Planning, designing for the convergence of imaging and surgery

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CHICAGO, Nov. 29—No matter what the technology is, where it is engaged, or how it impacts our work, there is a fundamental relationship with radiology planning and design, according to Morris A. Stein, FAIA, FACHA, who spoke on “The Art and Science of Radiology Planning and Design” at the 93rd annual meeting of the Radiological Society of North America (RSNA). 
“It is not just about designing products or buildings, but designing experiences,” said Stein, senior vice president of HKS Architects. “Not only are the physical lines blurring in radiology design, but so are the lines between technology and environment,” he said.

Stein said it is important to understand the relationship due to the explosion in new technology. “Not all the technology is the same,” he said. One manufacturer might have 21 different MRI systems and 16 new CT systems, making designing more of a challenge.

Incorporating the technology into the environment is important, he said, because of increased patient expectations. “The patient expects things to be better—what he or she wants is a five-star hospital with five-star service.” With increased patient expectations, it is important to have transparent planning so the issues that impact the product design and experience design are not missed, he said, and patient satisfaction and expectations can be met.

Stein said that in product design, certain elements must be examined and certain questions must be asked, for example, can environmental quality directly impact image quality? “I am convinced it can,” he said, with improved communications, site customization, and an inviting space can “invoke the body’s own healing capabilities.”

Stein said administrators and designers also must consider the following in radiology planning and design: Is there a positive financial return or performance return from a design investment? How do you use design to improve patient, family and staff satisfaction? Can architecture create work process improvements that equal the achievements in technology?

Bill Rostenberg, FAIA, FACHA, principal, Anshen & Allen, said that with these new technology environments, there are “new directions and patterns for imaging outside the traditional imaging department—particularly in designing for the convergence of imaging and surgery.”

Surgical and interventional radiology procedures have changed dramatically in recent decades and in many ways are converging, Rostenberg said. Yet, “why do the designs of surgical suites and interventional suites remain so different?”

The future of radiology planning and design is the integrated interventional suite, he said, that can adapt to the changing culture and needs of its environment. There is a need to plan and design for MRI in the OR—in one integrated room. Rostenberg said his clients, in the future, want to have the ability to do intraoperative MRI but in designing a suite for that, a whole new set of safety issues arise. The room has to be designed for MRI safety, protect against magnetic interactions with adjacent occupants and it must have increased structural, air and cooling capabilities. Rostenberg said the potential benefits to an integrated interventional suite include the ability to accommodate future clinical/operational practice models; multi-disciplinary collaboration; improved infection control for interventional procedures; and long term flexibility/adaptability.

Steven Horii, MD, FACRF, FSCAR, clinical director of Medical Informatics Group at the Hospital of University of Pennsylvania, said it is important to consider how changes in practice, expectations and workflow relate to facility design. “How you design a space or suite directly impacts the interaction between people, tasks, location, equipment and information needed to carry out a complete process,” he said. “It is important to remember that in the realm of fast imaging, slowing people down can be detrimental to productivity and patient satisfaction.”