DOH Health Facility Guidelines 2019

Part B – Health Facility Briefing & Design

350 Operating Unit
Part B: Health Facility Briefing & Design
Operating Unit

Executive Summary
The Functional Planning Unit (FPU) covers the requirements of a Operating Unit. An Operating Unit is
where surgeries are performed; and admission, preparation and procedure occur before patients are
moved to an inaptient unit for longer than a 24 hour period. The Unit will have access to or include one
or more Operating Rooms (or Procedure Rooms), with provision to deliver anaesthesia and
accommodation for the immediate post-operative recovery of patients.
The Operating Unit FPU describes operational, functional and design requirements for a range of
ambulatory surgical services to be accommodated in hospitals or stand-alone facilities.
The Functional Zones and Functional Relationship Diagrams indicate the ideal external relationships with
other key departments and hospital services. For an Operating Unit located within a hospital campus, a
relationship with Emergency Unit, Inpatient Units, Intensive Care Units and Sterile Supply Unit (SSU)
should be considered.
Design Considerations address a range of important issues including Accessibility, Acoustics, Safety and
Security, Building Services Requirements and Infection Control. This FPU describes the minimum
requirements for support spaces of a typical Operating Unit at Role Delineation Levels 3 to 6. The typical
Schedule of Accommodation is provided using Standard Components (typical room templates) and
quantities for quantities for these numbers.
Further reading material is suggested at the end of this FPU but none are mandatory.
Users who wish to propose minor deviations from these guidelines should use the Non-Compliance
Report (Appendix 4 in Part A) to briefly describe and record their reasoning based on models of care and
unique circumstances.
The details of this FPU follow overleaf.

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Table of Contents
Executive Summary ...................................................................................................................... 2
Table of Contents ......................................................................................................................... 3
350. Operating Unit ................................................................................................................. 5

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1. Operating Unit
1.1 Introduction
The Operating Unit provides a safe and controlled environment for the operative care of patients
undergoing diagnostic/ surgical procedures under anaesthesia and peri-operative care including post
procedure recovery.
1.1.1 Description
The Operating Unit may provide facilities for two modes of surgery, Inpatient Surgery or Day Surgery
or both according to the chosen model of care. These different modes are sometimes referred to as
Overnight Surgery vs Outpatient Surgery or Major Surgery vs Minor Surgery (which is not entirely an
accurate description). Day Surgery is also referred to as Same-day Surgery.
The difference between Overnight Surgery and Day Surgery is in the pre-operative and post-operative
patient flows as well as the facilities required. However, the operating rooms and most of the
supporting rooms can be common. This guideline defines the key zones and rooms such as Pre-op
holding, Operating Theatres, Post-op recovery, Sterile Stock Staff Change and Supporting rooms.
Operating rooms used mostly for minor surgery are also referred to as “Procedure Rooms”. However,
this is an imprecise description and has been avoided in these guidelines.
The most common models of operation which are possible within the same physical facility have
been described.
The Functional Relationship Diagrams for 2 common models of planning, Single Corridor and Double
Corridor have been provided, along with all internal and external flows.
Separate diagrams are provided to show many permutations of the arrangement of key rooms such
as Operating Room, Scrub Room, Sterile Stock room and Optional Anaesthetic Induction Room. These
permutations also indicate a fundamental aspect of Infection Control in Operating Units being the air
pressurisation regimes.
Generic Schedules of Accommodation (SOA) have been provided for all Role Delineation Levels from
3 to 6, separated by the functional zones.
It should be noted that an integrated Operating Unit may also incorporate other components such
as Endoscopy and Catheter Laboratory. A strict physical separation is not necessary as long as the air
pressurisation regimes and all the supporting rooms are achieved in the design. May facilities such
as Change rooms, Holding bays and Recovery bays may be regarded as generic patient management
facility and shared for all types of patients undergoing any type of invasive or minimally invasive
procedure.
It should be noted that these guidelines include the contemporary, acceptable and efficient planning
model. Older models of planning for Surgery which are still in use today but are regarded as in-
efficient or un-necessary have been omitted to avoid confusion.

1.2 Functional & Planning Considerations

1.2.1 Hours of Operation
The Operating Unit will typically operate on a long day basis, with emergency surgery available 24
hours per day. Even Day Surgery may be performed late into the night as long as overnight recovery
facilities and nursing service are available as part of the hospital. For the specific requirements of 23

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hour surgery model, pleaes refer to the Models of Care below. Also refer to the Day Surgery/
Procedure Unit FPU.
1.2.2 Operational Models
There are 4 basic models of surgery:
• Inpatient Surgery
• Day Surgery (Outpatient or Ambulatory Care Surgery) which may include
- Catheter Lab procedures
- Endoscopy procedures
• Same-day Surgery
• 24 Hour surgery
All of these models should ideally be operated from the same Integrated Operating Unit in the
interest of efficiency, safety and economy. These models require the following basic facilities and
services: Reception, Pre-operative facilities, Operating Room (or Procedure Room), Recovery Stage
1, Recovery Stage 2, Inpatient Unit (IPU) and Intensive Care Unit (ICU).
The difference between the models is the flow of patients from one unit to the next. The models may
utilize some facilities and by-pass other facilities.
Inpatient Surgery (Overnight Surgery)
Patients undergoing Elective or Emergency surgery are first admitted to an IPU, ICU or are transferred
from the Emergency Unit. After surgery, patients return to the IPU or ICU, but not Emergency Unit.
Inpatient Surgery may start early (e.g. 7 am) and continue into the late hours of the evening. Longer
hours of operation are highly efficient as they increase the throughput for the same physical facility
investment. A 30% increase in the hours of operation is almost exactly the same as having 30% more
operating rooms with every other support facility.

Overnight stay in Inpatient Unit, 1 to 4 days

Figure 1 Inpatient Surgery Model patient flow chart

Day Surgery (Outpatient Surgery)

Up to 70% of all surgery may be performed as Day Surgery. Every surgical case performed as Day
Surgery will save between 1 and 3 bed-days as no IPU bed will be occupied by the patient. This will
save costs whilst preserving valuable IPU beds for major inpatient surgery.
Day Surgery patients should be organised to arrive very early (e.g. 6 am) with the aim of starting
surgery as soon as possible (e.g. at 7 am). Day Surgery patients will recover in the unit and go home
before the evening. This means sufficient time should be set aside for the last patient’s recovery. The
last surgery may be around 4 pm or earlier. For some very minor procedures, the patient may not

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undergo general anaesthesia or may wake up immediately after surgery. These patients do not need
to go through Stage 1 Recovery and they can go directly to Stage 2 Recovery.
Catheter Lab
The patient flow will be similar to Day Surgery. There is no need to separate Catheter Labs as a unit,
however, the Catheter Lab should be located close to Stage 1 Recovery bays in order to share
facilities.
Endoscopy
Endoscopy procedures may follow the same patient flows as Day Surgery. It is anticipated that over
time many types of surgery will require a form of endoscopy. Therefore, surgical facilities need to
regard every operating room as an endoscopy theatre. With careful design it is not necessary to
perform endoscopy in a separate unit. As long as the endoscopy rooms are discretely located at one
end of the surgical unit, there should be no need to duplicate other facilities.

No overnight stay within Unit

Figure 2: Day Surgery patient flow chart

Same-day Surgery (or Day of Surgery Admissions- DOSA)

This is also known as a Peri-operative model and is similar to Day Surgery. However, there is no
expectation for the patient to recover and go home the same day. This model allows the patient to
be admitted to the hospital on the ‘day of surgery’, not earlier. The patient goes through the same
process as Day Surgery patients. However, the patient may undergo more complex surgery, then
recover in an Inpatient Unit between 1 and 4 days. Therefore, unlike Day Surgery, Same-day Surgery
can continue into the late hours of the night (e.g. 10 pm). After Stage 1 Recovery, Same-day Surgery
(DOSA) patients are formally admitted to an IPU bed, not before. This will save one bed-day for each
DOSA patient, which will save costs for the health system. It also preserves one bed-day for inpatient
surgery or medical use.

