Abstract:
A hospital layout comprising a plurality of adjacent OR/intervention rooms ( 46, 48 ) uniquely configured and equipped to perform surgical and other interventional procedures, with adjacent intubation rooms ( 52 ) configured and equipped to prepare patients for procedures to occur in the OR/intervention rooms and at least one extubation room ( 54 ) adjacent the OR/intervention rooms, configured and equipped to post-intervention awaken and extubate patients. A plurality of universal patient rooms ( 40 ) are located adjacent the OR/intervention rooms and universal patient rooms, and are configured and equipped to admit patients for surgery/intervention, prepare patients for surgery/intervention, allow patients to recover post-intervention, and discharge patients post-recovery.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    This application is a continuation-in-part of prior U.S. patent application Ser. No. 11/129,224, filed May 13, 2005, entitled OPERATING ROOM/INTERVENTION ROOM, which claimed the benefit of U.S. Provisional Application No. 60/570,843, filed May 13, 2004, the disclosures of which are all hereby expressly incorporated by reference. 
     
    
     FIELD OF THE INVENTION 
       [0002]    The present invention relates generally to hospital/clinical layouts, and more particularly, to the layout, structure and usage of intervention/operating rooms (OR), and related intubation, extubation and patient rooms. 
       BACKGROUND OF THE INVENTION 
       [0003]    Currently, a patient at a hospital or medical clinic is moved from location to location numerous times in order for a procedure to be completed. Also, typically, OR and intervention rooms and equipment used therein are underutilized in most hospitals and medical facilities, thereby increasing the cost of procedures. In addition, OR/intervention rooms are typically so crowded with equipment, lighting fixtures, booms, monitors, utility columns or booms, hoses, tubes and lines, that it is difficult for OR/intervention room personnel to actually move about efficiently. Also, such equipment can impair the vision of OR/intervention room personnel and impede laminar air flow from an overhead source, over the patient, and then out of the OR/intervention room. Such lighting fixture booms, equipment booms, etc., often set up air eddies or dead spaces. Also, fixtures, equipment, etc., can collect dust particles that can then be blown into the surgical field within the laminar air flow column at the surgical/intervention site thus compromised the laminar air flow system&#39;s purpose of reducing surgical/intervention wound infections. 
         [0004]    In addition, an extensive period of time is required to clean and prepare an OR/intervention room after a procedure has been completed. The room is manually cleaned, and the soiled equipment, diagnostics, linen, etc., must be removed manually from the room and new supplies, equipment, etc., delivered to the room and set up. This takes time, which reduces throughput and the number of cases per day. The cost of the personnel for carrying out these tasks is not insignificant. 
         [0005]    The present invention seeks to address the foregoing drawbacks of existing OR/intervention room structures and procedures. The present invention strives to reduce the number of patient moves, enhance patient safety and provide flexibility and adaptability of the OR/intervention room for future advances in patient care. 
       SUMMARY OF THE INVENTION 
       [0006]    One aspect of the present invention pertains to a plurality of adjacent OR/intervention rooms for performing medical procedures where each room comprises a surgical/intervention zone of a pre-determined area, generally surrounding the location in which the patient is positioned. The surgical/intervention zone is substantially free of monitors, displays, mountings for monitors and displays, overhead utility sources and outlets, equipment booms and mountings, equipment and supply cabinet mountings, as well as equipment, instrument and supply table mountings. The OR/intervention rooms also include an adjustable lighting system incorporated into the ceiling of the room to provide substantially unobstructed light to the surgical/intervention zone. In addition, a ventilation system provides unimpeded laminar flow of air from the ceiling through the surgical/intervention zone. 
         [0007]    In an aspect of the present disclosure, the OR/intervention room is constructed with a drop-down ceiling structure that defines a surgery/intervention zone around the patient that is free from articulating arms from monitors, from lighting fixtures, from equipment, and also free from hose drops and utility columns from the ceiling, or other electrical, data, medical gas, vacuum, or evacuation lines, tubes, or cords. The drop-down ceiling can be of a selected size and ideally from about 7 to 8 feet above the floor to establish an unobstructed, sterile zone for the surgery/intervention room. 
         [0008]    In a further aspect of the present invention, multiple light sources are recessed in the ceiling of the OR/intervention room and are carried by movable mounting systems that may be aimed, focused, or otherwise controlled as desired by the OR/intervention room personnel. The lighting system may be controlled by microchips mountable on gloves, wristbands, or other articles worn by OR/intervention room personnel, or may be controlled by radio frequency identification tags located on, or incorporated into, instruments used by the OR/intervention room personnel, or may be activated by audio commands. 
         [0009]    In another aspect of the present invention, a plurality of large, high resolution audio/video monitors are positioned outside of the intervention zone. Such monitors are configured to provide patient physiological information and digital images, provide communications within and outside of the OR/intervention room, and provide high resolution image guidance for intervention procedures. The content of the monitors may be controlled by a voice-actuated system. 
         [0010]    In another aspect of the present invention, movable imaging equipment is shared among the OR/intervention rooms. In this regard, a transportation system is provided for transporting the moving of the mobile imaging equipment among the OR/intervention rooms. Such mobile imaging equipment may include, for example, CT scanners and MRI devices. In addition, the transportation system may include an overhead rail system incorporated into the ceilings of the OR/intervention rooms. 
         [0011]    The present invention further comprises intubation rooms adjacent the OR/intervention rooms. The intubation rooms are configured and equipped to prepare patients for procedures to occur in the OR/intervention rooms. Such preparation can take place while the OR/intervention room is being prepared. The present invention also contemplates extubation rooms located adjacent the OR/intervention rooms. The extubation rooms are configured and equipped to post-intervention, awaken, and extubate patients. The OR/intervention room may be cleaned and readied for the next case while the patient would otherwise be awakening in the room. 
         [0012]    In accordance with a further aspect of the present invention, the foregoing OR/intervention rooms, intubation rooms and extubation rooms are part of a general hospital layout which also includes a plurality of universal patient rooms located adjacent the OR/intervention rooms. Such universal patient rooms are configured and equipped to admit patients for intervention, prepare patients for intervention, allow patients to recover post-intervention, and discharge patients post-recovery. Such universal patient rooms are adaptable to provide high-level intensive care post-intervention, as well as to function at a lower level in the manner of a traditional patient room, for example, for patient recovery and discharge after relatively minor or routine surgery. 
         [0013]    As a further aspect of the present invention, the hospital layout may also include procedural rooms located adjacent the OR/intervention rooms. Such procedural rooms are configured and equipped to share imaging equipment with the OR/intervention rooms. Regular imaging procedures can be carried out at high volume in the procedural rooms. As a consequence, the expensive imaging equipment may be more efficiently utilized than is currently the case. 
         [0014]    A further aspect of the present invention includes a novel surgical table, including an articulating platform, pedestal supporting the platform, and a floor-engaging base. The surgical table includes a connection system for connecting the base to a connector hub integrated into the floor of the OR/intervention room, thereby connecting the surgical table to utility outlets for medical gases, electricity, data lines, and cable connectors. In addition, the surgical table includes arm structures at the foot and head of the table, each having outlets or connections for the aforementioned utilities. Such arms are movable between an ergonomically correct position for connection to the utilities of gases, electricity, data, etc., and then movable to a position below the top surface of the table platform so as to be retracted out of the way. The outlet arms at the head or foot of the table permit the sterile surgical drape over the sides of the table to be undisturbed during a procedure. 
