US20070033889A1

US20070033889A1 - Multi-functional medical facility with diagnostic, therapeutic and interventional capabilities

Info

Publication number: US20070033889A1
Application number: US11/347,197
Authority: US
Inventors: James Manzione
Original assignee: Research Foundation of State University of New York
Current assignee: Research Foundation of State University of New York
Priority date: 2005-02-09
Filing date: 2006-02-03
Publication date: 2007-02-15

Abstract

A multi-functional medical facility permits emergent diagnostic imaging assessment, image guided therapeutic interventions, and open surgical procedures within the complex. The concept of bringing diagnostic and therapeutic imaging and operative equipment to the critically ill patient or the patient undergoing non-emergency, elective surgery, instead of bringing the patient to the equipment is a major clinical advantage that should improve efficiency, outcome and survival. An important economic advantage is that the components can be used separately and independently of each other, thus enabling them to also be used for routine emergency room (ER) work.

Description

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims benefit of U.S. Provisional Application No. 60/651,323 filed Feb. 9, 2005.

BACKGROUND OF THE INVENTION

1. Field of Invention
The invention relates generally to a multi-functional medical facility that includes adjacent rooms set up for imaging patients, such as for diagnostic imaging and image-guided interventional procedures, and for performing surgical procedures.
2. Description of Related Art
Hospitals and other medical care facilities typically include separate facilities for performing patient imaging and administering emergency services. Thus, when a critically ill or injured patient is admitted to an emergency room, it is necessary to transfer the patient to a different location to perform imaging. For example, the patient can be transferred to computed tomography (CT) and radiographic imaging suites for diagnostic studies, or to fluoroscopic and angiographic suites for diagnostic and image guided interventional procedures, to gain information needed before returning the patient to the operating room for a surgical procedure. However, the idea of bringing the critically ill patient to the diagnostic and therapeutic imaging and operative equipment is disadvantageous in terms of efficiency as well as patient outcome and survival. For example, oftentimes the patient is too ill to be moved and, when the patient can be moved, time is wasted, potentially resulting in an increase in patient morbidity or mortality. Moreover, additional personnel are needed to move the patient and time is unnecessarily wasted.

BRIEF SUMMARY OF THE INVENTION

The present invention addresses the above and other issues by providing a multi-functional medical facility that includes adjacent rooms set up for imaging patients, such as for diagnostic imaging and image-guided interventional procedures, and for performing surgical procedures
In one aspect, a multi-functional medical facility is provided as a diagnostic and therapeutic emergency room (ER) complex that permits emergent diagnostic imaging assessment, image guided therapeutic interventions, and open surgical procedures. The concept of bringing diagnostic and therapeutic imaging and operative equipment to the critically ill patient, or the patient undergoing non-emergency, elective surgery, instead of bringing the patient to the equipment, provides a major clinical advantage over current methods that should improve efficiency, outcome and survival. An important economic advantage is that the components can be used independently for routine ER work. Moreover, the cost of the complex can be paid back quickly since the equipment is used to more efficiently process a greater number of patients compared to conventional approaches.
In a particular aspect, a multi-functional medical facility is provided that includes an area equipped to provide emergent diagnostic imaging assessment of a patient, an area equipped to provide image guided therapeutic intervention of the patient, and an area equipped to provide a surgical procedure of the patient.
The facility can further include a transport mechanism for transporting the patient to each of the areas, which can be adjacent to one another. The transport can move the same patient table to each area to minimize patient discomfort.
While a CT scanner is illustrated in the figures as an example only, the area equipped to provide emergent diagnostic imaging assessment can include a CT scanner, MRI scanner, x-ray/angiography device, ultrasound device, and/or other imaging device. Similarly, the area equipped to provide image guided therapeutic intervention of the patient can include a CT scanner, MRI scanner, x-ray/angiography device, ultrasound device, and/or other imaging device. The area equipped to provide a surgical procedure of the patient can include a surgical set-up for an emergency and/or non-emergency, or elective, surgery. Moreover, each of the areas can be operating room-compatible.
The facility can also include at least one shielded, retractable door arranged to shield radiation from: (a) the area equipped to provide emergent diagnostic imaging assessment, and (b) the area equipped to provide image guided therapeutic intervention of the patient.
In another aspect, a multi-functional medical facility includes a central area equipped to provide at least one of emergent diagnostic imaging assessment of a patient, and image guided therapeutic intervention of the patient, and a plurality of areas adjacent to the central area that are each equipped to provide a surgical procedure of the patient, wherein each of the areas is operating-room compatible.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features, benefits and advantages of the present invention will become apparent by reference to the following text and figures, with like reference numbers referring to like structures across the views, wherein:
FIG. 1 illustrates a top view of a multi-functional medical facility that includes four operating rooms/trauma rooms that share access to a movable imaging device;
FIG. 2 a illustrates a top view of a multi-functional medical facility that includes four operating rooms/trauma rooms that share access to a movable imaging device, where a rotatable barrier is in a position for allowing access to the imaging device by two of the operating rooms/trauma rooms;
FIG. 2 b illustrates a top view of the multi-functional medical facility of FIG. 2 a, where the rotatable barrier is in a position for allowing access to the imaging device by the other two of the operating rooms/trauma rooms;
FIG. 3 a illustrates a top view of a multi-functional medical facility that includes four operating rooms/trauma rooms that share access to a movable imaging device, where retractable doors are in a position for allowing access to the imaging device by two of the operating rooms/trauma rooms;
FIG. 3 b illustrates a top view of the multi-functional medical facility of FIG. 3 a, where the retractable doors are in a position for allowing access to the imaging device by the other two of the operating rooms/trauma rooms.

