An Evidence-based Study on Traffic Flow in Operation Theater
Authors: Saraswati SV 
Published: March 2017

ABSTRACT

Introduction
An unusual amount of brisk and continuous traffic of people as well as goods crisscrossing every zone of the theater was noticed at an operation theater (OT) of a cardiothoracic center. Many storage areas were filled with cartons of various sizes which are good media for fungi and bacteria. Interactions with the theater staff and a study of the stores revealed that the traffic of people and goods was interconnected, and improper stores management was the root cause of the increased traffic. The focus of this study was to identify possible reasons for unusual traffic in the OT and to arrive at solutions in an objective manner for optimizing it.

Aim
The aim was to assess the traffic flow in an OT with the purpose to devise and implement measures for optimal and even flow of traffic during surgery and to create an additional operating room (OR) and instrument room and to improve the overall indoor air quality (IAQ).

Materials and methods
Scholarly articles regarding ventilation, traffic flow, and inventory management were reviewed along with information available onsite. The method of descriptive study was adopted. Data were collected after analyzing the traffic flow charts, prestudy questionnaire, nonstructured interview results, and nonparticipant observation study. Tools for the study included: (1) Anecdotal evidence, (2) checklists, and (3) rating scales of three different groups. Compliance levels of five different categories of people in the OT were assessed. Air efficiency microbial culture studies and wound swab cultures were carried out during and postimplementation.

Results
The process also resulted in generation of optimal traffic of staff and goods inside the ORs and decreased air turbulence, collateral benefits, such as (1) creating space for an additional OR, (2) creating a sterile area for storage of instrument packs, (3) optimal space management by segregation of bulk stores, (4) organized inventory control and indenting, and (5) good ventilation in ORs. Changes made in administration and training program increased awareness and compliance levels among staff. No surgical site infection was reported during poststudy observation period.

Conclusion
The study has resulted in improvisations originally conceived, planned, and implemented by the author at the work station. This study facilitated optimizing traffic of people and goods in OT and stores and in improving IAQ. Excellent cooperation among staff, clean and pleasant ambience, peaceful work situation, laid out standard operating procedures, segregated stores, and well-designed work hours boosted the morale of the entire staff.

Clinical significance
One of the main sources of airborne contamination in ORs is dead skin cells called “squames,” each around 15 μm or less in diameter shed by staff and patients. A proportion of these may carry harmful bacteria. The rate of shedding increases with movement. This study focused on optimizing traffic of people and goods in the OT and thereby resulted in improving overall IAQ.

How to cite this article
Saraswati SV. An Evidence-based Study on Traffic Flow in Operation Theater. Int J Res Foundation Hosp Healthc Adm 2016;4(2):70-78.