         [0015]    In a further aspect of the present invention, an anesthesia machine is detachably dockable to the base of the surgical table. The anesthesia machine has a connection system for connecting the anesthesia machine to the connector hub integrated into the floor of the OR/intervention room and also for connecting the anesthesia machine to the surgical table for utilities, communications, control cables, etc. A control system for controlling the anesthesia machine may be at a remote location so that several patients may be monitored at the same time. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0016]    The foregoing aspects and many of the attendant advantages of this invention will become more readily appreciated as the same become better understood by reference to the following detailed description, when taken in conjunction with the accompanying drawings, wherein: 
           [0017]      FIG. 1  is a schematic view of patient flow when utilizing a high volume OR/intervention room of the present invention. 
           [0018]      FIG. 2  is a schematic diagram of patient flow utilizing a high-acuity OR/intervention room of the present invention; 
           [0019]      FIG. 3  is a schematic layout of a hospital or clinical setting in accordance with the present invention; 
           [0020]      FIG. 4  is a perspective view of universal patient rooms in accordance with the present invention; 
           [0021]      FIG. 5  is a perspective view of several high volume OR/intervention rooms with adjacent intubation and extubation rooms in accordance with the present invention. 
           [0022]      FIG. 6  is a perspective view of an extubation room flanked by intubation rooms on either side in accordance with the present invention; 
           [0023]      FIG. 7  is a partial perspective view of a portion of an intubation room; 
           [0024]      FIG. 8  is a perspective view of two side-by-side high-volume OR/intervention rooms; 
           [0025]      FIG. 9  is a perspective view of the area above the OR/intervention rooms of  FIG. 8 ; 
           [0026]      FIG. 10  is a perspective view of a portion of the OR/intervention room of  FIG. 8 ; 
           [0027]      FIG. 10A  is a fragmentary elevational view of a ceiling light of the present invention; 
           [0028]      FIG. 10B  is a fragmentary elevational view of a connector hub to supply medical gases, vacuum source, electricity, data, and other utilities to the OR/intervention room; 
           [0029]      FIG. 11  is a perspective view of a high-acuity OR/intervention room; 
           [0030]      FIG. 12  is a perspective view of the area above the OR/intervention room of  FIG. 11 ; 
           [0031]      FIG. 13  is a perspective view of a portion of the OR/intervention room of  FIG. 8  shown partly in cross-section; 
           [0032]      FIG. 14  is a further perspective view of a portion of a high-acuity OR/intervention room illustrating the intervention zone created by the present invention; 
           [0033]      FIG. 15  is an isometric view of a surgical table in accordance with the present invention with an anesthesiology machine dock thereto; 
           [0034]      FIG. 15A  is a side elevational view of a surgical table with an anesthesia machine docked therewith, the anesthesia machine is connected to a floor hub to supply medical gases, a vacuum source, electricity, data and other utilities to the anesthesia machine. 
           [0035]      FIG. 15B  is an enlarged, fragmentary view of  FIG. 15A , showing the connection hub in larger scale. 
           [0036]      FIG. 16  is the view similar to  FIG. 15  but with the anesthesia machine dedocked therefrom; 
           [0037]      FIG. 17  is a perspective view of a typical robot used in conjunction with the present invention. 
           [0038]      FIG. 18  is a perspective view of a portion of an OR/intervention room, looking upward toward a drop-down ceiling portion that defines the surgery/intervention zone; 
           [0039]      FIG. 19  is a view similar to  FIG. 18 , but taken in a downward direction; 
           [0040]      FIG. 20  is a cross-sectional view of the drop-down ceiling portion of  FIG. 19 . 
           [0041]      FIG. 21  is a view of the drop-down ceiling portion of  FIGS. 18-20 , looking upward from below. 
           [0042]      FIG. 22  is an enlarged, fragmentary view of  FIG. 21 ; 
           [0043]      FIG. 23  is a side elevational view of one of the controllable light assemblies utilized in the drop-down ceiling of  FIGS. 18-21 ; and 
           [0044]      FIG. 24  is a view similar to  FIG. 23 , showing the light assembly tilted at an angle. 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
       [0045]      FIGS. 1 and 2  schematically illustrate patient flow utilizing the present invention. These figures will be discussed more fully below. 
         [0046]    Next, referring to  FIG. 3 , a hospital layout  30 , in accordance with one embodiment of the present invention, is illustrated. The layout includes a lobby area  32 , a portion of which may be occupied by a retail sub-area  34  offering flowers, gifts, toiletries, and other products, as in a typical hospital. Public/family support area  36  is adjacent to the lobby. In this area, family members can meet with hospital personnel to discuss/conduct administrative matters and consult regarding procedures being carried out or to be carried out. Also, waiting areas and restrooms may be provided. Concierge stations  38  are also located in the lobby adjacent to universal patient rooms  40  that are arranged in two rows on the opposite side of a center courtyard  42 . A nursing support area  44  is located at the opposite end of the courtyard from the public/family support area  36 . Nursing stations, a lounge, lockers, and other facilities for medical staff are in the support area  44 . 
         [0047]    A series of high volume intervention or operating rooms  46  and a series of high-acuity intervention or operating rooms  48  are located adjacent the nursing support area  44 . A series of imaging procedural rooms  50  are located adjacent or between the OR/intervention rooms  46  and  48  to create imaging suites. As discussed more fully below, the imaging procedural rooms and OR/intervention rooms share CT, MRI, and other imaging equipment. OR/intervention room Intubation rooms  52 , as well as extubation rooms  54 , are located adjacent to the high volume OR/intervention rooms  46 . A corridor  56  extends around the OR/intervention rooms and the intubation and extubation rooms and between rows of patient rooms  540 . The structure and use of universal patient rooms  40 , high volume OR/intervention rooms  46 , and corresponding intubation and extubation rooms  52  and  54  and high-acuity OR/intervention rooms  48  are described in further detail. 
         [0048]      FIG. 4  illustrates two universal patient rooms  40 , positioned side by side. Such patient rooms are located closely adjacent to the OR/intervention rooms  46  and  48  and are designed to eliminate several separate rooms or stations currently used for patient care between admission and discharge. Patients are initially met at the concierge station  38  and then taken directly to the universal patient rooms  40  for admission and preparation prior to the surgical/intervention procedure. From the patient room  40 , the patient is taken either to an intubation room  52  or directly to a high-acuity OR/intervention room  48 . Family members may be with the patient in rooms  40 . 
         [0049]    As shown in  FIG. 4 , the patient rooms  40  may include a bed  60  and a lounge area  61  furnished with a couch  62  or other types of seating furniture for the patient or family members. The rooms  40  are also configured with a desk surface  64  and desk chair  66  for use by the patient and/or family members. Toilet and bathing facilities  68  are provided for each of the universal patient rooms. A large screen monitor  70  is provided to display applicable physiological data of the patient being monitored, as well as to serve as a patient television for education, ordering of meals, and entertainment. 