1 to 4 days overnight stay in Inpatient Unit

Figure 3: Same-day Surgery/ DOSA patient flow chart

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23 Hour Surgery
Under all of the above models, the Stage 2 Recovery facilities will be unused overnight. This is seen
as a waste of resources and valuable investment, resulting in the introduction of 23 Hour Surgery.
This model is similar to Day Surgery, but there is no limit on how late the surgery can take place. A
patient may be admitted in late afternoon and undergo surgery as late as 10 pm. Then the patient
will recover overnight in the Recovery Stage 1 facilities and be discharged the next morning before
the new patients require this facility. Discharge can occur by around 7 am the following morning.
Therefore, the only different between 23 Hour Surgery and Day Surgery is the addition of overnight
nursing and suitable facilities for the patients’ overnight stay (eg toilets, showers and reasonable
privacy). Under this model, the patient admission and discharge should occur in a period of no more
than 24 hours regardless of the starting and finishing time. Under the 23 hour surgery model, patients
may not be kept for more than 24 hours unless the facility is attached to a Hospital. Even so, the
patient must be transferred to a bedroom within an Inpatient Unit.

Possible overnight stay within the Unit

Figure 4: 23 Hour Surgery patient flow chart

1.3 Unit Planning Models

The Operating Unit shall be located and arranged to prevent non-related traffic through the suite.
The number of Operating Rooms and Recovery beds and the sizes of the service areas shall be based
on the service plan and expected surgical workload. The size, location, and configuration of the
surgical suite and support service departments shall reflect the projected case load and service plan
of the Unit.
A number of planning models may be adopted including:
1.3.1 Single Corridor
The single corridor model involves travel of all supplies (clean and used) as well as patients (pre and
post-operative) in one main corridor. There is ongoing debate as to the suitability of this approach.
However, this option is considered suitable provided:
• The main corridor is sufficiently wide in order to permit separation of passage of goods and
services
• Handling of clean supplies and waste is carefully managed to avoid cross contamination
A major disadvantage of this planning model is that a patient awaiting surgery may be exposed to
post-operative patients.
1.3.2 Dual Corridor or Race Track
The Dual Corridor or ‘Race Track’ model allows for all the Operating rooms to be accessed from an
external corridor for patients and directly from a central Set Up/Sterile Stock Room for sterile goods.
This model aims to separate ‘dirty' from 'clean’ traffic by controlling the uses of each corridor. In this
design, there must not be cross traffic of staff and supplies from the decontaminated/ soiled areas
to the sterile/ clean areas.
In this model, stock and staff can be concentrated in one location, preventing duplication of
equipment stock and staff.

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1.3.3 Clusters of Operating Rooms

In this model Operating Rooms may be clustered according to specialty, with a shared Sterile Stock
and Set-up Room for each group or cluster.
Disadvantages of this model include:
• Additional corridor and circulation space required for corridors around clusters of rooms,
which reduces the available space for stock
• Potential duplication of stock and additional staff requirements may result in increased
operating costs
1.3.4 Dedicated Theatres with Fixed or Mobile Equipment
In this model Operating rooms are dedicated to specific types of surgery such as hybrid operating/
imaging rooms, urology, vascular, neurology or other specialties requiring specific equipment. This
may be beneficial in larger suites where the case volume justifies specialisation; however, smaller
suites may favour flexibility of Operating Room use. Fixed equipment can preclude the
multifunctional use of the room.
1.3.5 Sterile Supply Unit (SSU)
The Operating Unit is a major user of sterile stock and the location of the instrument processing area
and sterile stock is of high importance.
There are two main options available for supply of sterile stock to the Operating Unit:
• A dedicated SSU (Theatre Sterile Supply Unit or TSSU) serving only the Operating Unit
• A SSU (Sterile Supply Unit) that also serves other areas of the hospital.
The SSU may be located within the Operating Suite or externally. It is preferable to locate the SSU
adjacent with direct access to the Operating Suite. The SSU may also be located on another floor of
the building connected by dedicated clean and used goods lifts.
The SSU may be located in a service zone of the hospital. There is a strong functional link between
the SSU and the Operating Unit; efficient transport of stock to and from each unit will require careful
planning.
1.3.6 Functional Zones
The Operating Unit consists of the following functional zones:
• Admissions/ Reception and Holding area for receiving and admission of patients to the Unit,
with general overseeing of day to day operations, control of entry and exit from the Unit and
completion of general administrative tasks including:
- Reception and Waiting areas
- Interview room
- Staff Station and write up bay
- Bays for handwashing, linen
- Clean and dirty utilities
- Holding bays for holding and management of patients prior to their operation or
procedure
- Sealed carts are mandatory
• Operating Rooms area where procedures are carried out including:
- Operating Rooms, general, digital, specialty, hybrid imaging, catheter lab and endoscopy
- Anaesthetic Induction Rooms (optional)
- Scrub Bays

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- Exit Bays
• Support Areas including:
- Bays for linen, pathology equipment, mobile equipment
- Blood store
- Cleaners room/s
- Clean-up rooms
- Flash steriliser
- Storerooms and storage areas for:
▪ Anaesthetic supplies
▪ Drugs
▪ Equipment, including mobile items, table accessories, loan equipment
▪ Perfusion equipment and supplies (if cardiac surgery is undertaken)
▪ Sterile stock, non-sterile stock and consumables
• Recovery Areas where patients are assisted through the process of recovering from the
effects of anaesthetic including:
- Separate recovery areas for male and female patients
- Patient bed bays, open and enclosed for Isolation
- Bays for blanket warmer, linen, handwashing
- Clean and Dirty Utilities
- Store for consumable items and equipment
• Administrative and Staff Areas including:
- Change Rooms with showers, toilets and lockers and additional separate toilets for large
units; separate for male and female staff
- Staff Room
- Meeting rooms
- Offices and administrative space for clinical staff
1.3.7 Key Unit Areas and Functions
Some of the above zones and components are described and critical guidance is provided below:
Reception
The Reception is the receiving hub of the unit for patients and visitors entering the Operating Unit.
Patients undergoing Inpatient Surgery arrive from the IPU, ICU or Emergency Unit on beds. “Day
Surgery” or “Day of Surgery” patients arrive from the Peri-operative unit on foot or on a wheelchair.
The Reception should serve as the control check point and should therefore ensure the security of
the entire Unit through access control. Generally, the reception points for Inpatient arriving on a bed
from Inpatient Units, ICU or Emergency will be separate from the Reception for Day Surgery or Day
of Surgery patients.
Pre-operative (Pre-op) Holding
Incoming patients under the “Day Surgery” or “Day of Surgery” operational models are first received
in a reception area. Then they are directed to a curtained holding bed bay (or cubicle), preferably
with solid side walls and curtain front. The recommended number of bays/ cubicles is a ratio of 1:1
for each operating room (or procedure room). If necessary, a patient relative or carer may accompany
the patient and give assistance.
There is no need for separate change rooms as the Pre-op cubicle is regarded as the equivalent of a
temporary inpatient bedroom. The bed bay/ cubicle has facilities such as a bedside locker and

