Preparing for OR renovations session: One OR leader’s lessons from the field

Editor's Note: Originally published in 2022, this session recap remains highly relevant as OR leaders continue to face renovation projects amid shifting technology, staffing demands, and infrastructure renovation needs. We have resurfaced it as part of our ongoing focus on capital planning and perioperative design—even years later, the fundamentals still apply.

OR renovations may not happen often in a leader’s career, but when they do, the impact is lasting. Whether perioperative leaders need to upgrade outdated suites, accommodate new technologies, or optimize layout and workflows, even a single renovation can reshape how care is delivered for years to come. As health systems face capital constraints, staffing shortages, and rapid shifts in surgical technologies, the lessons from leaders who have done it before are more valuable than ever.

In this popular session from the OR Manager Conference in 2022, Maria Sullivan, MSN, MMHC, RN, CNOR, OR manager at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, shared firsthand what it takes to navigate the logistical, technological, and human realities of renovating 20-year-old ORs while maintaining surgical operations.

According to Sullivan, here are a few considerations people need to keep in mind going into a renovation project:

• the new technology that is being introduced into the space
• how to sustain surgical volume during that period
• how to remain in the space being renovated (if it’s not a construction project of a new center)
• how to stay on budget.

The technology aspect is often an underestimated part, said Sullivan. “Before starting, some of the things you can already be doing is identifying your technology needs and the cost, recognizing the integration that new technology is going to need, and identifying new procedures associated with them,” she said. “For instance, if you do not have a robotics program already and will be starting one, that's going to need a lot of new technology.”

Sullivan found that most OR managers will only go through one renovation, remodel, or some kind of new build in their career. “Is anybody currently about to go through or ever completed a new build?” she asked the room. A show of hands showed most attendees have gone, are going, or are about to go through this type of project. “Oh, wow. Y'all are like a bunch of unicorns. That’s just a great state for healthcare,” she said.

Everyone has a different process for obtaining capital, Sullivan pointed out before urging those about to start to be ready to make the case for a new build. “Make sure you can show that you're going to have an increase in volume, either because your region is seeing new growth, or maybe some other hospital system has left the market, or what have you,” she said. “That's the kind of information you need to get to your C-suite so they can make decisions to help you.”

Once the construction is underway, Sullivan reminded attendees to remember and communicate their pain points and rely on the construction crew and the architects when it comes to staying up to code. “Let's say you don't have a laser plug in every room, and you’re going to get a new laser. You are going to need a new plug,” she said. “Thinking things like that through from the beginning can make the whole process a lot easier.”

The most important thing to remember, according to Sullivan, is recognizing the need for help. “Obviously, it takes a village. Get buy-in from your nurses, your techs, your surgeons, your anesthesia. But you're also going to need a bunch of new friends on the construction side of things,” she joked. “Architects, equipment planners, project coordinators, company reps, IT support, and it goes on. They're actually some of the best resources you'll find because they probably have been through this type of project before, and they’ll know what works and what doesn't.”