         [0050]    As noted above, patients are taken from universal patient rooms  40  directly to an intubation room immediately prior to a procedure to be performed in a high volume OR/intervention room  46 , or directly to a high acuity OR/intervention room  48 . After the procedure is completed, patients are returned directly to the universal room  40  from either the high-acuity OR/intervention room  48  or a high volume OR/intervention room  46 , or via an extubation room  54 . In the universal patient room  40 , the patient is reunited with family members after an initial recovery period (Stage I Recovery) The patient remains in the universal patient room  40  during the recovery period and until discharged. The patient may be discharged directly from the universal patient room  40 , rather than having to be transported to a separate inpatient bed unit or discharge station/area. 
         [0051]    The use of the universal patient room  40  reduces the number of patient transports needed, thereby enhancing not only patient safety and reduced anxiety, but also operation efficiency, as well as reduction of potential medical errors. As a result, the satisfaction of both patients and medical staff is increased. To meet these goals, the universal patient rooms need to be “acuity adaptable.” In other words, the patient rooms must be able to accommodate a variety of activities, from an intensive care level, after an organ transplant, to a more traditional patient room, for example, for a patient recovering from surgery for a broken arm. The patient room is capable of accommodating the equipment and monitoring devices needed for intensive patient care. 
         [0052]    Next, the high volume OR/intervention rooms  46  and associated intubation rooms  52  and extubation rooms  54  will be described with reference to  FIGS. 5-10 .  FIG. 5  illustrates a series of high volume OR/intervention rooms  46  positioned in side-by-side pairs and separated by a common wall  80 . As also shown in  FIG. 5 , a singular extubation room  54  is positioned at the end of common wall  80  to serve both of the two OR/intervention rooms  46 . An intubation room  52  is located on opposite sides of the extubation room  54  so as to be adjacent a corresponding OR/intervention room  46 . A scrubbing station  82  may be located along each side of the intubation rooms  52  opposite the extubation room  54 . Also an equipment room  84  may be located between adjacent sets of OR/intervention rooms  46 . Of course, rooms for other purposes may also be positioned between the sets of OR/intervention rooms  46 . 
         [0053]    Next, referring to  FIG. 6 , one extubation room  54  is illustrated as positioned between two intubation rooms  52 . As described above, the extubation room  54  is shared by two adjacent OR/intervention rooms  46 . Some of the activities/tasks currently carried out in the OR/intervention room are instead performed in the intubation and extubation rooms  52  and  54 . A patient is prepped and induced in the intubation room while the previous procedure is being completed in the OR/intervention room and while the OR/intervention room is being cleaned and prepared for the patient. In this regard, the intubation room, as noted above, is located directly adjacent an OR/intervention room. Also in the intubation room, the patient is placed on a surgical table  90 , which is then simply rolled into the adjacent OR/intervention room and used during the procedure. As discussed more fully below, the surgical table includes an anesthesia unit  92  that docks to the surgical table and remains with the table until the patient has been extubated after the procedure. The patient is anesthetized in the intubation room so that the procedure may begin immediately upon the patient being moved to the OR/intervention room. 
         [0054]    As shown in  FIG. 7 , the OR/intervention room may include a large wall screen display  100  on which the patient&#39;s physiological condition, including vitals, can be displayed in large format. Also, digital X-rays, the results of prior CT scans, or MRIs can be shown on the screen display  100 . The intubation room may include other screens, for example, the ceiling  102  of the room can display various scenes, for instance the sky, even the condition of the actual sky outside of the hospital clinic. Another wall  104  of the intubation room may display a television screen or a video screen for the comfort and/or distraction of the patient. Once the patient has been prepared and the OR/intervention room has been turned over, the patient is moved directly into the OR/intervention room for the start of the procedure. 
         [0055]    After the procedure has been completed, the patient is immediately moved to the extubation room to be awakened and extubated. This allows the OR/intervention room to be immediately cleaned and readied for the next patient. As a consequence, the OR/intervention room can be used for more procedures than in a conventional or existing hospital or clinic, especially when the OR/intervention room is being used for interventions of less than about two hours duration. Such interventions may include, for example, orthopedic, general, urological, ENT, ophthalmological or plastic procedures. 
         [0056]    As in the OR/intervention room, the extubation room may include a large format screen display on one of the walls  106  of the room to display the physiological condition of the patient. Also, the room is equipped to provide medical cases, fluids, medication, etc., to the patient. In the room, the patient may be lying on the same surgical table previously used in the OR/intervention room and the intubation room. This reduces having to move the patient from a procedure surface to a recovery surface and then a transport surface. 
         [0057]    From the extubation room, the patient is returned to the same room  40  where the patient was admitted. The patient will recover and remain in the same room  40  until discharged. 
         [0058]    The OR/intervention room  46  will now be described with reference to  FIGS. 8 ,  9 , and  10 ,  10 A and  10 B. As shown in  FIGS. 8 and 9 , two OR/intervention rooms  46  are located side-by-side. This enables the two OR/intervention rooms to share an extubation room  54 . However, more than two OR/intervention rooms may be positioned side-by-side to each other. 
         [0059]    One severe problem with current OR/intervention rooms is that there is so much equipment, tables, booms, cords, and tubes leading to and from the patient and monitors, devices, etc., that mobility around the patient may be very difficult, and in fact dangerous. The present invention establishes a surgery/intervention zone of a defined size around the patient that is free from articulating arms for monitors, lighting, equipment, etc., free from hose drops and utility columns from the ceiling, or other electrical, data, medical gases, vacuum, or evacuation lines, tubes, and cords. Such surgery/intervention zone may be of a select size, for example, a 20-foot diameter. This establishes an unobstructed sterile zone for the surgery/intervention team to freely and efficiently function within. 
         [0060]    To establish the surgery/intervention zone, medical gases, electrical and data outlets, vacuum lines, evacuation lines, and communication lines, are brought into the OR/intervention room through an interstitial space located in the floor for connection to the base portion of the surgical table  90 . A connector hub assembly  107  for such medical gases, utilities, data, communications, vacuum, and evacuation, as shown in  FIG. 10B , is located centrally in the surgery/intervention zone for automatic and secure connection to the base  244  of the surgical table  90  when the surgical table is positioned over the connector hub assembly.  FIG. 10B  shows various lines that enter into the OR/intervention room  46  through a sleeve  108  in the floor  142 . The lines can include, for example, a vacuum line  110 , a power line  111 , a gas line  112 , and a data line  113 . Additional or alternative lines can be provided for other fluids and purposes, such as oxygen or nitrous oxide. Preferably, the sleeve and lines  110 - 113  are hermetically sealed at the floor  142 . 
         [0061]    Continuing to refer to  FIG. 10B , the hub assembly  107  includes a connection collar  114  for securely supporting the ends of the lines  110 - 113 . The connection collar  114  can be received in close registry within an indexing socket or cavity  115  at the bottom of the table base  244 , so that the terminal ends of line  110 - 113  are disposed in registry with the lower ends of corresponding lines  110 A,  111 A,  112 A and  113 A, having associated connectors  110 B,  111 B,  112 B, and  113 B. The connectors  110 B- 113 B may be powered or otherwise configured to automatically engage with the corresponding ends of lines  110 - 113  when the collar  114  is properly indexed with socket  115 . The present invention also contemplates a digital monitoring system  116  for receiving lines  110 A- 113 A, and for monitoring and controlling the gas, liquid or other fluid or data or electricity flowing through such lines. 
