Surgical Performance and the Working Environment

This chapter explores some of the interactions between the surgical working environment, human performance, infection control, and other surgical outcomes. It considers the properties necessary for a room that can appropriately support surgery, from different functions that need to be served, through design considerations and necessary trade-offs, to ventilation, lighting, and acoustics. Optimal OR size varies with procedures and technologies used, and has generally increased in size over time. It needs to be able to contain a range of devices and storage; support a range of visual tasks; allow easy entry, exit, and movement within the room; be easily cleanable; and allow flexibility for a range of procedures. The value of ancillary space – such as induction rooms – and the location of post-care units in relation to the OR are considered. A variety of studies that have explored different aspects of the OR environment – such as ventilation, door openings, acoustics, and humidity – are used to illustrate the interactions between work environment and performance. Finally, a number of methods are described that can be deployed to explore these effects.