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medical gases. Patient toilets should be located nearby. Patients are generally transferred from this
point on beds/trolleys and the same bed may go to surgery without patient transfer.
Operating Room/s (or Procedure Room)
The Operating or Procedure rooms are designed and set up to perform any type of procedure on the
patient. The procedures may be highly invasive, minimally invasive, sterile or non-sterile and the
design may vary slightly according to the intended procedures. It is recommended that designers
minimise the degree of specialisation as far as practical. A very high level of specialisation can lead to
inefficiency in surgical throughput due to the number of useable operating rooms. Under this
definition, a Procedure room includes a Catheter Lab, Endoscopy Procedure Room etc.
If obstetric services are provided in the hospital an additional dedicated Operating Room is
recommended for obstetrical emergencies. The Operating Room used for obstetric emergencies such
as C section may be within the main Operating Unit or as a fully functional satellite within the Delivery
Unit.
Operating and Procedures Rooms shall comply with Standard Components Room Data Sheets and
Room Layout Sheets, in these Guidelines.
Dental Surgery additional requirements
In addition to the standard operating room equipment and services (refer to Standard Component
Operating Rooms), items considered essential for dental procedures may be provided to enable
Dental Surgery. These may include compressed dental air, medical gases and dental x-ray facilities.
Refer to Standard Components for these provisions.
Scrub Bays
Scrub facilities shall be located adjacent to the Operating Rooms. Scrub Bays require sufficient
enclosure to ensure the mechanical ventilation system can extract the air and create a relative
negative pressure. This is to contain the floating droplets of water and minimise the spread of
contaminants potentially floating in the air and within the droplets.
Privacy can be provided to female staff through the use of doors off the corridor or a similar privacy
feature.
Scrub bays do not require a door to the corridor, however there must be a door access to the
operating room. For clarity, scrub bays created directly inside the operating rooms are not permitted.
Also, open scrub troughs along the main Operating Unit corridors are not considered desirable.
The door from the scrub bay to the operating room may be dedicated and direct. Alternatively,
surgeons and nurses can use the main doors to the operating room as long as electric doors are
provided with knee, elbow, gesture or similar activation pads.
Direct doors from scrub rooms to the operating rooms should ideally be light doors, opening both
ways by light pressure. This allows the surgeons and nurses to enter the operating rooms backwards
without touching the door or door handle.
Optionally, a window may be provided between the scrub bay and the operating room. This allows
the surgeons to observe the way the room is being set up for the next case.
Laboratory Areas
Depending on the service plan and unit policy, an area for preparation and examination of frozen
sections may be provided. This may be part of the general Pathology Laboratory if immediate results
are obtainable without unnecessary delay in the completion of surgery.
Flash Sterilising Facilities

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A Flash Steriliser should be located in the unit. However, the use of this method of sterilising should
be restricted to situations where a single instrument has been dropped and there is no sterile
duplicate available. Flash sterilising is not suitable for processing of cannulated, complex instruments,
suction and other tubing, textiles, paper or liquids. The number of Flash Sterilisers should be limited
to 1 or very few, to prevent in-appropriate operational practice.
Storage
Adequate Equipment Store room/s for equipment and supplies used in the Operating Unit shall be
provided. Equipment Stores should be provided at the minimum rate of 10 m2 per Operating Room.
Note:
• Store Rooms do not necessarily require doors
• Store Rooms are best designed in an elongated rectangular shape to allow easy access to all
items
• The design of the Operating Unit should allow for ease of access to the storage areas for
delivery of Operating Unit consumables. Controlled access from an external corridor is highly
desirable
• Store Rooms in the Operating Unit require positive pressure in relation to adjacent areas and
high efficiency filtration. Refer to Part E - Engineering Services for technical air-conditioning
requirements
Mobile Equipment Bays shall be provided for equipment such as portable X-ray equipment,
stretchers, trolleys, warming devices and mobile equipment. Mobile Equipment Bays shall comply
with Standard Components and provided at the minimum quantity of one per operating room.
Equipment Bays are best designed as elongated rectangular shapes and may be combined for space
efficiency.
Recovery Areas
Recovery areas shall be separated into male and female zones with sufficient privacy screening.
There are two types of Recovery space, which are used in according to the operational models
explained earlier in these guidelines.
Recovery Stage 1- After operations which require general anaesthesia, patient is taken to Recovery
Stage 1 and kept there until the effect of anaesthesia dissipates, patient is conscious and gag reflex
is present. During stage 1 recovery close monitoring of the patient is essential.
Following Recover Stage 1, patients who have undergone complex surgery which requires longer
term recovery are taken to an inpatient bed room or ICU. This applies to “Inpatient Surgery” and “Day
of Surgery” operational models. However, Patients who undergo “Day Surgery” and are discharged
the same day are moved to Stage 2 Recovery, vacating the bed bays for new patients. Patients who
stay overnight under the “23-hour surgery” model, stay in Stage 1 Recovery, unless Stage 2 Recovery
is also equipped with beds and sufficient privacy similar to Stage 1 Recovery.
If ICU is immediately adjacent the Operating Unit, it is possible to transfer some patients directly to
ICU. However not all surgical patients require transfer to ICU. This depends on the operation
performed and the opinion of the responsible clinicians.
The number of bed/trolley spaces in the Stage 1 Recovery Area will be dependent upon the nature
of surgery or procedures performed as outlined in the Operational Policy and the proposed
throughput. As a minimum, 2 bed/trolley spaces per Operating Room shall be provided.
The Stage 1 Recovery area will require the following support facilities:
• Staff station/s with a centrally located resuscitation trolley

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• Bays for linen and mobile equipment

• Clean Utility
• Dirty Utility
• Store room
• Patient toilets and showers, if used for overnight stay under “24-hour surgery” model
Recovery Stage 2- Patients undergoing Day Surgery require a Stage 2 Recovery area. Patients who
undergo general anaesthetic must first spend some time in Recovery Stage 1 as explained above.
Then they move to Recovery Stage 2 on foot or wheel chair. Stage 2 recovery requires, as a minimum,
a number of comfortable recliners. However, a percentage of bed bays may also be incorporated for
patients who may feel uncomfortable on recliners.
Patients who undergo local anaesthesia or are already awake upon leaving the operating room may
be taken directly to Recovery Stage 2, by-passing Recovery Stage 1.
The number of recliner/bed bays in the Stage 2 Recovery Area will be dependent upon the following:
• Nature of surgery or procedures typically performed as outlined in the Operational Policy
• The expected throughput based on the surgery time + change-over
• The expected recovery times
For fast throughput operations, more Stage 2 recovery bays are required. All of the above factors
may change on a daily basis and over time. Therefore, for Operating Units which perform a mix of
Inpatient and Outpatient Surgery, on balance it is considered that as a minimum 2 (but ideally 3)
Stage 2 recovery bays per Operating Room shall be provided. Within Recovery Stage 2 patients may
remain in surgical gowns or change back to street clothes. Whilst in Recovery Stage 2 patients may
want to drink or eat, therefore access to facilities for serving drinks and light meals such as
sandwiches should be provided.
Following Recovery Stage 2, patients may be discharged via the reception/ waiting area. Optionally a
dedicated Discharge Lounge (also referred to as Departure Lounge or Recovery Stage 3) may be
provided for a formal hand-over of the patient to family members or carers.
Depend on the operational model, Recovery Stage 2 may be combined back to back with the Pre-
operative areas, but management should ensure in-coming and out-going patients are not mixed or
confused.
In facilities which mainly cater for Day Surgery, Recovery Stage 2 may be placed back to back with
Recovery Stage 1.
All Recovery bed bays, recliner bays and support areas shall comply with the details identified in
Standard Components Room Data Sheets and Room Layout Sheets.
Administrative Areas
General and individual offices shall be provided as required for unit administration, record holding
and management, clerical and professional staff. These shall be separate from public and patient
areas with provision for confidentiality of records.
Office spaces shall be provided for the Unit Manager, or Nurse Manager, medical and administrative
staff as required.
Offices are to comply with Standard Components.
Staff Areas
Appropriate Change Rooms, toilet and showers shall be provided separately for male and female
personnel (nurse, doctors and technicians) working within the Operating Unit. The Change Rooms

