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Looking Ahead to a Day in the Pavilion’s Surgery Units

pavilion OR
The view from outside an operating room in the Pavilion, which remains under construction but will open officially this fall.

After a procedure lasting several hours, John Keogh, MD, a professor of Clinical Anesthesiology and Critical Care, steps out of the operating rooms on the Pavilion’s fifth floor. Almost immediately, he’s met by clear daylight and a view of blue skies cresting over Franklin Field’s bricks, coffee-colored in the shadow of the sun. In Keogh’s peripheral view, a linked pair of freight engines buzz along the Schuylkill River, pulling dozens of white container cars on the raised tracks.

“In a high-stress environment, the ability to look outside — see the sun, watch a train go by — that can’t be possible to overstate,” Keogh says.

It’s a time to breathe a little easier, a place where Keogh can take a moment and slow down, soak in the light a bit after some slight tenseness in the operating room under the necessary but bright halogen lights.

“Most places, when they put in their operating suites, they put them on the ground floor, or bury them in the interior of the building,” Keogh says. “It’s understandable, but this makes such a difference.”

As he takes a few moments more in the hall’s daylight, colleague H. Isaac Chen, MD, an assistant professor of Neurosurgery, heads to visit a post-op patient. The surgeon gives a rundown of a successful procedure, wearily smiling at them and their partner. The surgeon has performed the entire surgery in a room with an intraoperative MRI in place, which makes a complicated surgery a little easier and faster than having to move the patient back and forth between the operating room and a room with an available MRI, as might be the case elsewhere. It’s one of many advanced procedures made a little less complicated at Penn Medicine and the Pavilion, thanks to cutting-edge spaces and technology like the Epilepsy Monitoring Unit that helps give real time information on patients’ conditions, as well as the advanced, minimally invasive techniques for complex endovascular conditions like aortic aneurysms.

If the surgery Chen performed had taken place elsewhere, the patient and his partner might have been waiting in a room separated from another patient by a half wall or curtains. That means privacy could be fleeting, especially if the patient’s recovery from anesthesia is a little rough and they feel nauseous. But in the Pavilion’s private recovery areas, the patient asks a few more questions about their condition, queries that are more complicated and intimate than they likely would have made if there was a chance someone else in the room could hear.

None of this has happened yet. But it will in three months when the Pavilion opens this fall. Keogh and Chen can already picture more ways the Pavilion will soon change their typical days for the better.

“Private rooms provide patients with a more serene and quiet environment to begin their recovery from surgery,” Chen said. “Such an environment is particularly beneficial to diffuse the disorientation and confusion that can result from pain related to surgery and the haze of anesthesia. Not only that, these private rooms provide the privacy needed for discussions about how surgery went and next steps for care.”

Imagine, as the patient asks his questions in the recovery room with Chen, Keogh heads to the team space at his floor’s “end cap.” Many buildings have this type of touch-down space divided out into spaces belonging to physicians and others for nurses, technicians and other staff, but the Pavilion’s surgical team rooms allow for better familiarization between everyone taking part in a surgery.

“There’s more walking in each other’s shoes,” Keogh says.

In these shared areas, the staff can talk about everything from the procedure they just worked on together to how their kids did in the soccer games the previous weekend. This type of proximity obviously helps build esprit de corps in the operating rooms. It’s further supplemented by new technology that displays the names, faces, and roles of each person in the operating room during a procedure, making it easier to know who to ask for help. Elsewhere in the building, that same technology will also be utilized through smart boards in each private patient room, ensuring that patients and their family members have a good sense of who each care team member is.

“Everyone is wearing a mask, so it can be a little difficult to tell who is who at times,” Keogh says. “It helps us identify who we need quickly in the OR.”

Keogh will spend a little time in the team area before heading off to the next procedure he’s scheduled for. Before heading off, he’ll stop for one more moment to look out the window. The freight train is nearly finished rumbling past, ended with another engine instead of the caboose you see in the “Little Engine That Could” from childhood.

Keogh then can step into the operating room, a bit more centered.

The Pavilion will make daily scenes like this commonplace when it opens in three months. Because operating suites are one of the busiest and most important components of a hospital, they were a focus of many of the design choices for the Pavilion’s surgical areas was to do the little things that made them more functional. That includes adding the technology pieces, like the boards digitally displaying the identity and assigned job of everyone in the room for each procedure, to simple, low-tech choices, like the private pre-op and recovery rooms and large, building-long windows, both of which emphasize comfort during some uncomfortable times. These choices equally seek to positively affect everyone, whether they’re patients who might need to go in and out in a day, or the staff who spend their whole careers there.

“We of course design hospitals for patients,” Keogh said. “But this is a hospital that was designed with the staff in mind, too. It’ll be exciting to walk in and work there. And I think we’ll maintain that excitement with some of the ways it’s constructed.”

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