Cleveland Clinic this week promoted a study by its researchers that found that reducing air turnover in unoccupied ORs “can significantly decrease electricity use and costs without negatively affecting clinical outcomes,” including “no association with increased surgical site infection, mortality or ICU admission.
The study was the subject of a recently published research letter in JAMA Surgery.
“When occupied, OR air is turned over 21 times per hour in accordance with American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Standard 170, which is a standard adopted by The Joint Commission,” writes Clevelamd Clinic. “Although unoccupied rooms are permitted to have lower turnover rates, many ORs remain at occupied levels even when empty.”
Cleveland Clinic general surgeon Benjamin Miller, MD, corresponding author on the paper, notes of the findings: “When they’re unoccupied, the air change rate or the air turnover rate can be decreased to four to six times an hour. Historically, there has been some concern that even turning the air change rate down when rooms are unoccupied may introduce negative clinical outcomes like increased wound morbidity to surgical patients, even though it falls within ASHRAE guidelines. We wanted to see if that was the case.”
The retrospective pre-post study examined 127,878 surgical cases across 55 ORs before and after the implementation of automated ventilation setbacks. “Across the 55 ORs, reduced air turnover lowered electricity usage by 1,349,205 kWh annually, equating to $134,915 in annual cost savings,” notes Cleveland Clinic, which adds that, based on the findings, “similar per-OR reductions nationwide could reduce electricity use by more than 1.5 billion kWh annually—approximately $150 million in annual electricity costs.”
“Beyond the finding that there was not a difference in wound morbidity rates after implementing the air setbacks, there were also real environmental savings and real cost savings for the hospital, without clinical downsides,” says Dr. Miller, who adds that future research could examine whether current occupied-room ventilation standards are also higher than necessary.
Read the full Cleveland Clinic article here and access the full study here.