DETAILED DESCRIPTION OF THE INVENTION

The invention provides a multi-functional medical facility for evaluation and treatment of trauma and critically ill patients presenting to an emergency room. The facility contains all necessary equipment to evaluate and treat trauma/critically ill patients. Features of this trauma room that different from current conventional rooms include a synergistic arrangement of imaging equipment and operating room capabilities. Providing both imaging and operative capabilities as discussed herein will allow rapid assessment of such patients, while also providing image guided diagnostic and therapeutic procedures and/or open surgical interventions. The facility can eliminate the inherent delays and risks in transporting a critically ill or injured patient to imaging and operative facilities in different areas of a hospital. Several prototypic configurations are illustrated in the attached figures.
FIG. 1 illustrates a top view of a multi-functional medical facility that includes four operating rooms/trauma rooms that share access to a movable imaging device. The operating rooms/trauma rooms can include rooms or areas designated as Room I, Room II, Room III and Room IV. Generally, the rooms or areas can be arranged adjacent or otherwise proximate to one another. In one possible approach, a central area of the facility is equipped to provide emergent diagnostic imaging assessment of a patient, and/or image guided therapeutic intervention of the patient, while one or more areas adjacent to the central area are equipped to provide a surgical procedure of the patient.
In the example provided, Rooms I and II are major operating rooms/trauma rooms, while Rooms III and IV can be minor trauma rooms or additional major operating rooms/trauma rooms similar to Rooms I and II, respectively. The major operating rooms/trauma rooms are typically outfitted to handle patients such those who have been in an auto accident, or those who have experienced sudden illnesses such as a heart attack or stroke. The major operating rooms/trauma rooms can be configured to meet requirements for operating rooms with an appropriate surgical set-up, such as by having appropriate air handling and filtering systems, wash stations, lighting, wall, floor and other surfaces suitable for cleaning, sterilizing equipment, other medical equipment, and the like. Generally, any required equipment and facilities for pre-operative, operative, and post-operative procedures can be provided. For example, for a major trauma patient, equipment such as chest tubes, splints and large and small intravenous tubes can be needed to stabilize the acutely injured patient. Minor trauma rooms are typically outfitted to handle patients such as those involved in minor accidents and those experiencing less serious illnesses.
Each room includes a patient table/tabletop on which a patient is held. In one possible approach, the patient table in Room I can be moved from a position A to a position C or position D as indicated such as via a ceiling or other overhead track system, using ceiling-mounted arms shown diagrammatically, or other movement mechanism. However, such a mechanism is not required as the patient table can be moved on a wheeled table support or by other means to the different locations. In position C, the patient can be imaged by an imaging device such as a movable CT gantry that slides on tracks. When the patient table is moved to position C, the CT gantry can be positioned rightward (as viewed in the figure) to image the patient such as for a diagnostic assessment. The patient table can also be moved to a position D in which an additional imaging device, such as x-ray/angiographic equipment, is used to image the patient such as for a diagnostic assessment or an image-guided interventional procedure. Thus, a patient can be moved on the same patient table from an operating room to an imaging area having one or more imaging devices. Likewise, the patient table can be returned to the position A for further procedures in Room I. Similarly, a patient in Room II can be moved from an associated position B to position C and/or position D when the patient from Room I is not using the imaging equipment.
Moreover, when not needed for imaging patients from Rooms I and II, the CT gantry can be moved leftward on the scanner tracks to scan patients from Rooms III and IV, or from other locations, who have more routine injuries or illnesses.
To block radiation that can be emitted from various medical imaging devices, folding or other retractable lead shielded doors can be provided between the area in which the imaging devices are located and the other areas of the facility. For example, Doors A, B, D and E can be provided to shield Rooms I, II, III and IV, respectively, from the imaging device. Door C can extend behind the CT gantry to shield another patient on the other side of the gantry. That is, when the gantry is moved rightward to image a patient, Door C is closed to shield a patient on the left side of the gantry that is being prepared to be imaged. When the imaging is complete, the Door C can be opened and the gantry moved leftward, using appropriate mechanisms. Door C can then be closed to image the patient on the left side of the gantry while another patient from Room I or II is moved to the position C and prepared for imaging.
