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HOSPITAL DESIGN: Location of OR in relation to ED?

Some years ago, I was asked to find articles that mentioned where the emergency department was in relation to the surgical suite in hospitals.  A recent article on this topic (the one about Parkland below) caught my eye for that reason, and I decided to see what else might come up in a quick search of the literature.

Advice from Hayward & Associates (architects and space planners)

  • Emergency department entrance should be at grade level
  • These areas should be adjacent to the ED or directly accessible via elevator: Surgical suite, intensive care units, labor and delivery
  • The elevator should be oversized – large enough for stretcher, staff, and pieces of patient care equipment
  • If trauma service is provided – there must be a direct route from ED to surgical suite.  This can be a dedicated corridor if the departments are on the same level, or via elevator

CASE STUDY: Albert Einstein Medical Center (Philadelphia, PA) – 2009 article

  • Surgical suite is three floors above the ED
  • Cath lab is one floor above the ED

CASE STUDY: Carilion Roanoke Memorial Hospital (Roanoke, VA) – 2003 article

  • Cardiac cath labs and cardiac OR is four floors above ED and imaging departments

CASE STUDY: Emory University Hospital (Atlanta, GA) – 2014 article

  • Cath lab on 4th floor
  • Surgical suite on 3rd floor
  • ED on 1st floor

CASE STUDY: Florida Hospital (Orlando, FL) – 2011 article

  • Cath lab is 2 floors directly above the ED
  • Surgical suite is also 2 floors above the ED – but at some distance from the cath lab

CASE STUDY: Mercy Hospital (Springfield, MO) – 2012 article

  • Surgical suite is 2 floors above the ED
  • Cath lab is 3 floors above the ED
  • At the time this was written, they were anticipating a new heart institute project which would put the cath lab adjacent to the surgical suite.

CASE STUDY: Parkland Hospital (Dallas, TX) – 2015 article

  • New replacement hospital
  • ED designed for 180,000 visits per year
  • 154 treatment rooms in pods of 12 or 14
  • There are 4 trauma rooms – equipped as surgical suites – in the ED
  • The surgical suite is two floors above the ED
  • There are two trauma elevators – the largest dubbed the ‘megavator’

CASE STUDY: St. Agnes Medical Center (Fresno, CA) – 2015 article

  • Cardiothoracic services (3 cath lab suites and 4 dedicated operating rooms) are located 2 floors above the ED

CASE STUDY: University Health System (San Antonio, TX) – 2007 article

  • ED is on the sublevel with cath labs close by
  • Imaging is two floors up
  • Surgical suite is on the 11th floor
  • There are trauma elevators


Hayward, C. (2015). SpaceMed guide: A space planning guide for healthcare facilities. (3rd ed.). Ann Arbor, Mich.: HA Ventures, p. 1-12 to 1-13, and 2-15 to 2-16.

[About Albert Einstein]. Visco, J., and Irwin, G.H. (2009, Aug.). Albert Einstein Medical Center. Cath Lab Digest, 17(8). Retrieved from http://www.cathlabdigest.com/articles/Albert-Einstein-Medical-Center

[About Carilion]. Smith, C.D. (2003, Sept.). Carilion Roanoke Memorial Hospital. Cath Lab Digest11(9). Retrieved from http://www.cathlabdigest.com/articles/Carilion-Roanoke-Memorial-Hospital

[About Emory]. Sarpong, N. (2014, Dec.). Spotlight: Emory University Hospital cardiac cath lab. Cath Lab Digest, 22(12). Retrieved from http://www.cathlabdigest.com/article/Spotlight-Emory-University-Hospital-Cardiac-Cath-Lab

[About Florida]. Egolf, B. (2011, Sept.). Florida Hospital. Cath Lab Digest, 19(9). Retrieved from http://www.cathlabdigest.com/articles/Florida-Hospital

[About Mercy]. Hutchison, L.M., and Myears, D.W. (2012, Oct.). Spotlight interview: Mercy Springfield. Cath Lab Digest. 20(10). Retrieved from http://www.cathlabdigest.com/articles/Spotlight-Interview-%EF%BB%BFMercy-Springfield

[About Parkland]. Eagle, A. (2015, Sept.). Minutes count: Designs that improve ED performance. Health Facilities Management, 28(9), 16-21. Retrieved from http://www.hfmmagazine.com/display/HFM-news-article.dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/HFM/Magazine/2015/Sept/hfm-emergency-department-designs-improving-emergency-department-design

[About St. Agnes]. (2015, Aug.). Spotlight: Saint Agnes Medical Center. Cath Lab Digest23(8). Retrieved from http://www.cathlabdigest.com/article/Spotlight-Saint-Agnes-Medical-Center

[About University Health System]. Espanto, F.D. (2007, June). University Health System. Cath Lab Digest. 15(6). Retrieved from http://www.cathlabdigest.com/articles/University-Health-System  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

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