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EBD Journal Club: Simulation-Based Mock-Up Evaluation of a Universal Operating Room

When: April 30, 2020
Time: 10:00am Pacific
Price: FREE

Simulation-Based Mock-Up Evaluation of a Universal Operating Room
Health Environments Research & Design Journal


Evidence-Based Design Journal Clubs are one-hour sessions that provide opportunities to interact with authors who recently published EBD papers or articles in peer-reviewed journals such as HERD. Learn as they share ways to put their research into practice.

Designing or renovating a physical environment for healthcare is a complex process and is critical for both the staff and the patients who rely on the environment to support and facilitate patient care. 

Conducting a simulation-based mock-up evaluation as part of the design process can enhance patient safety, staff efficiency, as well as user experience, and can yield financial returns. A large urban tertiary care center located in Vancouver, Canada followed a framework to evaluate the proposed design template for 28 universal operating rooms (ORs) included within the OR Renewal Project scope.

Simulation scenarios were enacted by nursing staff, surgeons, anesthesiologists, residents, radiology techs, and anesthesia assistants. Video and debriefing data were used to conduct link analyses, as well as analyses of observed behaviors including congestions and bumps to generate recommendations for evidence-based design changes that were presented to the project team.

Recommendations incorporated into the design included relocating doors, booms, equipment, and supplies, as well as reconfigurations to workstations. These recommendations were also incorporated into the mock-up and retested to iteratively develop and evaluate the design. Findings suggest that incorporating the recommended design changes resulted in better room utilization, decreased congestion, and enhanced access to equipment.


Presenting Faculty


Jonas Shultz, MSc, EDAC
Human Factors Specialist
Health Quality Council of Alberta

Jonas Shultz works as a Human Factors Specialist with the Health Quality Council of Alberta. He is also an adjunct lecturer with the Department of Anesthesia, University of Calgary. Working over the last 14 years in medical human factors, he has provided human factors expertise to a variety of healthcare organizations, including Alberta Health Services, Vancouver Coastal Health Authority, Health Canada, ISMP Canada, CSA Group, as well as the Center for Health Design and Clemson University’s Center for Health Facility Design and Testing in the United States. The majority of Jonas’ work has focused on evaluating the design of built environments for healthcare, such as hybrid operating theatres and ambulances, minimizing human error during medication administration, evaluating medical devices, as well as testing usability and comprehension of visual displays. Jonas has published his work in peer reviewed papers, influenced provincial and national healthcare facility design standards, and has been an invited speaker at numerous national and international venues in Canada, the United States, Australia, Kingdom of Saudi Arabia and the United Arab Emirates.

Shelly Fleck, MBA
Director Strategic Initiatives, VA; Operations Director, Surgical Services 
VA & VGH Simulation Center

Shelly is the Director, Surgical Services at Vancouver Acute, an organization comprised of 3 hospitals and a number of outpatient facilities located in Vancouver British Columbia Canada.  Within Vancouver Acute, there are a total of 31 Operating Rooms as well as  6 ORs in private centres.  Shelly is the Clinical Project Director for the Vancouver General Hospital OR Renewal Project, a $102M project that will see the construction of 16 new ORs and a 40 bay PCU in the existing hospital (located one floor above the current surgical suite).  Shelly received her MBA from the UBC Sauder School of Business.


Host: Deborah Wingler, PhD, MDS-HHE, EDAC
Vice President and Healthcare Research Lead
HKS, Inc

Dr. Wingler is Vice President and Healthcare Research Lead for HKS. Dr. Deborah Wingler’s research focuses on improving the patient and staff experience within the ambulatory care environment through research studies that utilize real-time data collection techniques to elicit insight into patient and staff physiological, psychological and neural responses to high stress healthcare environments. Her research interests also include bringing high-quality care to vulnerable populations and medically underserved communities within the United States and internationally.