Thus, in this approach, the facility includes a movable multislice CT gantry that can be shared by adjacent imaging rooms. Additionally, a radiographic and ultrasonic unit with fluoroscopic, angiographic and digital imaging capabilities can be provided in one or both of the imaging rooms to be shared. Generally, any type of imaging equipment, including a CT scanner, MRI scanner, x-ray/angiography device, ultrasound device, and/or other imaging device, can be used in areas of the facility that are equipped to provide emergent diagnostic imaging assessment of a patient, and/or an image guided therapeutic intervention of the patient. Furthermore, each room or area of the facility is operating room (OR) compatible, indicating, e.g., that the rooms are configured to meet requirements for operating rooms, such as by having appropriate air handling and filtering systems, wall, floor and other surfaces suitable for cleaning, and the like.
Thus, the patient can be transferred from the operating room to one or more imaging rooms or areas in the middle of surgery, for instance, to evaluate the effect of the surgery on the patient, and then back to the operating room to complete the surgery.
Moreover, each piece of equipment can be used together or separately and independently. Utilizing the equipment together produces a highly sophisticated, synergistic and technologically advanced environment to evaluate critically ill patients that have experienced trauma or other conditions. When not being utilized together for such purposes, each piece of equipment can be used for routine ER diagnostic and therapeutic purposes since each piece of equipment can be utilized separately and independently.
In an example use of the facility, a major trauma patient can be admitted to Room I or II, where procedures are carried out in an attempt to stabilize the patient. The patient can be moved to the x-ray/angiographic equipment in position D to perform an initial scan from head to toe to locate broken bones or a collapsed lung, for instance. The x-ray/angiographic equipment provides a 2-D image of the patient, and can be used for image-guided interventional procedures, such as inserting chest tubes or intravenous tubes. If a more sophisticated, 3-D image is required, the patient can be positioned to position C to perform a CT scan, for instance, which allows development of an appropriate diagnosis and treatment. The transition from position D to position C can be achieved by simply rotating the patient table by ninety degrees, for instance. Subsequently, a further angiogram can be obtained in position D such as to study a blood vessel or for another interventional therapeutic procedure.
Note that, in each of the embodiments described herein, the operating rooms, such as Rooms I and II, can be configured for emergency surgery and/or elective, non-emergency surgery. Thus, a configuration similar to what is illustrated in FIG. 1 can be provided where imaging equipment for assessments and/or interventions is adjacent to or surrounded by one or more operating rooms in a general-purpose operating suite. Generally, for emergency patients, the imaging equipment is used to determine what surgical procedures are needed, while for the non-emergency patients, imaging has previously been performed to determine what elective surgical procedures are needed. In either case, the imaging equipment can be used during the surgery to assess the progress of the surgery.
Thus, in another example use of the facility, a patient undergoing elective, non-emergency surgery can be admitted to Room I or II. Such a patient typically has already undergone imaging to determine that the elective surgery is needed. For instance, a urologist can perform a surgery to remove a kidney stone, or a neurologist can perform a surgery to close off an aneurysm. In these surgeries, a minimal incision is made in the patient and an appropriate device is inserted into the body to perform the procedure. During the procedure, it can be desirable to use the imaging equipment in the other areas of the facility to assess the progress of the surgery, thereby enabling the surgery to proceed more quickly and with greater success. For example, the imaging can allow the neurologist to determine if a clip has been placed properly to close off the aneurysm. The patient can then be returned to the surgery area to make the appropriate adjustments as needed.
FIG. 2 a illustrates a top view of a multi-functional medical facility that includes four operating rooms/trauma rooms that share access to a movable imaging device, where a rotatable barrier is in a position for allowing access to the imaging device by two of the operating rooms/trauma rooms. Rooms I and II can be configured as major operating rooms/trauma rooms, while Rooms III and IV can be minor trauma rooms or additional major operating rooms/trauma rooms similar to Rooms I and II. Or, Rooms III and IV can be rooms where patients are prepped for imaging. Or, Room III can be an x-ray/angiography prep room. Doors A and B are retractable shielded doors for shielding Rooms I and II, respectively, from the central area where imaging is performed by a CT gantry, for example, which is movable on tracks. A rotating x-ray/angiographic C-arm can also be used in the central imaging area.
A rotating CT-angiography complex barrier or wall can be used which includes a shielded circular wall with openings having the retractable doors, Door A and Door B. The barrier separates the central imaging area from the surrounding rooms, and is mounted on a mechanism which allows it to rotate so that the doors are positioned to allow access to the central imaging area by either Rooms I and II, or Rooms III and IV. In the position shown, patient tables from Rooms I or II can be moved into the central imaging area. For example, a patient table I can be moved from Room I to table position C for CT scanning and/or x-ray/angiographic assessment. Similarly, when the imaging area is not in use, table II can be moved from Room II to table position C for CT scanning and/or x-ray/angiographic assessment.
