The operating room of the future is becoming a thing of the present, thanks to the efforts of one Los Angeles-based medical center.
Cedars-Sinai is partnering with the United States military, looking to propel surgical care forward. It's designed an OR that seeks to allow docs to treat patients more quickly and intelligently, using movable walls and equipment, color-coded instruments that are easier to locate, and an iPhone app that sends surgeons info on patients before the critically ill or injured even arrive at the hospital.
Funded by $3.8 million in grants from the Department of Defense, the "OR 360" project was developed in collaboration with U.S. military personnel. Clinicians from Cedars-Sinai were able to visit military medical centers in both the U.S. and Europe to see how their skilled surgeons respond in high-pressure situations.
Bruce Gewertz, M.D., surgeon in chief and chairman of the hospital's department of surgery, says the lessons learned from recent wars might be a silver lining for the medical field.
"That's always the case if you look at the development of surgery, in particular — wars, as horrible as they are, have helped advance care," Gewertz says. "There are many elements of medical advances that have always been a reflection of experience and the necessity of dealing with war. It's a high price to pay, and there might be better ways to do it, but any way you look at it, it's definitely helped."
For more on surgical suite technology, check out H&HN’s story on hybrid ORs by Geri Aston, one of our contributing writers.
Cedars-Sinai has already adopted several of the advancements, including the color-coded trauma bays, whiteboards that display detailed patient information for the trauma team, and the use of briefings before patients arrive to better prepare clinicians when their work begins. Those advancements have produced results, reducing the time it takes to capture the first radiological images by more than 10 percent, and the time to draw first blood for lab tests by more than 20 percent, according to a press release. Gewertz points out that if a soldier makes it to the first level of care, the likelihood of his or her surviving is greater than 90 percent.
The iPhone app, meanwhile, is still in the simulation phase, and has yet to be tested in a live situation. It allows EMTs to input vital signs into the program, which are then transmitted to the trauma team at the hospital, so clinicians are better prepared when the patient arrives.
"Everybody who's involved gets the information about the patient as it's really happening," he says. "So, even before they come down to the emergency room, they've got an orientation as to what the problems are with the patient and where they stand, in terms of their blood pressure and other vital signs, but also literally where they are. Because sometimes when patients come in, they need X-rays, they need this, they need that. It's sometimes even hard to know where they are in the hospital."
Gewertz says the information would be beamed up to a computer cloud and be HIPAA-compliant, but medical center executives are looking for partners to help put it into use. Up next, Cedars-Sinai is also exploring ways to perfect the handoff of patients from one place to the next. The hospital hopes that the use of adaptable equipment, including moving walls and pivoting equipment, will help to foster more creative thinking in — and smoother transitions from — the OR.