         [0062]    Although the hub assembly  107  is illustrated as utilized in conjunction with the base  244  of the surgical table  90 , alternatively or in addition, the same or similar hub arrangement may be utilized in conjunction with the anesthesia machine  92  when docked with the surgical table  90 , as discussed below. Also, when the surgical table  90  and/or anesthesia machine  92  is disengaged from hub assembly  107 , the adjacent ends of the lines  110 - 113  and  110 A- 113 A are automatically closed to prevent gas/liquid/data flow or contamination. 
         [0063]    Alternatively, the water-tight collar  114  may be flush with the floor surface when not in use to permit unobstructed cleaning of the floor between cases. The collar may be motorized to raise automatically from the floor surface for quick connection and disconnection to the utility portals in the surgical table. 
         [0064]    To establish a surgical/intervention zone, the OR/intervention room  46  is free from the typical lights mounted on articulated arms suspended from the ceiling. Such arms are difficult to manipulate and create barriers between medical personnel, as well as block sightlines of the personnel. Moreover, such arms, as well as the lighting fixtures themselves, interfere with the laminar airflow over the surgical/intervention site, as discussed more fully below. 
         [0065]    In the present situation, multiple lights  118  are positioned in recesses  120  formed in the ceiling. The lights may be of various types, including, for example, halogen or xeon lights. As shown in  FIG. 10A , the lights  118  may include a bulb  122  mounted in a socket assembly  124 . A high performance reflector  126 , for instance a cold mirrored glass reflector, may be used to direct the light from the bulb  122 . The lights include individual mounting systems  128  that enable the direction of the lights to be moved or manipulated, and focused as desired. For example, the light  118  can be tilted and swiveled about the mounting system to direct the light as desired. Actuation of the mounting systems may be by microchip-driven radio frequency controls or other types of controls positioned in the glove of surgical/intervention room personnel to enable the lights to be aimed and focused as desired as well as the intensity of the light to be varied. Rather than being mounted on a glove, the microchip controls can be mounted in other locations, such as on a wrist band, or head band of OR/intervention room personnel. 
         [0066]    The light controls can also be tied to a radio frequency identification device or tag that can be embedded in or mounted on a clamp or other device located within the surgical/intervention zone that would remain static in the area during the procedure. Further, the lights can be pre-set by an automatic lighting system based on the procedure being performed. In this regard, the positioning of the lights can be programmed using a wall panel or remote control unit, or controlled from a central computer system. Additionally, or alternatively, the lights can be voice actuated. Lights of the nature of the present invention are articles of commerce, but retrofitted with special high intensity bulbs capable of achieving optimum focal length from the surface of the OR/intervention room ceiling to the surgical/intervention site. As shown in  FIG. 10 , substantially the entire ceiling portion of the intervention zone is covered with openings  120  for placement of the lights for the present invention. 
         [0067]    As mentioned previously, in current OR/intervention rooms, light fixtures, utility cord drops, and other items obstruct the laminar air flow from the ceiling of the OR/intervention room to the surgical/intervention site This situation is corrected by establishing the surgical/intervention zone in the OR/intervention room, including by eliminating typical boom-mounted light fixtures. As a consequence, air can be introduced into the OR/intervention room through openings  120  similar to those used for the lights, and the air can flow, unobstructed, in a laminar manner down to the surgical/intervention site and out through exit outlets  140  located about the OR/intervention room near the floor  142 . 
         [0068]    As shown in  FIGS. 5 and 9 , relatively deep wells  144  are formed in the interstitial space above the ceiling of the OR/intervention room where the ventilation air that is routed downwardly into the OR/intervention room through ceiling panel diffusers using openings  120 . Use of the ventilation wells  144  ensures that a uniform flow of ventilation air is supplied to the entire volume of the OR/intervention rooms, so that no significant “dead air” space exists. Moreover, with the elimination of lighting fixtures, equipment, etc., from the intervention zone, air flow eddies are eliminated within the laminar air flow to the surgical/intervention site. 
         [0069]    Other sources of “congestion” in the OR/intervention room are the various monitors used to display physiological data of the patient, anesthesia data, as well as for image guidance, for example, during laparoscopic surgery or other procedures that utilize endoscopic cameras. Moreover, these monitors and display screens block light from the typical lighting fixtures used in OR/intervention rooms, as well as block the flow of ventilation air. Such monitors currently typically are mounted on articulating booms suspended from the ceiling within the surgical intervention zone. 
         [0070]    In accordance with the present invention, a plurality of large flat screen monitors  160  are arrayed outside of the surgical/intervention zone. In this regard, see also  FIG. 14  which illustrates a high-acuity OR/intervention room  48 . The monitors are suspended from arms  162  that suspend downwardly from a rail system extending around the perimeter of the OR/intervention room outwardly of the intervention zone. The monitors may be of various types, such as plasma screen monitors, LCD screen monitors, etc. The important point is that the monitors  160  are of a size and high resolution so that their content may be easily viewed by the personnel in the OR/intervention room. The monitors include screens  164  that are supported by a mounting structure  166  that enables the screens to be adjusted both vertically and horizontally. In addition, the mounting structure  166  can be designed to enable the screens  164  to be rotatable about a vertical axis, and also about a horizontal axis for better viewing by personnel. To this end, the mounting structure  166  may include upper and lower tracks  168  and  170  as well as vertical end tracks  172  for guiding horizontal and vertical movement of the screens  164 . Alternatively, the mounting structure  166  may be designed to move vertically relative to arms  162 . The position of the screens can be controlled by voice command. The content of the screens can also be controlled by voice command. Moreover, the instruments and other devices that are being monitored on the screens  164  may also be controlled by voice command. Such control systems are articles of commerce. Voice recognition software is commercially available for use with voice command systems. The large screen monitor may be pre-programmed and arrayed for specific procedures and individual surgeon/interventionist preferences. 
         [0071]    To create the surgical/intervention zone, a perimeter ring or rail system  180  is formed in the ceiling of the OR/intervention room around a perimeter thereof. As shown in  FIG. 10 , arms extend downwardly from the rail system to support previously floor-mounted tables, equipment, and cabinets. For example, a vertical arm  184  is illustrated as extending downwardly from rail system  180  to support the distal end of a first horizontal articulating arm  186  which in turn is pivotally coupled to a second horizontal articulating arm  186 . A telescoping vertical arm system  188  extends downwardly from the proximal end of horizontal arm  186 . The corners of two vertically spaced apart upper and lower shelves  190  and  192  are coupled to telescoping arm  188  by collar assemblies  194 . The collar assemblies allow the shelves  190  and  192  to pivot relative to telescoping arm assembly  188  and then lock in position once the position of the shelves is as desired. A telescoping arm assembly  188  enables the shelves  190  and  192  to be raised and lowered as desired. When the shelves  190  and  192  are not in use, they can be removed beyond the intervention zone by rotation of horizontal arms  184  and  186 . The movement of such arms, as well as the operation of telescoping arms  188 , can be controlled by various means, such as a remote control device. Also, the movement of such arms can also be controlled by voice command. 