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shall contain adequate lockers, showers, toilets, hand basins and space for donning surgical attire
and booting. Staff Change Rooms shall be arranged to encourage a one-way traffic pattern so that
personnel entering from outside the surgical suite can change and move directly into the Operating
Unit.
Alternatively, the entrance to the Change Rooms may be planned in direct view of a Staff Station at
the entrance to the Operating Unit. The Change Room entrance door shall be provided with locks or
electronic access devices to prevent the entry of unauthorised persons into the Operating Unit.
Notes:
• It is desirable but not mandatory to increase the number and area of facilities for female
change rooms by approximately 30%
• In male change rooms 50% of toilets may be replaced with urinals
• Warm air hand dryers shall be avoided
• Staff showers are mandatory in Operating Units
1.4 Functional Relationships
A Functional Relationship can be defined as the correlation between various areas of activity whose
services work together closely to promote the safe delivery of services that are efficient in terms of
management, cost and human resources.
1.4.1 External Relationships
The Operating Unit requires close relationships with the following areas, particularly for urgent cases:
• Emergency Unit
• Intensive Care Units
• Obstetric/ Birthing Unit for Caesarean Section procedures (unless dedicated facilities are
provided)
• Helipad
• Inpatient Units
Links between these Units and the Operating Unit should be rapid, direct (as far as possible) and
discreet; transit of severely ill patients to and from the Unit through public corridors should be
avoided.
The Operating Unit has a direct operational link with the following Units:
• Peri-operative Unit/ Day Surgery (in an integrated unit)
• SSU
1.4.2 Internal Relationships
Internally, the Operating Unit will be arranged in the functional zones described above. Due to the
complexity of this unit and different models of care which may be implemented at the same time,
the Internal Relationships are best demonstrated by a series of Functional Relationship Diagrams and
their permutations provided below.
1.4.3 Functional Relationship Diagrams
The requirements for the models of care, infection control and patient management result in a
number of planning 'models' that have proved successful through numerous built examples and
many years of practice. Most contemporary Operating Unit plans are a variation of one of these
'models'.

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A plan substantially based on one of these diagrams is 'deemed to satisfy' the requirements of these
Guidelines. A plan that is significantly different to these diagrams should be carefully examined by
expert reviewers against all the individual requirements and principles established in these
Guidelines, especially those of Infection Control, to determine if it is acceptable.
In reviewing and using the Operating Unit Functional Relationship Diagrams, designers should
carefully consider a number of issues:
• Each diagram represents a method of managing the patient access, surgeon and nurses
access, sterile instrument flows, clean/dirty flow, air pressurisation.
• The diagrams may present different permutations of solutions, but each addresses the issues
involved in a satisfactory manner. Each option may suit a different management mode or
building configuration.
• Designers are strongly cautioned against creating hybrid options by combining features of
various diagrams. This may result in wrong clean/ dirty flows or other unacceptable features.
If in doubt, designers should seek advice from specialist Operating Room consultants and
Infection Control nurses, who should in turn be guided by the principles established here.
• Designers are strongly advised not to mix the recommendations of different standards and
guidelines.
The functional relationship diagrams below show base linear models. The models can be stretched
or contracted to create the exact number of Operating Rooms desired. The support facilities required
also grow with the number of Operating Rooms.
Each module includes the configuration of:
• Operating Rooms
• Anaesthetic Induction Rooms (optional)
• Scrub Bays
• Sterile Stock Store / Set-up Room
• Clean-up Room
• The optimal internal relationships demonstrate:
• Arrows indicate the direction of flow
• Adjacencies of rooms indicate the desired relationships
• Separate entrances to the Unit for staff, services and patients
• Control of access for all persons and patients entering
• Staff Station located in relation to bed bays
• Air Pressurisation Regime intended to ensure uni-directional flow of air
Functional Relationship Diagrams provided are based on two planning models considered efficient
and most appropriate. These also allow for easy expansion when required. The models are referred
to as “Single Corridor” and “Double Corridor”.
The cluster of key rooms such as operating room, scrub room, sterile stock/setup room, clean-up
room and optional anaesthetic induction room are regarded as a “Module”. Several Alternative
Modules have been provided which and considered acceptable.
Nothing in the following diagrams should be interpreted to encourage or require a “Dirty Corridor”.
In modern Operating Unit design, all corridors are considered as different degrees of clean. In
Alternative Modules which connect operating rooms directly to the decontamination area of SSU (eg
Alternative Module G) such corridors should be regarded as regular service corridors, like any other
within the unit.

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Operating Unit Single Corridor Model

Operating Unit Double Corridor Model

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Alternative Modules and Air Pressurisation Diagrams

The alternative module diagrams with air pressurisation shown below represent acceptable
variations of the arrangement of Operating Rooms with Anaesthetic and support rooms. Each
module represents ideal relationships and maintains correct clean/ dirty flows.
Air pressurisation and traffic flows have been graded according to the following legend below. For
the pressure differential between each two grads, refer to Part E - Engineering Services of these
guidelines:

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Alternative Modules A to D

Figure 3. Air Pressurisation Diagram: Operating Unit – Modules A to D

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4.1.1.1 Alternative Modules E to H

Figure 4. Air Pressurisation Diagram: Operating Unit – Modules E to H

1.5 Design Considerations

1.5.1 Environmental Considerations
Acoustics
Acoustic privacy is required in Operating Rooms/ Procedure rooms, Interview rooms and any rooms
where confidential information may be discussed.
The transfer of sound between clinical spaces should be minimised to reduce the potential of staff
error from disruptions and miscommunication and to increase patient safety and privacy. Noisy areas
such as Staff rooms should be located away from procedural areas.
It should be noted that it is common to have sound systems to provide piped music in operating
rooms. Therefore, the acoustic design should take this into consideration.
Refer to Part G – Acoustics of these Guidelines for more information.

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Natural Light
The need for an external view from the Operating Room is an important consideration. Provision of
windows need to consider the following:
• Vision from the Operating Room could be through a corridor, set up area or directly to the
external environment.
• Many procedures require black-out, so any windows should incorporate black-out features.
• There are heating, cooling and shading implications for windows in the Unit located on the
outside of the building that may have an impact on the recurrent costs for maintenance and
cleaning.
• Viewing windows from a corridor to the Operating Room can be useful for supervision and
training purposes.
• Any window to the operating room must be fixed, be double glazed with internal louvers for
light control.
Windows to Recovery areas are desirable, but not mandatory.
Windows to Staff Lounge where staff spend a considerable amount of their time should be given a
high priority in design. However, this is not a mandatory requirement.
Privacy
The design of the patient areas within the Day Surgery Unit needs to consider the contradictory
requirement for staff visibility of patients while maintaining patient privacy. Unit design and location
of staff stations will offer varying degrees of visibility and privacy. The expected patient acuity, age,
gender and level of dependency should be considered.
Each bed bay or recliner bay in pre-op and post-op areas shall be provided with bed screens (curtains)
to ensure privacy of patients when needed. Refer to the Standard Components Room Data Sheets
and Room Layout Sheets for examples.
The following features shall be integrated to the design of the Unit:
• doors and windows to be located appropriately to ensure patient privacy and not comprise
staff security
• discreet spaces to enable confidentiality of discussions related to a patient
• location of patient change areas to provide direct access to waiting areas to prevent patients
in gowns travelling through public areas when changed before and after procedures
1.5.2 Accessibility
All patient areas and paths should be wheelchair accessible and designed to comply with relevant
accessibility standards. Reception desks and Staff stations should provide wheelchair accessible
counters.
The Reception desk, Waiting areas and Interview rooms should provide access for patient relatives
and visitors in wheelchairs. Also refer to Part C - Access, Mobility, OH&S within these Guidelines.
1.5.3 Doors
All entry points, doors or openings requiring bed/trolley access including Operating Rooms are
recommended to have a clear opening of 1400 mm. Larger openings may be required for special
equipment, as determined by the Operational Policy, to allow the manoeuvring of equipment without
manual handling risks and risk of damage.
Also refer to Part C – Access, Mobility, OH&S within these Guidelines.

