiser Permanente National Facilities Services
Oakland CA
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Original Message:
Sent: 08-16-2014 16:51
From: Michael Clark
Subject: Hybrid OR

The Cath Lab of today should be within the OR restricted area, supported by OR Services.
The Cath Lab of tomorrow should be within the OR restricted area, supported by OR and Cath Lab services or in their own Cath Lab restricted space that meets the same requirements as an OR Suite.  
In other words, Cath Labs are moving toward being used as OR's with a million dollar piece of equipment in them.
Ask the Cardiologist if cardiology work is done better in two rooms or is it better in just one.

-------------------------------------------
Michael Clark AIA
Director Of Design
H&H Design-Build
New Albany IN
-------------------------------------------


Original Message:
Sent: 08-06-2014 08:23
From: Heather Lewis
Subject: Hybrid OR

Yes.  The question is where should it be; within the OR restricted area, supported by OR services, or with the Cath Labs?

-------------------------------------------
Heather Lewis AIA
Manager, Architectural Services
University of Michigan Hospitals & Health Services
Ann Arbor MI
-------------------------------------------


Original Message:
Sent: 08-04-2014 10:39
From: Michael Scherbel
Subject: Hybrid OR

Have you experienced a trend in Cardiac Cath suites adding a hybrid OR to support EVAR and TAVI procedures? 

-------------------------------------------
Michael Scherbel AIA
Plunkett Raysich Architects LLP
Milwaukee WI
-------------------------------------------

I see it as more. A Hybrid OR needs about 800 square feet, room for a Pump, a pump maintenance room, access to the sterile core, an enclosed control room with leaded window that has entry from the Hybrid Room and the corridor and maybe is outside the sterile area to allow consultation without scrubbing. Room a team of up to 11? Also, there are tables that pivot 90 degrees and help with the transition to open surgery. 

 
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Daniel Klute AIA
AIA
GMA ARCHITECTS
Eugene OR
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Original Message:
Sent: 08-18-2014 19:43
From: S. Ross Bogen
Subject: Hybrid OR

Agreed, assuming you mean "semi-restricted" zone. We aren't officially building hybrid ORs, except in a few special locations, but all our Cath Labs (and most IR suites, incidentally) are designed as ORs, at least partly because the State of CA requires us to do so (don't start...).  We go beyond the minimum Cath requirements, however, in terms of area and anesthesia support, and all we'd really need to do to make them "hybrid" is add decent OR lights. And figure out how to make the table work for both PCI and open surgery, and all the other problems that come along with hybrids, etc etc, but we'll build that bridge when we get to the river.

-------------------------------------------
S. Ross Bogen AIA
Prinicpal Architect/Planner
Kaiser Permanente National Facilities Services
Oakland CA
-------------------------------------------


Original Message:
Sent: 08-16-2014 16:51
From: Michael Clark
Subject: Hybrid OR

The Cath Lab of today should be within the OR restricted area, supported by OR Services.
The Cath Lab of tomorrow should be within the OR restricted area, supported by OR and Cath Lab services or in their own Cath Lab restricted space that meets the same requirements as an OR Suite.  
In other words, Cath Labs are moving toward being used as OR's with a million dollar piece of equipment in them.
Ask the Cardiologist if cardiology work is done better in two rooms or is it better in just one.

-------------------------------------------
Michael Clark AIA
Director Of Design
H&H Design-Build
New Albany IN
-------------------------------------------


Original Message:
Sent: 08-06-2014 08:23
From: Heather Lewis
Subject: Hybrid OR

Yes.  The question is where should it be; within the OR restricted area, supported by OR services, or with the Cath Labs?

-------------------------------------------
Heather Lewis AIA
Manager, Architectural Services
University of Michigan Hospitals & Health Services
Ann Arbor MI
-------------------------------------------


Original Message:
Sent: 08-04-2014 10:39
From: Michael Scherbel
Subject: Hybrid OR

Have you experienced a trend in Cardiac Cath suites adding a hybrid OR to support EVAR and TAVI procedures? 

-------------------------------------------
Michael Scherbel AIA
Plunkett Raysich Architects LLP
Milwaukee WI
-------------------------------------------

We've created a hybrid OR by adding a c-arm to a larger OR in our surgical suite.  Our surgical suite is more stringently controlled from an infection prevention viewpoint than our Heart and Vascular Interventional Services (HVIS) suite. (HVIS corridors are semi-restricted; OR corridors are fully restricted.)  The two services are in close proximity, so staff does not have to travel far between them.

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Linda Sigman AIA
Project Manager
Christiana Care Design & Construction
Newark DE
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Original Message:
Sent: 08-04-2014 10:39
From: Michael Scherbel
Subject: Hybrid OR

Have you experienced a trend in Cardiac Cath suites adding a hybrid OR to support EVAR and TAVI procedures? 

-------------------------------------------
Michael Scherbel AIA
Plunkett Raysich Architects LLP
Milwaukee WI
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Yes, big trend.  Over 30 requests in past year. 

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Donald Myers AIA
Director, Facilities Standards Service
US Department of Veterans Affairs
Henrico VA
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Original Message:
Sent: 08-04-2014 10:39
From: Michael Scherbel
Subject: Hybrid OR

Have you experienced a trend in Cardiac Cath suites adding a hybrid OR to support EVAR and TAVI procedures? 

-------------------------------------------
Michael Scherbel AIA
Plunkett Raysich Architects LLP
Milwaukee WI
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