For example, when table I is moved into the central imaging area, Doors A and B can be closed to allow imaging to take place. Door A can be opened to move table I back into Room I, after which Door B is opened and table II can be moved into the central imaging area. Doors A and B can then be closed to allow imaging to take place again. Door B can then be opened to move table II back into Room II. Subsequently, the barrier can be rotated to arrive at the configuration of FIG. 2 b.
FIG. 2 b illustrates a top view of the multi-functional medical facility of FIG. 2 a, where the rotatable barrier is in a position for allowing access to the imaging device by the other two of the operating rooms/trauma rooms. Here, the CT-angiography complex barrier has rotated ninety degrees counterclockwise. Thus, Doors A and B allow access to the central imaging area by table III in Room III, and by table IV in Room IV, respectively. Moreover, the x-ray/angiographic C-arm can rotate to allow table III to move to table position C via Door A. Alternately, table III can engage the x-ray/angiographic C-arm for continued x-ray evaluation of the ER/major trauma patient. Opposite Room III, Door B can be opened to allow the CT gantry to be positioned to move into Room IV to image a patient on table IV, e.g., for routine CT scanning Furthermore, Door B can be closed once the CT gantry is moved into Room IV to allow the x-ray/angiographic C-arm to be used simultaneously and independently of the CT gantry for any purpose. Door B shields Room IV from radiation emitted by the x-ray/angiographic C-arm, while also shielding the central imaging area from radiation emitted by the CT gantry, while Door A shields Room III similarly.
FIG. 3 a illustrates a top view of a multi-functional medical facility that includes four operating rooms/trauma rooms that share access to a movable imaging device, where retractable doors are in a position for allowing access to the imaging device by two of the operating rooms/trauma rooms. As before, Rooms I and II can be configured as major operating rooms/trauma rooms, while Rooms III and IV can be minor trauma rooms or additional major operating rooms/trauma rooms similar to Rooms I and II. Or, Rooms III and IV can be rooms where patients are prepped for imaging. Or, Room III can be an x-ray/angiography prep room. Doors A, B, C and D are retractable shielded doors for shielding Rooms I, II, III and IV, respectively, from the central area where imaging is performed by a CT gantry, for example, which is movable on tracks.
A rotating x-ray/angiographic C-arm can also be used in the central imaging area. The C-arm can rotate to allow table III to move to table position C.
In Room I, patient table I can be moved from Room I to table position C for CT scanning and/or x-ray/angiographic assessment. Similarly, when the imaging area is not in use, table II can be moved from Room II to table position C for CT scanning and/or x-ray/angiographic assessment. Door C allows table III in Room III to access the central imaging area, while Door D allows table IV in Room IV to access the central imaging area. In the central area, imaging can be performed by a CT gantry, for example, which is movable on tracks. A rotating x-ray/angiographic C-arm can also be used in the central imaging area.
For example, when table I is moved into the central imaging area, Doors A, B, C and D can all be closed to allow imaging to take place. Door A can be opened to move table I back into Room I, after which Door B is opened and table II can be moved into the central imaging area. Doors A and B can then be closed to allow imaging to take place again. Door B can then be opened to move table II back into Room II, then closed again. Subsequently, Door C or D can be opened as indicated in the configuration of FIG. 3 b.
FIG. 3 b illustrates a top view of the multi-functional medical facility of FIG. 3 a, where the retractable doors are in a position for allowing access to the imaging device by the other two of the operating rooms/trauma rooms. The x-ray/angiographic C-arm can rotate to allow table III to move to table position C via Door A. Alternately, table III can engage the x-ray/angiographic C-arm for continued x-ray evaluation of the ER/major trauma patient. Opposite Room III, Door D can be opened to allow the CT gantry to be positioned to move into Room IV to image a patient on table IV, e.g., for routine CT scanning. Furthermore, Door D can be closed once the CT gantry is moved into Room IV to allow the x-ray/angiographic C-arm to be used simultaneously and independently of the CT gantry for any purpose. As before, Door D shields Room IV from radiation emitted by the x-ray/angiographic C-arm, while also shielding the central imaging area from radiation emitted by the CT gantry, and Door C similarly shields Room III.
Accordingly, it can be seen that the present invention provides a multi-functional medical facility that permits emergent diagnostic imaging assessment, image guided therapeutic interventions, and surgical procedures. The concept of bringing diagnostic and therapeutic imaging and operative equipment to the critically ill patient instead of bringing the patient to the equipment is a major clinical advantage that should improve efficiency, outcome and survival. An important economic advantage is that the components can be used separately and independently of each other, thus enabling them to also be used for routine ER work. Moreover, the invention can be implemented by retrofitting an existing structure, or by providing the appropriate design when building a new structure.
The invention has been described herein with reference to particular exemplary embodiments. Certain alterations and modifications may be apparent to those skilled in the art, without departing from the scope of the invention. The exemplary embodiments are meant to be illustrative, not limiting of the scope of the invention.