         [0072]      FIG. 10  also illustrates cabinet  200  which is mounted on a pair of horizontal articulating arms  202  and  204 , which in turn are supported by a vertical arm  206  that extends downwardly from track system  180 . The cabinet  200  may include shelves and drawers for storing various instruments, supplies, and other equipment. Cabinet  200  can be positioned by personnel at desired locations by remote control or by voice command, in the manner of the shelves  190  and  192 . As with the shelves  190  and  192 , the cabinet  200  can be moved out of the way, and outwardly of the surgical/intervention zone, when not in use. 
         [0073]    Referring to  FIG. 14 , utilities needed for cauteries, lasers, drills, and other accessories may be stationed remote from the surgical/intervention zone as a secondary utility distribution system from that provided in the floor  142 . Such utilities can be provided in a vertical arrayed mounting system  210  which illustrates various medical gas, electrical, data and communications outlets  212 - 222 . Such outlets will supplement corresponding outlets provided in the floor of the OR/intervention room beneath the table  90 . It will be appreciated that the above described lighting system, monitors, table supports, cabinet supports, and auxiliary utilities allow elimination of virtually all ceiling and floor mounted obstructions in the surgical/intervention zone. Moreover, they also keep the floor free from obstructions whereby the floor can be cleaned by automated robots, described below. 
         [0074]    Next, describing the surgical table  90  in greater detail, referring specifically to  FIGS. 10 ,  15 , and  16 , in basic form, the table includes a top portion  240 , a pedestal portion  242 , and a base portion  244 . The top portion  240  is constructed in various sections, including a head section  246 , a shoulder section  248 , a torso section  250 , and a lower extremity section  252 . Each section may be pivotable or elevatable relative to the adjacent section. 
         [0075]    The retractable arm structures  254  and  256  are positioned at the head and foot of the tabletop  240 , on which are mounted outlets for all medical gases, vacuum source, evacuation source, electrical supply, data and communications that are brought into the OR/intervention room through the floor  142 , as described above. The arm structures  254  and  256  include connections that are made at an ergonomically correct height and then are rotatable downward to a position below the surgery intervention table surface so as to move out of the way and not be accidentally bumped. Also by locating the arm structures at the head and foot of the table  90 , the outlets are maintained clear of a sterile surgical drape which may be clamped on the sides of the patient. Further, an arm structure is accessible to the anesthesiologist located at the head of the patient. 
         [0076]    The medical gases, vacuum, utilities, data lines, tubes, and cords are routed to the arms  254  and  256  through pedestal  242  from the base  244 . As mentioned previously, the base has a connector assembly that connects with the connector hub located in the OR/intervention room floor  142 . In this manner, ceiling drops, columns, and articulating booms and cords to carry medical gases, vacuum, evacuation, electrical, and data to the location of the immediate patient area are eliminated. 
         [0077]    As previously discussed, the same table  90  is used to support the patient from the intubation room  52 , the OR/intervention room  46  and the extubation room  54 . As such, the surgical table  90  is provided with wheels in the base  244  to enable the table to be easily moved from place to place. As also mentioned above, an anesthesia machine  94  is configured to be dockable and dedockable to the table base  244 . The anesthesia machine  94  has quick disconnect fittings to connectors located on the table base  244  or pedestal  242 , which, in turn, are connected to the utility hub in the floor  142 . Anesthesia outlets may also be incorporated into the table arm structure  254  and  256 . By this construction, the anesthesia machine  94  is independently mobile relative to the table for cleaning and servicing. Moreover, the anesthesia machine may be controlled by an anesthesiologist or technician in a remote control room. As such, physical intervention and manipulation of the anesthesia machine in the OR/intervention room is not required. Of course, a nurse anesthesiologist may be present in the OR/intervention room to administer to the patient. However, the anesthesiologist can move from OR/intervention room to OR/intervention room or be located in a remote control room to monitor a number of patients at one time, thereby increasing efficiency of the anesthesiologist and safety of the patient. 
         [0078]      FIGS. 15A and 15B  illustrate an anesthesia machine  304 , docked with surgical table  90 , but with the anesthesia machine coupled to a hub assembly  307  in a manner similar to hub  107  coupled to the surgical table  90  shown in  FIG. 10B . In  FIGS. 15A and 15B  the components similar to those shown in  FIG. 10B  are given corresponding part numbers but as a “300” series. 
         [0079]    As in  FIG. 10B , in  FIGS. 15A and 15B  medical gases, vacuum lines, evacuation lines, electrical and data outlets and communication lines are interfaced with the OR/intervention room through an interstitial space located in floor  342  for connection to the base portion of anesthesia machine  304 . As in  FIG. 10B , a connector hub assembly  307  is utilized for such medical gases, utilities, data, communications, vacuum and evacuation. The connection hub assembly  307  includes a lower connection collar  314 A that is nominally disposed within a recess  309  formed in the floor  342 . The collar  314 A may be raised upwardly into engagement with a corresponding collar  314 B, positioned at the base portion of the anesthesia machine. The upward extension or downward retraction of the lower collar  314 A is via linear actuator  318  connected to the collar  314 A via push-pull rod  319 . 
         [0080]    As shown in  FIGS. 15A and 15B , the terminal ends of vacuum line  310 , power line  311 , gas line  312 , and data line  313 , are attached to connection collar  314 A. Connectors  310 C,  311 C,  312 C, and  313 C are provided for the lines  310 - 313 , which connectors are held securely by the connection collar. 
         [0081]    The lines  310 ,  311 ,  312 , and  313  are connectable to the lower ends of corresponding lines  310 A,  311 A,  312 A, and  313 A, which extend downwardly from the anesthesia machine to terminate at connectors  310 B,  311 B,  312 B, and  313 B, securely held by upper collar  314 B. As in  FIG. 10B , a control and monitoring system  316  is interposed in lines  310 A- 313 A for monitoring and controlling the gas, liquid or other fluids, or evacuation or data or electricity transmitted through such lines. Also, when lower connection collar  314 A is in retracted position within recess  309 , connectors  310 C,  311 C,  312 C, and  313 C automatically close off corresponding lines  310 ,  311 ,  312 , and  313 . 
         [0082]    When the anesthesia machine  304  is docked with surgical table  90 , lines  310 A,  311 A,  312 A, and  313 A automatically connect to corresponding lines  310 D,  311 D,  312 D, and  313 D of the surgical table  90 . To this end, a second set of connection collars  320  and  322  are provided between the anesthesia machine and the surgical table. The collars  320  and  322  automatically mate with each other upon the docking of the anesthesia machine with the surgical table, thereby to permit flow between lines  310 A- 313 A to corresponding lines  310 D- 313 D. As in connection collar  314 A, one or both of the connection collars  320  and  322  can be designed to extend forwardly or retract rearwardly to lock with the corresponding connection collar. When the anesthesia machine and surgical table are disengaged from each other, the adjacent ends of lines  310 A- 313 A and  310 D- 313 D are automatically closed to prevent gas, liquid, data, vacuum, electrical flow or contamination. 
