Day surgery and procedure units are specialized healthcare facilities designed for outpatient surgical procedures, meaning patients can be treated and discharged on the same day. These units are commonly found in hospitals, ambulatory surgical centers (ASCs), and specialized clinics.
Key Features
- Minimally invasive procedures: Common surgeries include cataract removal, endoscopies, orthopedic procedures, and cosmetic surgeries.
- Short recovery times: Patients receive care in a monitored recovery area before being discharged, eliminating the need for overnight stays.
- Cost-effectiveness: Since hospitalization is not required, day surgery significantly reduces medical expenses for both healthcare providers and patients.
- Specialized medical teams: Surgeons, anesthesiologists, and nurses work together in an optimized environment to ensure safe and efficient procedures.
If you want to know about the Types of slabs or Permeable concrete or Islamic architecture, please click the link.
1) Introduction
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
2) Planning of Day Surgery / Procedure Unit
i) 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.
ii) 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, records and 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.
iii) Functional Relationships
External
The Day Surgery/ Procedure Unit will have functional relationships with the following units
- Operating Suite;
- Pre-Admission Clinic;
- Transit Lounge.
Ambulance Access
A discreet pick-up point, preferably under cover, shall be provided for the transfer of patients to and from the Day Surgery/ Procedure Unit.
Car Parking
Adequate car parking facilities with convenient access needs to be provided.
Internal
Within the Unit, key functional relationships will include:
- Unidirectional patient flow from arrival at Reception, through holding, Procedure Rooms, Recovery rooms, then to the Peri-operative Unit, Inpatient Unit, Lounge areas and discharge to home;
- Separation of clean and dirty traffic flows
- Staff visibility of patient areas for patient supervision and safety
3) Design of Day Surgery / Procedure Unit
i) General
Pre-operative and post-operative patient facilities can be located together as required.
ii) Environmental Considerations
Acoustics
Design should consider reduction of the ambient noise level within the unit, particularly waiting areas. Acoustic privacy treatment will be required to:
- Consulting / interview rooms
- Operating/ Procedure Rooms
Natural Light
The design of the unit should incorporate external views and natural light as far as possible, particularly to Waiting Areas, Pre-operative and Recovery areas. It is recommended that external views and natural light are provided in staff areas such as Staff Rooms and Offices and areas where staff are confined to one location e.g. Reception, Clean-up Rooms.
When external views and natural light are provided in patient areas, care must be taken to minimise glare and ensure privacy is not compromised. Sun penetration should be controlled to exclude glare and heat gain or loss. If Procedure Rooms include external windows, provision of controlled level of lighting during procedures may be required.
iii) Safety and Security
Security measures will include the following:
- Controlled access to Procedural and staff areas
- Security and safe storage of drugs
iv) Building Services Requirements
Radiation Shielding
Radiation shielding to be recommended by AERB safety standards will be required in all procedure rooms where imaging will occur.
4) Components of the Unit
The Day Surgery/ Procedure Unit will contain a combination of Standard Components and Non-Standard Components. Provide Standard Components to comply with details in the Standard Components described in these Guidelines. Refer also to Standard Components Room Data Sheets and Room Layout Sheets.
i) Non Standard Components
Endoscope Store
Description and Function – The Endoscope Store may be provided to store a variety of cleaned and decontaminated and sterile endoscopes, ready to use.
Location and Relationships – The endoscope store will be located immediately adjacent to the endoscope processing room.
Considerations – Endoscopes will be stored in appropriately ventilated cabinets. Air supply to this room should be HEPA filtered to prevent contamination of clean endoscopes.
5) Schedule of Accommodation
Day Surgery / Procedure Unit Generic Schedule of Accommodation
Schedule of Accommodation follows and assumes a 2 room and a 4 room suite that may incorporate day surgery. The schedule will need to be amended in accordance with the requirements of the Service Plan.
Provision of Offices, Workstations and support areas will be dependent on the Operational Policy and service demand and may vary from the Schedule of Accommodation.
Please note the following:
- Areas noted in Schedules of Accommodation take precedence over all other areas noted in the FPU.
- Rooms indicated in the schedule reflect the typical arrangement according to the Role Delineation.
- Exact requirements for room quantities and sizes will reflect Key Planning Units identified in the service plan and the policies of the Unit.
- Room sizes indicated should be viewed as a minimum requirement; variations are acceptable to reflect the needs of individual Unit.
- Office areas are to be provided according to the Unit role delineation and staffing establishment.
- Staff and support rooms may be shared between Functional Planning Units dependant on location and accessibility to each unit and may provide scope to reduce duplication of facilities.
6) Functional Relationship Diagram
Day Surgery / Procedure Unit Functional Relationship Diagram