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1.5.4 Ergonomics/ OH&S

Design of clinical spaces including Operating and Procedure rooms must consider Ergonomics and
OH&S issues for patient and staff safety and welfare. Particular attention should be given to storage
of stock and equipment, to minimise manual handling and provide minimum distances between
shelving aisles.
Refer to Part C – Access, Mobility, OH&S of these Guidelines for more information.
1.5.5 Size of the Unit
The size of the Operating Unit as defined by the number of Operating Rooms will be determined
based on the Clinical Services Plan (SCP) or Feasibility Study establishing the intended services scope,
complexity and population catchment served.
Generic Schedules of Accommodation (SOA) have been provided for typical units at role delineation
levels 3 (less complex services) to 6 (teaching/ research facilities).
1.5.6 Safety and Security
The Operating Unit shall provide a safe and secure environment for patients, staff and visitors, while
maintaining a non-threatening and supportive atmosphere conducive to recovery.
Internal spaces and zones should offer security through grouping functions, controlling access and
egress from the Unit and providing optimum observation for staff. Patient holding, procedural and
recovery areas will require restricted and controlled access to prevent unauthorised entry by visitors
or others.
1.5.7 Restricted Staff Access
It should be noted that hospital staff may not enter the unit without first changing in the change
rooms provided. This also applies to staff delivering patients on beds and trolleys, those delivering
rood for the staff rooms and those delivering boxes to the non-sterile store. Design should restrict
the access to staff who deliver the items mentioned above but are not required to enter the unit in
person. The typical solution is a hand-over zone where items are passed from the outside to the
inside, across a table, through a hatch or across a red line.
1.5.8 Drug Storage
Narcotics, Controlled and Semi Controlled drugs must be kept in a secure cabinet with alarm within
the Anaesthetic Room, Anaesthetic Store, Operating Room or Clean Utility/ Medication Room,
according to operational and drug storage policies.
A lockable refrigerator or a refrigerator located within a lockable room is required to store restricted
substances.
1.5.9 Finishes
Finishes including fabrics, floor, wall and ceiling finishes, should be appropriate to the highly clinical
nature of this unit including the following considerations:
• Ease of cleaning
• Infection control
• Acoustic properties
• Durability
• Fire safety
• Movement of equipment and impact resistance

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• Operating Units shall have the following finishes:

• Floors that are smooth, non-slip, impervious, continuous and cleanable with aggressive
chemical agents
• Wall finishes which are seamless, impervious and washable
• Ceilings which are smooth and impervious and cleanable
• Floors and ceiling finishes should be anti-bacterial and anti-fungal
• Intersections of walls and ceilings to be smooth without any gaps or joints
In areas where clinical observation is critical such as Operating/ Procedure rooms, Recovery and bed
bays, lighting and colour selected must not impede the accurate assessment of skin tones.
For further information and details refer to Part C – Access, Mobility, OH&S within these Guidelines.
1.5.10 Curtains/ Blinds
Windows that require screening within the entire Operating Unit shall be double glazed with internal
blinds. Surface mounted blinds or window curtains are not permitted in Operating Unit due to
difficulty in cleaning and maintaining a dust free environment.
Privacy bed screens/curtains must be washable, fireproof and cleanly maintained at all times.
Disposable bed screens may also be considered.
1.5.11 Fittings, Fixtures and Equipment
Consideration should be given to Occupational Health and Safety (OH& S) aspects of compactus units
for sterile items, storage and movement of heavy loan equipment and shelving for storage of heavy
items within the Operating Unit.
Refer to Part C - Access, Mobility, OH&S of these Guidelines, the Room Layout Sheets (RLS) and
Room Data Sheets (RDS) for more information.
1.5.12 Add-on Modules
A number of compatible modules may be integrated with a typical Operating Unit catering for
Inpatients and Day Surgery patients. These modules include Catheter Labs and Endoscopy.
In doing so, the procedural areas (e.g. Cath Lab or Endoscopy Room) may be grouped together with
the Operating Rooms or slightly separated.
The patient management area such as Reception, Pre-op and Post Op may also be integrated with
the balance of the Operating Unit.
Refer to separate FPU’s for the requirements of these facilities and ensure all items are provided or
shared within an integrated unit.
1.5.13 Building Service Requirements
This section identifies unit specific services briefing requirements only and must be read in
conjunction with Part E - Engineering Services for the detailed parameters and standards applicable.
Information and Communication Technology
The Operating Unit will require special consideration of the following IT/ Communications systems:
• Electronic Health Records (EHR) which may form part of the Health Information System (HIS),
incorporating Patient Administration System (PAS).
• Hand-held tablets and other smart devices
• Picture archiving communications systems (PACS) and location of monitors

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• Paging and personal telephones replacing some aspects of call systems

• Voice and data cabling for telephones and computers
• Bar coding systems for supplies and records
• Wireless network requirements
• Videoconferencing requirements for meeting rooms
• Digital operating room requirements particularly linkages to seminar and education facilities
for teaching purposes
• Communications rooms and server requirements
Staff Call
Patient, Staff Assist and Emergency Call facilities shall be provided in all patient bed areas (e.g.
Anaesthetic Induction Rooms, Holding bays, Recovery bays, Lounges, Change Rooms and Toilets) in
order for patients and staff to request for urgent assistance. Staff assist, and Emergency call facilities
are required in each Operating/ Procedure room.
All calls are to be registered at the Staff Stations, in circulation corridors and must be audible within
the service areas of the Unit including stores, Clean Utilities and Dirty Utilities. If calls are not
answered the call system should escalate the alert accordingly. The call system may also use mobile
paging systems or SMS to notify staff of a call.
Heating Ventilation and Air-conditioning (HVAC)
The Operating Rooms will require special air-conditioning with positive pressure, HEPA filtration.
Temperature, humidity and air changes per hour are to comply with relevant standards and
guidelines established in Part E of these guidelines as well as other standards and guidelines
referenced. Individual Operating Room temperatures should be controllable by staff from within the
room.
Refer to Part E - Engineering Services in these Guidelines for specific details.
Medical Gases
The Operating Unit shall provide medical gases and quantities of outlets identified in Standard
Components Room Data Sheets and Room Layout Sheets for Operating/ Procedures rooms and
various Pre-op and Post-op bed bays.
Each space routinely used for administration of inhalation anaesthesia or analgesia shall include a gas
scavenging system to vent waste.
Medical Gases must be dedicated to each patient. Gas outlets may not be shared between two
patients in bed/chair bays.
Provision shall be made in the hospital for additional separate storage of reserve gas cylinders
necessary to complete at least one day's procedures.
Refer to Part E - Engineering Services in these Guidelines for medical gases technical design
requirements.
Radiation Shielding and Radiation Safety
Operating Rooms that are used for undertaking imaging procedures require radiation shielding. A
certified physicist or qualified expert will need to assess the plans and specifications for radiation
protection as required by the FANR. A radiation protection assessment will specify the type, location
and amount of radiation protection required for an area according to the final equipment selections,
the layout of the space and the relationship between the space and other occupied areas.

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Incorporate all radiation protection requirements into the final specifications and building plans and
re-evaluate radiation protection if the intended use of a room changes, equipment is upgraded, or
surrounding room occupancy is altered. Consideration should be given to the provision of floor and
ceiling shielding when rooms immediately above and below are occupied.
As the future use of operating rooms may not be predictable, it is highly desirable to provide
Radiation shielding to all operating rooms by default.
Hydraulics
Warm water supplied to all areas accessed by patients within the Unit must not exceed 43 degrees
Celsius. This requirement includes all staff handwash basins and sinks located within patient
accessible areas.
1.5.14 Infection Control
Consideration of Infection Control is important in the design of this Unit. Separation of clean and
dirty workflows in surgery and clean-up areas and separation of patient care areas and contaminated
spaces and equipment is critical to the function of the Unit and to prevent cross infection. Procedure/
Operating rooms will be used for a variety of clients whose infection status may be unknown.
Standard precautions must be taken for all clients regardless of their diagnosis or presumed
infectious status.
Staff hand washing facilities, including disposable paper towels, must be readily available and highly
visible.
Standard precautions apply to the Day Surgery Unit areas to prevent cross infection between
patients, staff and visitors.
Refer also to Part D – Infection Prevention and Control in these Guidelines for additional
information.
Hand Wash Basins
Clinical hand-washing facilities shall be provided within all patient holding and recovery areas and
convenient to the Staff Stations. The ratio of provision shall be a minimum of one clinical hand-
washing facility for every four patient bays in open-plan areas.
Refer also to Part D - Infection Prevention and Control in these Guidelines for additional information.
Antiseptic Hand Rubs
Antiseptic hand rubs should be located so they are readily available for use at points of care, at the
end of patient beds and in circulation areas.
The placement of antiseptic hand rubs should be consistent and reliable throughout facilities.
Antiseptic hand rubs are to comply with Part D - Infection Prevention and Control, in these
guidelines.
Antiseptic Hand Rubs, although very useful and welcome, cannot fully replace Hand Wash Bays. Both
are required.
Isolation Rooms
By default, Operating Rooms will require Positive Pressure. The need for Negative Pressure Operating
Rooms shall be determined by the Service Plan and Operational Policy of the Unit. Such a provision
must be restricted to certain patient types.