         [0083]    As an alternative to the foregoing, when the anesthesia machine  304  is docked with surgical table  90 , a hub assembly similar to hub  307  can be used to connect utilities, gases, data, to the surgical table rather than to the anesthesia machine. In this option, when the anesthesia machine is docked with the surgical table, a connection system is utilized at the lower portion of the anesthesia machine to connect to the surgical table, in a manner similar to connection collars  320  and  322 . In this situation, the anesthesia machine controls the flow of gases and other utilities to and from the surgical table in a manner similar to that contemplated in the embodiment of the present disclosure shown in  FIGS. 15A and 15B . This may be a less desirable option than having the hub assembly  307  connectable to the anesthesia machine, since it requires that the surgical table also be configured to connect to the hub assembly, thereby duplicating the connection capabilities of the anesthesia machine. 
         [0084]    In  FIG. 15 , the anesthesia machine  94  is shown as supported on the floor  342  by wheels. As an alternative, when the anesthesia machine  304  is docked with surgical table  90 , the anesthesia machine could be carried by and supported by the surgical table. To this end, wheel channels or supports (not shown) could extend along the inside portions of rails  245  of base  244  of the surgical table to receive wheels  340  of the anesthesia machine  304 . 
         [0085]    Another source of expense and inefficiency in a typical hospital or medical clinic setting is that patients must be transported from OR/intervention rooms to remote locations where imaging equipment is located. Alternatively, the costly imaging equipment may be dedicated to a single OR/intervention room. The transport of the patient to a remote imaging room can increase the incident of medical errors and compromise patient safety. 
         [0086]    In accordance with the present invention, scanning equipment, for example, scanner  270 , shown in  FIGS. 8 and 10  may be brought into an OR/intervention room, as needed, by an overhead monorail system  272 , as shown in  FIGS. 8 and 9 . The monorail system allows the scanner  270  to be moved among a number of OR/intervention rooms for real time use during an intervention procedure. When not needed in an OR/intervention room, the scanner can be used for routinely scheduled diagnostic studies in imaging suites  50 , see  FIG. 3 . This enables the scanner to be used more efficiently than in existing hospitals and medical facilities. 
         [0087]    Various types of scanners can be employed in the mobile manner of the present invention, including CT scanners, MRI machines, fluoroscopy C-arm, ultrasound, and other types of scanners. As shown in  FIG. 10 , the scanner  270  is connected to the lower end of a vertical arm  274 , with the upper end of the arm connected to a powered carriage  276  which moves along the monorail system  272 . All required electrical and data services are provided by retractable cables. In the case of moveable MRI scanners, a telescoping duct system extends or retracts to exhaust cryogen gases in the event of an unexpected “quench” of the cryogen system. Appropriate retractable openings  278  can be formed in the walls of the OR/intervention rooms to allow passage of the vertical arm  274 . The imaging equipment can be controlled and operated by a logistics core, for example, located at the center of a number of OR/intervention rooms. This provides for efficient usage of imaging equipment personnel. 
         [0088]    Alternatively, the scanning device such as a CT or MRI scanner may be fixed in an imaging room positioned between two OR/intervention rooms. In this alternative, the patient is automatically transported from the surgical/intervention zone to the centrally located scanner on a commercially available surgical/intervention table. 
         [0089]      FIGS. 8-10  illustrate OR/intervention room  46 , which is specifically designed for relatively high volume usage, meaning for procedures of about two hours or less. To make maximum usage of the OR/intervention room  46  adjacent intubation and extubation rooms  52  and  54  are utilized, as described above.  FIGS. 12-14  illustrate the high-acuity OR/intervention room  48  which is used for longer and more extensive procedures than in OR/intervention room  46 . Such procedures may include, for example, orthopedic, general, craniofacial, cardiovascular interventions, neurological interventions and organ transplants. As such, intubation rooms and extubation rooms are typically not utilized with the high-acuity OR/intervention room  48 . However, in other respects, the OR/intervention room  48  is constructed and laid out similarly to the OR/intervention room  46  described above. Thus, like components and structures used in OR/intervention room  48  are given the same part numbers as the corresponding structure/components used in OR/intervention room  46 . As in OR/intervention rooms  46 , the high-acuity OR/intervention rooms  48  also utilize mobile imaging equipment  270 . Further, as in the high volume OR/intervention rooms, a surgical/intervention zone is established in the high-acuity OR/intervention rooms  48 . In addition, as in the high volume OR/intervention room  46 , the high-acuity OR/intervention room  48  includes a utilities hub in the floor of the room for connection to the base of the surgical table  90 . 
         [0090]    An area of hospital/clinical practice usage that has not kept pace with diagnostic and treatment technologies is materials logistics, supplying the instruments, equipment and other items needed in the OR/intervention room. These are typically delivered to the OR/intervention room manually and also removed from the OR/intervention room manually after usage. 
         [0091]    The present invention incorporates the use of robots to deliver case packs, supplies, instruments, etc., to the OR/intervention room and remove used linens, supplies, instruments from the OR/intervention room in an efficient and quick manner. Case packs and supply cabinets can be configured as part of a robot itself, for example, robot  300 , shown in  FIG. 17 . Also, the instrument  302  shown in  FIG. 14  may be incorporated into a robot. Such robots enter the room vertically by automatic cart lifts incorporated into the OR/intervention room, for example, along the perimeter thereof. The robots are delivered to the OR/intervention room from a logistics core, located at the center of a plurality of OR/intervention rooms. The deployment of the robots and their return to the logistics core can be completely or partially automated or controlled from the logistics core. The robots return soiled linens, instruments, equipment and waste to a decontamination area of Central Sterile Supply. 
         [0092]    Robots of the foregoing nature are articles of commerce. Such robots are available, for example, from PYXIS Corporation. Such robots may operate without fixed tracks or guidewires. Another robot is marketed under the designation Transcar Automated Guided Vehicles from Swisslog HCS. Such robots are able to efficiently travel from location to location, avoiding stationary moving objects. Some may need elevators or lifts. Such robots announce their arrival at a destination, signaling closed doors to open and maintaining communications with a central computer system. 
         [0093]    Instruments and re-usable supplies are frequently not available when needed in an OR/intervention room, often due to breakdowns in the logistics system. This may result in costly as well as dangerous or compromising delays during a procedure. As a consequence, greater inventories are often prescribed than actually needed, to compensate for such delays. The present invention contemplates tracking instruments and re-usable equipment with a radio frequency system, which is not affected by the sterilization process. Radio frequency tags may be mounted on, or incorporated into, such instruments and re-usable equipment. The location of such equipment can then be monitored or readily ascertained. As a consequence, instrument and re-usable equipment loss, as well as inventories, may be reduced, thereby resulting in lower operational costs, fewer or shorter delays, as well as reduced medical errors. Radio frequency tags are articles of commerce, as well as equipment from monitoring or reading such tags. 
