Operating room design using agent-based simulation to reduce room obstructions

Kevin Taaffe, Yann B. Ferrand, Amin Khoshkenar, Lawrence Fredendall, Dee San, Patrick Rosopa, Anjali Joseph

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


This study seeks to improve the safety of clinical care provided in operating rooms (OR) by examining how characteristics of both the physical environment and the procedure affect surgical team movement and contacts. We video recorded staff movements during a set of surgical procedures. Then we divided the OR into multiple zones and analyzed the frequency and duration of movement from origin to destination through zones. This data was abstracted into a generalized, agent-based, discrete event simulation model to study how OR size and OR equipment layout affected surgical staff movement and total number of surgical team contacts during a procedure. A full factorial experiment with seven input factors – OR size, OR shape, operating table orientation, circulating nurse (CN) workstation location, team size, number of doors, and procedure type – was conducted. Results were analyzed using multiple linear regression with surgical team contacts as the dependent variable. The OR size, the CN workstation location, and team size significantly affected surgical team contacts. Also, two- and three-way interactions between staff, procedure type, table orientation, and CN workstation location significantly affected contacts. We discuss implications of these findings for OR managers and for future research about designing future ORs.

Original languageEnglish (US)
Pages (from-to)261-278
Number of pages18
JournalHealth Care Management Science
Issue number2
StatePublished - Jun 2023


  • Agent-based simulation
  • Markov chains
  • Operating room design
  • Operations management
  • Operations research
  • Statistical analysis
  • Surgical safety

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • General Health Professions


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