The Los Angeles-based Cedars-Sinai Medical Center has partnered with the U.S. military to design an “operating room of the future” that will enable emergency medical teams to respond more quickly and effectively to patients with life-threatening injuries.
Under the project—called “OR 360,” funded by $3.8 million in grants from the U.S. Department of Defense—research teams have reconfigured the operating room with movable walls and equipment for more flexible use, identified ways to eliminate disruptions during surgery, and developed an iPhone app that provides diagnostic information about blood pressure and other vital signs before patients arrive in the emergency room.
The initiative, drawing on practices from surgery, psychology, aviation and other disciplines, focuses on addressing potential breakdowns in the coordination of trauma care during the so-called “golden hour,” when prompt medical attention can mean the difference between life and death.
Physicians from Cedars-Sinai and military hospitals in the U.S. and Europe, along with researchers from several universities, have analyzed the complex processes of trauma care—from the moment a doctor’s pager is triggered to the time a patient arrives in a trauma bay to the patient's transfer to an intensive care unit.
“Our goal is to improve the efficiency and effectiveness of acute trauma care in both civilian and military settings by introducing innovations in communication, technology, workflows and the way medical personnel perform their jobs,” Bruce Gewertz, M.D., surgeon-in-chief and chair of the department of surgery at Cedars-Sinai, said in a news release. “The quicker we get patients cared for, the better the outcomes.”
The aim of this research has been to find ways to simplify the time-pressured nature of trauma care. Gewertz said that means improving communication and teamwork among medical staff, making better use of technology, and re-engineering the operating room so that bulky equipment pivots effortlessly around surgical teams rather than cluttering workspaces.
To learn how military hospitals avoid these types of disruptions, members of the Cedars-Sinai team visited military surgical teams in the U.S. and Europe to observe their practices and to interview surgeons, nurses and other medical personnel. Team members took away important lessons about standardizing the setup of trauma bays and how to better use technology in the operating room.
Some of the innovations they've introduced as a result of these visits include:
- Creating color-coded trauma bays, allowing staffers to more quickly locate supplies and equipment
- Installing whiteboards in trauma bays that display key patient information such age, gender, pre-hospital vital signs and field treatment, providing important facts as trauma teams respond to fluid situations
- Developing an iPhone app that puts patient diagnostic data at the fingertips of surgeons, nurses, pharmacists, and other trauma team members as they converge on a case from different parts of the medical center.
- Conducting pre-briefings in trauma bays before trauma patients arrive, allowing doctors, nurses and others to understand their roles and to ensure that correct equipment and medications are ready