         [0094]    In another aspect of the present invention, OR/intervention rooms, as well as intubation and extubation rooms, are automatically cleaned between uses. Currently, OR/intervention rooms are manually cleaned requiring a significant length of time. As such, if existing clean durations can be reduced significantly, the number of surgical interventions performed in an OR/intervention room per day can be increased. To this end, the present invention incorporates the use of several cleaning robots  304  that are housed in the OR/intervention room or in the intubation/extubation rooms, see  FIGS. 10 and 13 . Such cleaning robots are capable of dispensing a biocidal cleaning solution onto the floor and then scrubbing and vacuuming the floor thoroughly. Such robots have a biocidal cleaning solution storage compartment, scrub brushes, a vacuum system, and a waste bin for collecting the used cleaning solution and other debris or items removed from the OR/intervention room floor. Waste cleaning solution and debris are automatically purged from the cleaning robots in their docked position. Cleaning robots somewhat similar to robots  304  are available from iRobot Corporation. 
         [0095]    After cleaning by the cleaning robots, a biocide aerosol is dispensed into the OR/intervention room through ports in the ceiling. The aerosol decontaminates all surfaces of the OR/intervention room. The aerosol is exhausted from the OR/intervention room through the exhaust ports  140  located near the floor. The biocide aerosol is non-hazardous to humans, though typically staff will not be in the room during the cleaning process. Applicants estimate that the time for cleaning an OR/intervention room using the foregoing equipment and process to be reduced to about two minutes. This dramatically shortens cleaning time over current manual procedures. 
         [0096]    A further aspect of the present invention to improve the quality and efficiency of hospital/clinical procedures is to utilize an automated hand/arm scrubbing system. Currently, manual scrubbing by the intervention team takes at least eight minutes. The present invention contemplates utilizing an automatic scrubber system, not shown, utilizing power brushes to gross clean the hands and arms of the surgical/intervention team members. The system could include efficient powered brushes to reach all areas of the users hands, fingers, and arms, as well as a biocide cleaning solution and sterile water for rinsing. The system also contemplates a self-cleaning system for the brushes after usage. After gross cleaning by the brushes, final cleaning occurs by the application of a biocidal solution, for instance, by spraying such solution onto the hands and arms of the user. Using the foregoing equipment and procedure, it is estimated that the time required for scrubbing can be reduced from eight minutes to approximately two minutes with greater effectiveness. 
         [0097]    Alternatively, the hand wash system may not utilize brushes, but instead numerous rotating nozzles that automatically spray water and anti-bacterial solution on the hands and under the fingernails. Thereafter, the hands are rinsed with non-irritating, high-pressure water spray, and then dried with a built-in air dryer. Alternatively, paper towels can be used for drying. Such hand washers are articles of commerce, for example, available from Meritec, Inc., of Centennial, Colo. 
         [0098]    Referring to  FIG. 1 , the method of the present invention is schematically illustrated. In accordance with the method, a patient is received at a medical/clinical facility at the concierge area  38  by personnel having information about the patient, the intervention to take place, and the schedule of the intervention. The patient is taken to a universal patient room  40 . Here the patient can be admitted, and pre-preparation tasks performed. Also in the patient room, family members may be present. From the patient room  40 , the patient is taken to the induction room  52  for induction tasks performed, including, for example, attachment of monitoring and fluid lines to the patient, performing anesthesiology on the patient, and carrying out final pre-intervention preparation of the patient. In the next step the patient is transported to the OR/intervention room  46 , where the intervention is performed. As noted above, such interventions typically are of relatively short duration, typically two hours or less. After the intervention, the patient is transported to an adjacent extubation room  54  for extubation of the patient, including awakening the patient and possibly removing monitoring and fluid lines from the patient. Next, the patient is returned to the patient room for recovery. The patient room, as noted above, is adaptable to the acuity level required for the patient, from high level intensive care to traditional low level recovery and rest. Subsequently the patient is discharged directly from the patient room. 
         [0099]      FIG. 2  is a schematic flow diagram similar to  FIG. 1 , but for high acuity interventions, wherein the intubation room  52  and extubation room  54  are not utilized. Rather, the patient is taken directly from the patient room  40  to the high acuity OR/intervention room  48  for performance of the intervention procedure. Thereafter the patient is taken directly from the OR/intervention room back to the patient room  40  for recovery. 
         [0100]    Next, referring to  FIGS. 18 ,  19 , and  20 , a further disclosure of an OR/intervention room  400  constructed and operationally very similar to the other OR/intervention rooms of the present application. The OR/intervention room  400  includes a drop-down ceiling structure  402  which is shown as being circular in shape to define the surgery/intervention zone around the patient that is free from articulating arms, from monitors, lighting, equipment, etc., and also free from hose drops and utility columns from the ceiling or other electrical, data, medical gas, vacuum or evacuation lines, tubes, or cords. The surgical/intervention zone may be of a selected size defined by the size of the drop-down ceiling structure  402  which may be from, for example, 10-20 feet in diameter. As previously discussed, this establishes an unobstructed sterile zone for the surgery/intervention team to freely and efficiently function within. 
         [0101]    As shown in  FIGS. 18-20 , the drop-down ceiling structure  402  extends downwardly from the ceiling height of the rest of the OR/intervention room  400 , with the ceiling height of structure  402  being, in one disclosure of the present application, approximately 7.5 feet above the floor. Of course, this height may be varied somewhat, for example in the range of about 7 feet to 8 feet above the floor. The lowered height of the ceiling structure  402  has advantages in providing a better focal length for the lighting of the OR/intervention room, as discussed more fully below, and requiring a shorter distance for the ventilation air to flow from the ceiling structure to the floor and then out of the OR/intervention room  400 . 
         [0102]    As previously mentioned, in conventional OR/surgical sites, lights are mounted on booms directly over the surgical site. These lights must be positioned manually by the surgeon or scrub nurse. Also, the suspended lights and boom obstruct the work zone. In addition, the lights and their support beams dramatically disrupt laminar flow of the ventilation air. Further, particulates and squames collect on the lights and the support beams, including during the time that the OR/surgical site is not in use, and then are drawn into the surgical site by the laminar ventilation flow. These drawbacks are substantially reduced, or even eliminated, by the OR/intervention room  400  and drop-down ceiling  402  that promote laminar air flow for the entire distance from the ceiling, to the surgical site, and then to the floor. 
         [0103]    Also, the typical ten-plus-foot high ceilings in existing OR/surgical sites (necessitated by surgical light beams) enable cold air from the ceiling to accelerate in the downward air flow direction due to gravity. Air supplied at 30 feet per minute at the ceiling can accelerate to 90 feet per minute at the surgical site. This relatively high velocity air can overcome the “thermal plume” from the surgical wound and impinge contaminated particles into the wound site. 
         [0104]    Also, the heat disseminated from typical surgical lights can cause the surgical staff to require lower ambient room temperatures for their comfort. For example, the supply air at the ceiling can be from about 5 to 15 degrees cooler than the ambient temperature. The requirement for lower ambient temperature due to heat from typical surgical lights, and the increase in laminar air flow velocity due to the ten-foot-plus high ceiling, can create a condition of hypothermia at the wound site. It has been documented that achieving nomothermia at a wound site can enhance healing and reduce the risk of surgical site infections. Thus, laminar air flow systems in typical OR/surgical sites can result in less than optimal conditions and may contribute to increased risk of surgical site infections. 