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The need for Isolation rooms (Positive and Negative Pressure) in Holding and Recovery areas is to be
evaluated by an infection control risk assessment and will reflect the requirements of the Service
Plan.
Any Endoscopy rooms integrated within the Operating Unit may be designed with Positive Pressure
or Negative Pressure. However, considering the range of usage of Endoscopy Rooms, it is
recommended that all endoscopy rooms be designed with Negative Pressure.
Switchable negative/ Positive pressure rooms must be avoided.

1.6 Standard Components of the Unit

Standard Components are typical rooms within a health facility, each represented by a Room Data
Sheet (RDS) and a Room Layout Sheet (RLS).
The Room Data Sheets are written descriptions representing the minimum briefing requirements of
each room type, described under various categories:
• Room Primary Information; includes Briefed Area, Occupancy, Room Description and
relationships, and special room requirements)
• Building Fabric and Finishes; identifies the fabric and finish required for the room ceiling, floor,
walls, doors, and glazing requirements
• Furniture and Fittings; lists all the fittings and furniture typically located in the room; Furniture
and Fittings are identified with a group number indicating who is responsible for providing
the item according to a widely accepted description as follows:

Group Description
1 Provided and installed by the builder
2 Provided by the Client and installed by the builder
3 Provided and installed by the Client

• Fixtures and Equipment; includes all the serviced equipment typically located in the room
along with the services required such as power, data and hydraulics; Fixtures and Equipment
are also identified with a group number as above indicating who is responsible for provision
• Building Services; indicates the requirement for communications, power, Heating, Ventilation
and Air conditioning (HVAC), medical gases, nurse/ emergency call and lighting along with
quantities and types where appropriate. Provision of all services items listed is mandatory
The Room Layout Sheets (RLS’s) are indicative plan layouts and elevations illustrating an example of
good design. The RLS indicated are deemed to satisfy these Guidelines. Alternative layouts and
innovative planning shall be deemed to comply with these Guidelines provided that the following
criteria are met:
• Compliance with the text of these Guidelines
• Minimum floor areas as shown in the schedule of accommodation
• Clearances and accessibility around various objects shown or implied
• Inclusion of all mandatory items identified in the RDS
The Operating Unit will consist of Standard Components to comply with details described in these
Guidelines. Refer to Standard Components Room Data Sheets (RDS) and Room Layout Sheets (RLS)
separately provided.

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1.6.1 Non-Standard Rooms

Non-standard rooms are rooms are those which have not yet been standardised within these
guidelines. As such there are very few Non-standard rooms. These are identified in the Schedules of
Accommodation as NS and are separately covered below.
Exit Bay
The Exit Bay is an area adjacent to the Operating/ Procedure rooms which is designed to hold the
patient bed/trolley during the procedure. The Exit Bed Bay should consider and include the following:
• 1 Exit Bay must be provided per Operating / Procedure Room
• Adequate space to accommodate patient bed without encroaching on circulation corridor
• Adequate power should be provided to recharge the bed and any equipment attached
Perfusion Room
The Perfusion Room is for the preparation of perfusion equipment, and where set-up for cardiac
procedures is undertaken. The room will be located in close proximity to the Cardiac Operating
Room/s and adjacent to a Perfusion Store. Room requirements may include:
• Heavy duty shelving for storage of perfusion fluids and equipment
• Computer workstation for a perfusion technician including power and data outlets
• Handwashing basin Type B with paper towel and soap fittings
• Bench, sink and cupboard unit for servicing of the perfusion machine

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1.7 Schedule of Accommodation

The Schedule of Accommodation (SOA) provided below represents generic requirements for this Unit. It identifies the rooms required along with the
room quantities and the recommended room areas. The sum of theroom areas is shown as the Sub Total as the Net Area. The Total area is the Sub Total
plus the circulation percentage. The circulation percentage represents the minimum recommended target area for corridors within the Unit in an efficient
and appropriate design.
Within the SOA, room sizes are indicated for typical units and are organised into the functional zones. Not all rooms identified are mandatory therefore,
optional rooms are indicated in the Remarks. These guidelines do not dictate the size of the facilities, therefore, the SOA provided represents a limited
sample based on assumed unit sizes. The actual size of the facilities is determined by Service Planning or Feasibility Studies. Quantities of rooms need to
be proportionally adjusted to suit the desired unit size and service needs.
The Schedule of Accommodation are developed for particular levels of services known as Role Delineation Level (RDL) and numbered from 1 to 6. Refer
to the full Role Delineation Framwork (Part A - Appendix 6) in these gduielines for a full description of RDL’s.
The table below shows a typical Operating Unit at RDL’s 3 to 6 with 2 OR’s, 4OR’s, and 12 OR’s.
Any proposed deviations from the mandatory requirements, justified by innovative and alternative operational models may be proposed and record in
the Non-Compliance Report (refer to Part A - Appendix 4) with any departure from the Guidelines for consideration by the DOH for approval
1.7.1 Operating Unit
Note: RDLs 1 and 2 involve minor day surgery and are not applicable for Operating Unit.
ROOM/ SPACE Standard Component RDL 3 RDL 4 RDL 5/6 Remarks
Room Codes Qty x m2 Qty x m2 Qty x m2
Admission/ Reception/ Pre-op Holding 2 ORs 4 ORs 12 ORs

Reception/ Clerical RECL-10-D similar RECL-15-D 1 x 12 1 x 12 1 x 15

Waiting WAIT-10-D WAIT-30-D 1 x 10 1 x 10 1 x 30 Divided into male/ female areas

Waiting - Family WAIT-10-D WAIT-30-D 1 x 10 1 x 10 1 x 30

Meeting Room - Small MEET-9-D similar 1 x 9 1 x 9 1 x 12 Interviews with family

Staff Station SSTN-5-D 1 x 5 Reception area can be used for levels 3-4

Patient Bay - Holding (Male/ Female) PBTR-H-10-D similar 2 x 10 2 x 10 6 x 12 1 per 2 Operating Room; optional; Separate Male/Female

Toilet - Patient WCPT-D 2 x 4 2 x 4 2 x 4 Separated for male and female.

Bay - Blanket Warmer BBW-1-D similar 1 x 2 1 x 2 As required

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ROOM/ SPACE Standard Component RDL 3 RDL 4 RDL 5/6 Remarks

2 2 2
Room Codes Qty x m Qty x m Qty x m
Bay - Handwashing, Type B BHWS-B-D 1 x 1 1 x 1 2 x 1

Bay - Linen BLIN-D 1 x 2 1 x 2 May be shared for Level 3; 1 per 16 bed spaces

Clean Utility - Sub CLUR-8-D 1 x 8 1 x 8 1 x 8

Dirty Utility - Sub DTUR-S-D 1 x 8 1 x 8 RDL 3 may share Dirty Utility

Office - Write-up Bay OFF-WI-1-D similar 1 x 6 1 x 6 1 x 6 Staff work area based on 3m2 per person, as required

Operating Rooms (OR) Areas 2 ORs 4 ORs 12 ORs

Anaesthetic Induction ANIN-D 2 x 15 4 x 15 10 x 15 Optional

Anaesthetic Induction - Large ANIN-D similar 2 x 18 Optional, larger room for teaching purpose if required

Operating Room - General ORGN-D 2 x 42 1 x 42 2 x 42 For minor procedures

Operating Room - Digital OR-DIG-D 3 x 55 10 x 55 55m2 is the optimal size for this OR

Operating Room - Large ORLA-D 1 x 60 Optional; Provide according to service demand

Operating Room - Hybrid/ CT OR-HY-CT-D 1 x 70 Optional; Provide according to service demand

Operating Room - CT Control OR-CTCR-D 1 x 10 For Operating Room - Hybrid/ CT

Computer Equipment Room COEQ-D 1 x 8 For Operating Room - Hybrid/ CT

Optional; Provide according to service demand; Provide a

Operating Room - Hybrid/ MRI ORLA-D similar 1 x 60 door (1200mm clear opening) from Operating Room going
into the adjoining MRI Scanning Room.