Claims

1. A multi-functional medical facility, comprising:

an area equipped to provide emergent diagnostic imaging assessment of a patient;

an area equipped to provide image guided therapeutic intervention of the patient; and

an area equipped to provide a surgical procedure of the patient.

2. The multi-functional medical facility of claim 1, further comprising:

a transport mechanism for transporting the patient to each of the areas.

3. The multi-functional medical facility of claim 1, wherein:

the areas are adjacent to one another.

4. The multi-functional medical facility of claim 1, wherein:

the area equipped to provide emergent diagnostic imaging assessment includes a CT scanner, MRI scanner, x-ray/angiography device, ultrasound device, and/or other imaging device.

5. The multi-functional medical facility of claim 1, wherein:

the area equipped to provide image guided therapeutic intervention of the patient includes a CT scanner, MRI scanner, x-ray/angiography device, ultrasound device, and/or other imaging device.

6. The multi-functional medical facility of claim 1, wherein:

the area equipped to provide a surgical procedure of the patient includes a surgical set-up for an emergency surgery.

7. The multi-functional medical facility of claim 1, wherein:

the area equipped to provide a surgical procedure of the patient includes a surgical set-up for a non-emergency surgery.

8. The multi-functional medical facility of claim 1, wherein:

each of the areas is operating-room compatible.

9. The multi-functional medical facility of claim 1, further comprising:

at least one shielded, retractable door arranged to shield radiation from at least one of: (a) the area equipped to provide emergent diagnostic imaging assessment and (b) the area equipped to provide image guided therapeutic intervention of the patient.

10. A multi-functional medical facility, comprising:

a central area equipped to provide at least one of emergent diagnostic imaging assessment of a patient, and image guided therapeutic intervention of the patient; and

a plurality of areas adjacent to the central area that are each equipped to provide a surgical procedure of the patient;

wherein each of the areas is operating-room compatible.