         [0105]    The OR/intervention room  400  with its drop-down ceiling structure  402  also leads to “reduced age” of the air for the entire OR/intervention room generally, and also at the surgical site. Studies have shown that the age of the air in the OR/intervention room  400  is about 16% less than in a typical OR room with 10-foot-plus high ceilings. This reduced length of time air remains in the OR/intervention room  400  reduces the likelihood that the air is simply recirculating in the OR. It also reduces the possibility that the air at the surgical site comes from entrainment. 
         [0106]    The drop-down ceiling structure  402  includes a perimeter sub-substructure  404  that defines the outer perimeter of the ceiling structure. A support grid  406  (see  FIGS. 22 and 23 ) is supported by the lower portion of the perimeter substructure  404  which in turn supports a diffuser in the form of a perforated stainless steel ceiling panel  408 . The support grid may be composed of inverted “T” members or structural members of other shapes. The ceiling panel  408  serves as a laminar airflow diffuser so that the uniform, laminar flow of ventilation air is supplied to and flows downwardly through the surgical zone. This uniform laminar air flow system reduces, or even substantially eliminates, any dead air spaces or air flow eddies that commonly occur in conventional OR/surgical rooms. 
         [0107]    The perforated ceiling panel diffuser  408  supports a HEPA or other type of filter  410 , see  FIGS. 23 and 24 . Of course, the HEPA filters may be alternatively located upstream. The ceiling structure also includes a diffuser housing  425  spaced above the diffuser in the form of panel  408 ). An insulation layer  414  overlies the upper panel  412  of the diffuser housing  424 . The insulation layer can be composed of an appropriate material for heat and noise insulation. The ceiling structure is supported by a series of spaced apart support beams  415  that span across the ceiling  402  of the OR/intervention room, see  FIG. 20 . The beams  415  can be composed of structural channels, I beams or numerous other structural shapes and types that are sufficient to support the ceiling structure. 
         [0108]    Referring specifically to  FIG. 20 , ventilation air for the OR/intervention room  400  is supplied from a building source to large ducts  420 . The ducts  420  are attached to the building source ducts by a “quick connect” coupling apparatus pre-installed on both components for convenient and rapid installation. A series of branch distribution ducts  422  direct the ventilation air from ducts  420  downwardly and exhaust the ventilation air through volume control dampers  423  and old exhaust nozzles  424  at a location above ceiling diffuser panel  408 . The distribution ducts  422  are arranged about the area of the diffuser  408  to provide substantially uniform flow of laminar air downwardly through the surgical site. Of course the volume, temperature, and other aspects of the air can be automatically or manually or semi-automatically controlled. As noted above, the reduced height of the ceiling structure  402  results in a shorter distance that the ventilation air flows from diffuser housing  424  and diffuser  408  to the floor, thereby enhancing the ability to provide laminar air flow through the surgical zone than if the air were required to flow downwardly from the full height of the OR/intervention room, typically at least 10 feet. 
         [0109]    Referring additionally to  FIGS. 21-23 , the series of light assemblies  430  are spaced about the area of ceiling panel  408 . Several light assemblies  430  are clustered about the central portion of the ceiling panel to provide increased light at the surgical/operational site. The lights may be of various constructions. In  FIGS. 22-24 , such lights are shown as composed of an array of LED lights  432 , each having a high performance reflector  434 . The lights  432  and corresponding reflectors  434  are mounted on a carrier  436 , which in turn is mounted on a yoke  438  to pivot about pivot axis  442 . A servomotor  444  acts through a linkage assembly  446  to pivot the carrier  436 , and thus lights  432 , about axis  442 . 
         [0110]    The yoke  438  is in turn carried by a shaft  450 , which may be rotated by a second servomotor  452 , thereby to rotate the yoke about axis  454 . The servometer  452  is mounted to and carried by a housing  456  constructed from perforated aluminum or other suitable material that can serve to mount the light assembly  430  rigidly to ceiling structure  402  and provide ventilation to remove the heat generated by the lights  432 . As noted above, such removal of the heat from the lights can significantly improve the thermal conditions in the OR/intervention room  400 . Rather than perforations, other types of ventilation openings can be used. Through the operation of the two servomotors  444  and  452 , the lights  432  may be pivoted about a dual axis to enable the lights to be aimed at a desired direction, see  FIG. 24 . 
         [0111]    A combination optical lens and dust-proof cover  460  is generally semi-circular in shape to cover the lights  432  as well as provide a desired directionality and focal length for the lights. The cover  460  mates with the housing  456  to protect and encase the internal components of the light assemblies  430  described above. As noted above, the drop-down ceiling structure  402  places the light assemblies  430  closer to the operational site than if the light assemblies were positioned at a higher elevation, as in present typical operating rooms for example, the elevation of ambient lights  470 , as shown in  FIG. 18 . 
         [0112]    The intensity and direction of lights  432  can be individually controlled or controlled in groups or collectively controlled to not only aim the light in desired direction(s), but also change the intensity and color temperature of the of the LED lights. Such control can be carried out by systems described above, including microchip-driven radio frequency controls, controls positioned in or on the glove of surgical/intervention room personnel, on a wrist band or head bank worn by surgical/intervention room personnel, or controlled by voice actuation. In addition, as described above, the controls for lights  432  can be tied to a radio frequency identification device or tag that can be imbedded in or mounted on a surgical tool or other device, located within the surgical/intervention zone, that would remain in static position during the procedure being conducted. Also, the lights can be pre-set by an automatic lighting system based on the procedure being performed. In this regard, the positioning of lights can be programmed using a wall panel or a remote control unit, or controlled from a central computer system or controlled by voice actuation. 
         [0113]    The OR/intervention room  400 , as in the other OR/intervention rooms of the present disclosure, includes a support ring or rail system  480  formed in the ceiling  482  of the room, see  FIGS. 18 and 20 . As in the rail system  180  discussed above, arm assemblies  484  extend downwardly from the rail system to support previously floor-mounted cabinets  486 , tables, equipment, etc. The arm assembly  484  may be constructed to telescope upwardly and downwardly, and also includes articulating horizontal arms to move the cabinet  486  closer or further from the center of the surgical zone. Such movement can be controlled by remote-controlled device, including by voice actuation. As shown in  FIGS. 18 and 20 , additional arm structures  488  are provided for mounting monitors  490 . The arm structure  488  is illustrated as being telescopically extendable downwardly or retractable upwardly. The monitor  490  could be mounted on other types of arm assemblies, including arm assembly  484 , or arm assemblies described above and illustrated in other figures of the present disclosure. The rail system  440  also may be used to support a utility supply system, such as similar to system  210  shown in  FIG. 14 . 
         [0114]    Although the drop-down ceiling structure is shown as circular in shape, it can be of other shapes, such as oval, triangular, square, or rectangular. Also, the drop-down ceiling structure and the associated lighting, ventilation, and other components described above can be pre-manufactured in an off site factory environment and subsequently installed in the OR/intervention room  400  as substantially a unitary product. For example, the unitary ceiling structure  402  can be designed to be attached to ceiling beams  414  by any number of standard attachment methods, such as by bolting or welding. 
         [0115]    The foregoing has described a number of advances in the structure, construction and usage of hospital/clinical facilities for performing of surgery interventions. It is to be understood that some or all of the foregoing advancements can be utilized in a particular situation. Also, although specific examples of the foregoing structures, apparatus and methods have been described, the present invention is not limited thereto.