About 20 years ago, medical designers and planners began developing the idea of an interventional platform—co-locating surgical operating rooms (ORs), hybrid ORs, imaging, procedure rooms, endoscopic rooms and cardiac-cath labs, all into one common, integrated space.
Many hospitals have begun to add elements of the interventional platform to their existing surgical floors. But to create the integrated platform as conceived requires design from the ground up.
“It’s difficult to create this coordinated interventional platform in a renovation,” said George Tingwald, MD, AIA, director of medical planning for Stanford Health Care. “A fresh start is optimal to have the right structural grid to the building. It requires a big enough footprint to put all of the necessary services with their varied functions in the same space.” Tingwald, who helped develop and champion this revolutionary concept, is thrilled to be able to not just conceive of the design, but to see it being built at the new Stanford Hospital.
“If you want to know what this building provides that’s different from any other new hospital, the interventional platform is it,” he said. In designing the new Stanford Hospital, Planning Design + Construction worked with the architect to create a dedicated space to achieve this goal. The largest floor of the hospital was devoted to creating this integrated surgical, procedural and imaging space. Covering three acres across the entire second floor, the interventional platform includes 20 operating rooms (ORs); two hybrid ORs; eight interventional, radiology, image-guidance rooms; three MRIs; three CTs; and one intra-operative MRI.
“The benefits of integration allow Stanford to provide the most innovative care in the most efficient way,” said Sam Wald, MD, MBA, FASA, vice president, inpatient perioperative services and associate chief medical officer, perioperative and interventional services. “Stanford patients gain the most advanced interventional and surgical care with simultaneous state-of-the-art imaging.”
The interventional platform brings together multiple surgical and procedural specialties—cardiologists, gastroenterologists, surgeons, radiologists and pulmonologists—into one common area. The space is further integrated with a centralized Pre-Op and Post-Anesthesia Care Unit (PACU). This flexible and nimble area includes 70 private patient bays and a centralized provider workstation and support area. Each patient bay can transition from a pre-operative space into a recovery area to accommodate patients both before and after procedures with a large, comfortable waiting lounge for families and caregivers.
The ability to image patients during surgery is one of the most anticipated capabilities of the new Stanford Hospital’s hybrid operating suites. These advanced surgical suites are equipped with an intra-operative magnetic resonance imaging machine (iMRI), a sterile operating room itself, immediately adjacent to the neurosurgical and neuro-interventional suites. This allows patients to be co-located with access to an MRI during their neurologic intervention while still under anesthesia. The physicians have access to real-time images during surgery for immediate attention. Multi-stage procedures that were once performed in separate locations and at separate times can now be done within one scheduled procedure time and location. With this new capability, neurosurgeons capture images of the brain during surgery to determine if a tumor has been removed sufficiently before completing the surgery. By using iMRI, the need for patients to have additional procedures is reduced with the most optimal outcomes for Stanford patients, said Wald.