Optional; Provide according to service demand; Adjoining

MRI Scanning Room MRI-42-D 1 x 42
an Operating Room.

Control/ Reporting Room ANCRT-D similar 1 x 14 For MRI Scanning Room

Computer Equipment Room COEQ-D 1 x 8 For MRI Scanning Room

Operating Room - Imaging (Vascular/ Cardiac) OR-VC-D 1 x 70 Optional; Provide according to service demand

Operating Room-Control Room OR-CTCR-D 1 x 10 For Operating Room - Hybrid/ CT

Computer Equipment Room COEQ-D 1 x 8 For Operating Room - Imaging (Vascular/ Cardiac)

Operating Room - Robotic ORRB-D 1 x 55 Optional; Provide according to service demand

Scrub-Up/ Gowning SCRB-6-D similar 1 x 8 2 x 8 6 x 8 1 per 2 Operating Room

Exit Bay NS 2 x 8 4 x 8 12 x 8 1 per Operating Room

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ROOM/ SPACE Standard Component RDL 3 RDL 4 RDL 5/6 Remarks

2 2 2
Room Codes Qty x m Qty x m Qty x m
OR Support Areas
Audio-visual Room audv-d 1 x 10 As required for digital recording

Anaesthetic Store anst-d similar 1 x 15 1 x 20 2 x 20

Anaesthetic Workroom anwm-d similar 1 x 10 1 x 15 1 x 20 Also used for Biomedical equipment

Bay - Blanket/ Fluid Warmer bbw-1-d 1 x 1 1 x 1 1 x 1 Optional

Bay - Linen blin-d 1 x 2 2 x 2 2 x 2

Bay - Mobile Equipment bmeq-4-d similar 1 x 2.5 2 x 2.5 6 x 2.5 1 per 2 OR, may be collocated

Bay – Resuscitation Trolley bres-d similar 1 x 1.5 2 x 1.5 2 x 1.5

Bay - Pathology bpath-1-d similar 1 x 1 1 x 4 1 x 6 Optional for RDL 3 & 4

Blood Store blst-d similar 1 x 2 1 x 2 1 x 4

Cleaners Room clrm-6-d 1 x 6 2 x 6 4 x 6 Minimum of 1 per approximately 1000m2

Clean-Up Room clup-7-d 1 x 7 2 x 7 6 x 7 1 per 2 OR, may be collocated and shared between ORs

Disposal Room disp-8-d similar 1 x 10 1 x 10 2 x 10

Optiona,Only for emergency use and dropped single

Flash Steriliser fst-2-d 1 x 2 1 x 2 1 x 2
instruments

Office - Write-up Bay off-wi-1-d similar 1 x 6 1 x 6 1 x 6

Set-up Room setup-8-d similar 1 x 8 1 x 16 1 x 16 Optional. depends on Operational Policy of the unit

Store - Drugs stdr-5-d similar 1 x 5 1 x 10

Store - Equipment, Major steq-14-d steq-20-d similar 1 x 14 1 x 30 2 x 36 6m2 per OR recommended for RDL 5/6

Store - Equipment, Minor steq-14-d steq-20-d similar 1 x 14 1 x 14 2 x 30 5m2 per OR recommended for RDL 5/6

Store - Loan Equipment steq-10-d steq-16-d similar 1 x 10 1 x 10 1 x 15 Optional, for equipment on consignment

Store - Non-Sterile/ De-boxing steq-20-d similar 1 x 20 1 x 30 1 x 30

Store - Sterile Stock stss-20-d similar 1 x 24 1 x 44 1 x 120 Based on 10-12 m2 per OR

Perfusion Room NS 1 x 20 Optional, for cardiac specialties

Store - Perfusion stgn-20-d 1 x 20 Optional, for cardiac specialties

Toilet - Staff wcst-d 2 x 3 2 x 3 In addition to toilets in Change Rooms

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ROOM/ SPACE Standard Component RDL 3 RDL 4 RDL 5/6 Remarks

2 2 2
Room Codes Qty x m Qty x m Qty x m
Recovery Areas – Stage 1 2 ORs 4 ORs 12 ORs

2 bays per OR(including isolation); separate Male/ Female

Patient Bay – Recovery Stage 1 pbtr-rs1-12-d similar 4 x 9 8 x 12 22 x 12
areas

1 Bed Room – Isolation, Negative Pressure 1br-isn-18-dsimilar 2 x 12 Provide according to service demand

Anteroom anrm-d 2 x 6 for Isolation Room, Negative Pressure

Ensuite ens-st-d 2 x 5 For Isolation Room Negative Pressure

Staff Station sstn-14-d similar sstn-20-d 2 x 10 2 x 12 2 x 20 1 each for Male/ Female areas

Bay – Blanket Warmer bbw-d 1 x 1 1 x 1 1 x 1 As required

Bay - Handwashing, Type A bhws-a-d 1 x 1 2 x 1 6 x 1 1 per 4 bays; Refer to Infection Control Part D

Bay - Linen blin-d 1 x 2 2 x 2 2 x 2

Bay - Resuscitation bres-d 1 x 1.5 1 x 1.5 1 x 1.5

Clean Utility clur-12-d similar 1 x 12 2 x 12 2 x 14

Dirty Utility dtur-12-d 1 x 12 2 x 12 2 x 12

Store - General stgn-8-d similar 1 x 6 2 x 6 2 x 10

OR Staff Areas 2 ORs 4 ORs 12 ORs

Change - Staff (Male/Female) chst-20-d similar 2 x 20 2 x 35 2 x 70 Toilets, Shower & Lockers; size depends on staff numbers

Meeting Room - Small meet-9-d similar 1 x 9 1 x 9 1 x 12 Optional, according to service demand

Meeting Room – Medium/ Large meet-l-15-d meet-l-30-d 1 x 15 1 x 30 Optional, according to service demand

Office - Single Person off-s12-d 1 x 12 1 x 12 Note 1; Service Manager

Office - Single Person off-s9-d 1 x 9 1 x 9 2 x 9 Note 1; Unit Manager OR, Unit Manager Recovery

Office - Single Person off-s9-d 1 x 9 2 x 9 4 x 9 Note 1; Surgeons, Anaesthetists, Specialist Nurses

Office - 2 Person, Shared off-2p-d 1 x 12 1 x 12 Note 1; Nurse Educators, Medical Specialists, Clinicians

Office - 3 Person, Shared off-3p-d 1 x 15 2 x 15 Note 1; Registrars, Medical Officers

Staff Room srm-15-d srm-25-d similar 1 x 15 1 x 30 1 x 60 May divide into Male & Female areas

Toilet - Staff wcst-d 2 x 3 In addition to toilets in Change Rooms, separate M/ F

Toilet - Accessible, Staff wcac-d 1 6 Unless available nearby

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ROOM/ SPACE Standard Component RDL 3 RDL 4 RDL 5/6 Remarks

2 2 2
Room Codes Qty x m Qty x m Qty x m
Sub Total 551.5 1042.5 2941.5

Circulation % 40 40 45

Area Total 772.1 1459.5 4118.1

1.7.2 Peri-operative Unit (Optional)

The Perioperative Unit required for the management of Day Surgery patients may be collocated with Operating Unit for Inpatient Surgery. If collocated,
the following SOA applies. Otherwise refer to Day Surgery FPU for further details.
ROOM/ SPACE Standard Component RDL 3 RDL 4 RDL 5/6 Remarks
2 2 2
Room Codes Qty x m Qty x m Qty x m
2 ORs 4 ORs 12 ORs
Admissions/ Reception
Reception/ Clerical recl-10-d similar recl-15-d similar 1 x 9 1 x 9 1 x 12 May be shared with OR/ Day Surgery Reception

