Implementation of integrated operating rooms: How much time is saved and how do medical staff experience the upgrading A mixed methods study in Denmark

Kathrine Carstensen, Emma Kejser Jensen, Mads Lænsø Madsen, Anne Marie Ladehoff Thomsen, Claus Løvschall, Nasrin Tayyari Dehbarez, Bettina Wulff Risør*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

1 Citation (Scopus)


Objectives To evaluate staff experiences of the implementation and use of integrated operating rooms (IORs) in comparison to conventional operating rooms (CORs) in Denmark. Design This study used a mixed methods approach by combining quantitative (registry-based analysis of surgical time) and qualitative (interviews with experienced surgical staff) perspectives. Setting Hospitals in Denmark. Methods The quantitative component compared the time consumption of patients between the integrated and CORs in two hospital departments at Aarhus University Hospital. Data were extracted from the administrative system in the hospital. Independent t-tests were used to estimate the statistical differences in the mean time spent on patients between the two operating rooms (ORs), and linear regression was applied to adjust for the potential influence of the surgeon. The explorative qualitative research component involved interviews with 20 informants from 10 hospital departments across seven Danish hospitals, all of whom participated between February and April 2019. Data were analysed using thematic analysis. Results The quantitative analyses showed that preparation time for lobectomy was significantly lower and completion time for cholecystectomy significantly higher in the integrated compared with CORs. No other statistically significant differences were found. The qualitative analysis showed that some nurses experienced better cooperation with the surgeon and that non-sterile nurses experienced an improved working environment in the integrated compared with CORs. Surgical staff experienced that the IORs led to improved workflow during surgery. Conclusions This study identified no disadvantages regarding the use of IORs compared with CORs. The quantitative component of the research did not identify convincing statistically significant differences in the time consumption per patient between the ORs and according to the qualitative analyses IORs were not experienced by study participants to lead to major improvements among staff.

Original languageEnglish
Article numbere034459
JournalBMJ Open
Issue number7
Publication statusPublished - 29 Jul 2020
Externally publishedYes

Bibliographical note

Funding Information:
Funding The research was supported by Aarhus University Hospital and the five Danish regions.

Publisher Copyright:
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.


  • integrated operating room
  • minimally invasive surgery
  • surgical workflow
  • technical equipment


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