Description

A Day Surgery/ Procedure Unit is where operative or endoscopic procedures are performed and
admission, procedure and discharge occurs on the same date. It comprises one or more Operating
Rooms, with provision to deliver anaesthesia and accommodation for the immediate post operative
recovery of day patients. The range of procedures that may be undertaken in a Day Surgery/Procedures
Unit may include:  Surgical procedures, particularly ENT, Dental, Plastic Surgery, Ophthalmology 
Endoscopy - gastrointestinal, respiratory, urology;  Electroconvulsive Therapy (ECT) for psychiatric
inpatients  Day Medical Procedures including intravenous infusions and minor treatments

Planning

Operational Models The range of options for a Day Surgery/ Procedure Unit may include:  a stand
alone centre, fully self contained  a dedicated fully self-contained unit within a hospital  a Unit
collocated with a specialist clinical service such as Gastroenterology or Respiratory Medicine , within an
acute hospital  a Unit collocated with the Operating Unit with shared facilities. If the facility is part of
an Acute Care Hospital or other Medical Facility, services can be shared, as appropriate to minimise
duplication.

Functional Areas

The Day Surgery/ Procedure Unit may consist of a number of Functional Zones:  Entry/ Reception/
Administration and Waiting areas  Perioperative Area (provides for admission on the day of surgery),
including patient change areas, toilet and lockers  Procedural Area  Recovery Area ( this may also
include extended recovery areas where patients are discharged within 24 hours)  Discharge Lounge 
Staff Amenities  Day Medical Unit (if collocated). ENTRY / RECEPTION/ WAITING AREAS A covered
entrance for picking up patients after surgery shall be provided. The Entry may be a shared Outpatient
Facility and shall include:  Reception and information counter or desk  Waiting areas that allows for
the separation of paediatric and adult patients, if organised Paediatric Services are provided 
convenient access to wheelchair storage  convenient access to public toilet facilities  convenient
access to public telephones ADMINISTRATIVE AREAS General and individual offices shall be provided as
required for business transactions, recordsand administrative and professional staff. These shall be
separate from public and patient areas with provision for confidentiality of records. Enclosed office
spaces shall be provided for:  Administration and consultation  Manager / Nurse Unit Manager as
required Offices are to comply with Standard Components. CLINICAL RECORDS A secure room shall be
provided with provision for storage, recording and retrieval of clinical records. If geographically
appropriate, and if the Day Procedures Unit is part of, or attached to, an acute hospital, the general
clinical records facility might be used in lieu of a dedicated and separate room.

HOLDING AREA

A Holding Area may be provided where gowned patients enter after changing and wait for their
procedure. Additional holding areas may be provided for seated patients before an operation or
procedure. Such an area must have access to nurse call services. The Pre-operative Holding area shall be
provided with the following minimum requirements as appropriate to the proposed service:  A patient
trolley or patient seating  Privacy screening  Handbasins with liquid soap and paper towel fittings 
Patient nurse call/ emergency call buttons with pendant handsets and indicators  Medical gases
including oxygen and suction and power outlets to each bed OPERATING/ PROCEDURES ROOMS The
design of the Operating / Procedure Rooms must allow for adequate space, ready access, free
movement and demarcation of sterile and non sterile zones. Operating Rooms are to comply with
Standard Components.

OPERATING ROOM/S FOR ENDOSCOPY

The number and operation of Operating Rooms for Endoscopy shall be as determined by the Service
Plan. Room size may vary, dependent upon:  The use of video equipment  Electrosurgical laser
treatment  Fluoroscopy  Multiple endoscope activity  Multiple observers  The use of X-ray (image
intensifying) Where basic endoscopy is to be performed, the room size shall be no smaller than 36 m2.
Where video equipment is used the room size should be 42 m2. Larger sizes, where possible, are
recommended for flexibility and future developments. The ceiling height shall be 3000 mm. Operating
Rooms for Endoscopy shall be fitted out as for a Minor Operating Room, for example, it will be suitable
for general anaesthetic with appropriate medical gases, power, lighting, air-conditioning and ventilation.
Staff assistance call shall be provided. Consideration shall also be given to the special requirements of
laser equipment A clinical scrub up basin shall be provided outside the entrance to the Operating
Room/s for Endoscopy. Direct access to the Clean-up Room is recommended Impervious wall, floor and
ceiling treatments are essential for ease of cleaning.

PATIENT CHANGE AREAS

Separate areas shall be provided where outpatients can change from street clothing into hospital gowns
and be prepared for surgery, convenient to the Waiting Area. The patient change areas shall include
Waiting Rooms and lockers. Design of Change Areas is to facilitate management of patient lockers,
patient property and keys.

PERI-OPERATIVE UNIT

Where Day Procedures (day only surgical service) are provided within the same area as Inpatient Acute
Surgery (shared facility), the design shall consider the need to separate the two distinct functions at the
incoming side. The design shall also preclude unrelated traffic from the Day Procedures Unit and the
Operating Unit.

PREPARATION ROOM

A Preparation Room may be required for patients undergoing certain procedures such as Endoscopy or
Ophthalmology. If included, the Preparation Room should include:  Handbasin - Clinical  Bench, and
cupboards for setting up of procedures  Adequate space for procedures equipment trolleys 
Examination couch  Patient privacy screening

RECOVERY AREAS

In larger facilities it is often considered desirable to have a three stage recovery area. The first stage
involves intensive supervision, the second stage has changing facilities in more casual surroundings and
in the third stage, the patient is fully mobile and is awaiting discharge. Supervision of the patient is vital
at each stage. If Paediatric Surgery is part of the function, the Recovery Room shall provide for the needs
of parents/attendants. Recovery areas will require:  Staff station with a centrally located resuscitation
trolley  Linen Bay  Clean Utility  Dirty Utility  Store room
Stage 1 Recovery

The number of bed/trolley spaces in the Stage 1 Recovery Area will be dependent upon the nature of
surgery or procedures performed as outlined in the Operational Policy and the proposed throughput. As
a minimum, 1.5 bed/trolley spaces per Operating Room shall be provided.

Stage 2 Recovery

Stage 2 Recovery Room may be provided as required to accommodate:  Patients who have regained
consciousness after anaesthesia but require further observation  Patients who have undergone
procedures with local anaesthetic.

The patient is required to remain under observation until ready for discharge. Stage 2 Recovery areas
can be further described as follows:  Stage 2A: Provision of patient trolley bays Patients in this area
may recover in recliners/chairs. A ratio of two chairs (minimum) to each Operating/ Procedure room, in
addition to the above bed requirement, is considered appropriate.  Stage 2B: Provision of patient
recliners. This area is also referred to as a Discharge Lounge or Stage 3 Recovery. Patients are ambulant,
dressed and may await discharge in comfortable chairs. The lounge will require access to patient
refreshment facilities and patient toilets. External windows are to be provided in Stage 2 Recovery
Minimum space requirement is three bed/ trolley/ chair spaces per Room and some comfortable seating
for ambulant patients.