Clerical Support/ records; May be shared with OR/ Day

Office off-s9-d off-2p-s 1 x 9 1 x 9 1 x 12
Surgery

Toilet – Public (Male/ Female) wcpu-3-d 2 x 3 2 x 3 2 x 3 Unless available nearby

Toilet - Accessible wcac-d 1 x 6 1 x 6 2 x 6 Unless available nearby

Waiting wait-20-d similar 1 x 20 1 x 20 1 x 25

Waiting – Female/ Family wait-20-d wait-30-d similar 1 x 20 1 x 30 1 x 50 Separate Female/ Family Waiting areas may be provided

Waiting wait-sub-d 1 x 5 1 x 5 1 x 5 Wards persons/ Orderlies

Pre-operative Area
Optional, Includes Toilet, Shower, Lockers; provide toilets
Change –Patient (Male/ Female) chpt-12-d similar 2 x 12 2 x 12 2 x 24
not less than 1:6 bed bays

Waiting – Changed Patient (Male/ Female) wait-10-d wait-20-d similar 2 x 10 2 x 25 2 x 25 Optional, Alternatively, use patient holding bays

Patient Bay - Holding pbtr-h-10-d 2 x 10 3 x 10 10 x 10 1 per OR (including isolation) recommended

Patient Bay Enclosed, Isolation pbtr-h-e-12-d 1 x 12 Class S Isolation

1 Bed Room – Isolation, Negative Pressure 1br-isn-18-d 2 x 18 Provide according to service demand

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ROOM/ SPACE Standard Component RDL 3 RDL 4 RDL 5/6 Remarks

2 2 2
Room Codes Qty x m Qty x m Qty x m
2 ORs 4 ORs 12 ORs
Anteroom anrm-d 2 x 6 for Isolation Room, Negative Pressure

Ensuite ens-st-d 1 x 5 2 x 5 For Enclosed Bed Bay & Isolation Room Negative Pressure

1 per 4 bays; Refer to Part D Infection Prevention and

Bay - Handwashing, Type B bhws-b-d 1 x 1 1 x 1 3 x 1
Control

Bay - Linen blin-d 1 x 2 1 x 2 May be shared with Recovery

Bay - Resuscitation Trolley bres-d 1 x 1.5 1 x 1.5 1 x 1.5 May be shared with Recovery if close

Clean Utility clur-8-d clur-12-d 1 x 8 1 x 12 1 x 12 Includes medications; May be collocated with Staff Station

Consult/ Exam Room cons-d 2 x 13 3 x 13 4 x 13 Provide according to service demand

Dirty Utility dtur-s-d 1 x 8 1 x 8 1 x 8 May be shared with Recovery

Toilet – Accessible, Patient wcac-d 1 x 6 2 x 6 2 x 6 May share with Recovery areas if close

Post-operative Area (Recovery Stage 2/3)

Separate Male/Female areas, may be combination of bed
Patient Bay - Holding, Recovery Stage 2 pbtr-h-10-d 6 x 10 12 x 10 24 x 10
and chair spaces; allow 3 beds/ chairs per Day Surgery OR

Optiona,Separate Male/Female areas, may be collocated;

Lounge – Recovery, Stage 2/3 lnpt-rs2-d 2 x 18 2 x 36 2 x 54 allow 3 lounge chairs per Day Surgery OR at 6m2 per chair
as per the nominated standard component

Staff Station sstn-14-d similar 1 x 10 2 x 12 2 x 14

Bay - Beverage, Open Plan bbev-op-d 1 x 5 1 x 5 1 x 5

Bay -Blanket/ Fluid Warmer bbw-d 1 x 1 1 x 1 1 x 1 As required

1 per 4 beds/ chairs; refer to Part D Infection Prevention

Bay - Handwashing, Type B bhws-b-d 4 x 1 6 x 1 9 x 1
and Control

Bay - Linen blin-d 1 x 2 1 x 2 2 x 2

Bay - Pathology bpath-1-d 1 x 1 1 x 1 1 x 1

Bay - Resuscitation Trolley bres-d 1 x 1.5 1 x 1.5 1 x 1.5

Cleaner’s Room clrm-6-d 1 x 6 1 x 6 1 x 6

Clean Utility clur-8-d clur-12-d similar 1 x 8 1 x 12 1 x 14

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Part B: Health Facility Briefing & Design
Operating Unit

ROOM/ SPACE Standard Component RDL 3 RDL 4 RDL 5/6 Remarks

2 2 2
Room Codes Qty x m Qty x m Qty x m
2 ORs 4 ORs 12 ORs
Dirty Utility dtur-s-d dtur-12-d dtur-14-d 1 x 8 1 x 12 1 x 14 May be shared

Disposal Room disp-8-d similar 1 x 8 1 x 10 1 x 10 May be shared

Store - Equipment/ General steq-14-d steq-20-d 1 x 14 1 x 14 1 x 20 Equipment, consumable stock

Toilet – Patient wcpt-d 2 x 4 4 x 4

Toilet - Accessible wcac-d 2 x 6 2 x 6 2 x 6

Staff Areas
Meeting Room - Small meet-9-d 1 x 9 1 x 9 1 x 9 May be shared

Office – Write-up (Shared) off-wis-d 1 x 12 1 x 12 1 x 12 Note 1

Office – Single Person off-s9-d 1 x 9 1 x 9 1 x 9 Note 1; Unit Nurse Manager

Property Bay - Staff prop-3-d similar 1 x 3 2 x 6 2 x 6

Staff Room srm-15-d similar 1 x 15 1 x 20 1 x 20 May share with an adjacent Unit

Toilet - Staff wcst-d 2 x 3 2 x 3 2 x 3

Sub Total 420 656 1026

Circulation % 40 40 40

Total Area 588 918.4 1436.4

Note 1: Offices to be provided according to the number of approved full-time positions within the Unit
Please also note the following:

• Areas noted in Schedules of Accommodation take precedence over all other areas noted in the Standard Components
• Rooms indicated in the schedule reflect the typical arrangement according to RDL and number of OR’s
• All the areas shown in the SOA follow the No-Gap system described elsewhere in these Guidelines
• Exact requirements for room quantities and sizes will reflect Key Planning Units identified in the service plan and the policies of the Unit
• Room sizes indicated should be viewed as a minimum requirement; variations are acceptable to reflect the needs of individual Unit

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Part B: Health Facility Briefing & Design
Operating Unit

1.8 Further Reading

In addition to Sections referenced in this FPU, i.e. Part C- Access, Mobility, OH&S, Part D - Infection
Prevention and Control, and Part E - Engineering Services, Part G-Acoustics readers may find the
following helpful:
• AORN (Association of peri-Operative Registered Nurses (USA); Position Statement on
Perioperative Safe Staffing and On-Call Practises, 2014; refer to website:
https://www.aorn.org/guidelines/clinical-resources/position-statements
• AHIA, Australasian Health Facility Guidelines, Part B Health Facility Briefing and Planning, 520
- Operating Unit, Revision 5, 2016, refer to: https://healthfacilityguidelines.com.au/health-
planning-units
• ASHRAE American Society of Heating Refrigeration and Air-conditioning Engineers, HVAC
design manual for hospitals and clinics, 2003 refer to website:
https://www.ashrae.org/standards-research--technology/standards--guidelines
• CDC Centres for Disease Control and Prevention, Guideline for Disinfection and Sterilisation
in Healthcare Facilities, 2008, refer to website:
http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf
• DH (Department of Health) (UK) Health Building Note HBN 26 Facilities for surgical
procedures: Volume 1, 2009, refer to website:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/148490/H
BN_26.pdf
• DH (Department of Health) (UK) Health Building Note HBN 00-03 Clinical and clinical support
spaces, 2013, refer to website:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/147845/H
BN_00-03_Final.pdf
• Guidelines for Design and Construction of Health Care Facilities; The Facility Guidelines
Institute, 2014 Edition refer to website: www.fgiguidelines.org

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