O.R. in a trailer: UVA's newest medical facilities

In September, Martha Jefferson Hospital is set to open its swanky new $17-million Outpatient Care Center at Peter Jefferson Place on Pantops Mountain. In July, UVA will unveil its... operating rooms in a couple of doublewides.

And some of the university's medical staff are not too happy about the contrast in facilities.

But first of all, the trailers are actually called "modular operating rooms," corrects hospital administrator James McGowan. And they're being leased to handle surgical volume while the hospital expands during construction between now and 2006.

"They make us look stupid," says a staff physician, who commented only upon condition of anonymity. "How can we be a top 100 hospital and have mobile O.R.s?"

UVA Medical Center currently has 19 operating rooms; the total will be 24 after construction is complete. Until then, the addition of two mobile O.R.s will boost the number to 21– and McGowan says that demand makes the units necessary. Critics concede that surgery is profitable for the hospital.

What about the standard of care? "I can stand in front and say the quality of care is no different from the main O.R.s," says McGowan.

Of course, surgeons won't be performing open-heart or brain surgery in the trailers. But some procedures– such as orthopedic foot surgery, ophthalmology, or vascular access procedures– will work just fine in the auxiliary O.R.s, according to McGowan.

In fact, with the complex equipment required for 21st-century surgery, the size of the room dictates what sort of procedure can be performed in it, he explains. New operating rooms built today contain around 700 square feet. The mobile O.R.s are between 350 and 400 square feet– the same as at least three current UVA operating rooms.

"They're going to have to be very careful which cases go in the mobile O.R.s because they can't meet the same standards of care," contends a hospital physician, who's also concerned how new, stricter federal privacy standards will be met in the smaller quarters of the modular operating rooms.

Each trailer has a prep area, an O.R., and a recovery area. "We feel we can control how we place patients sequentially" and maintain privacy using "queuing," says McGowan.

UVA Medical Center is one of the top indigent health care providers in the state. Is there any chance those low-income patients will be shuffled out to the trailers in back?

"Of course not," McGowan replies indignantly.

Nor will patients have to walk through the rain to get an operation. The mobile O.R.s will be joined to the existing building by an attached, climate-controlled corridor.

A hospital employee describes the temporary home of the auxiliary O.R.s as a "smelly, ugly part of the hospital," and says, "There is no nice way to get all the patients there and back."

And what of tornados, the bane of mobile home parks? McGowan says that in such an emergency, the mobile units will take the same precautionary steps as the main hospital."

"We're sensitive to the trailer park mentality," he says.

UVA is not alone in using mobile technology. With the soaring cost of medical equipment, more hospitals are finding it's cheaper to rent technology on wheels– McGowan mentions computer tomography, MRIs, and cath labs– one or two days a week than to have expensive equipment sit around unused.

Still, some resident wags have suggested a promotional campaign to launch the new O.Rs: "Free wifebeaters to the first 200 patients," and "Free pork rinds– and after a tour of the doublewides, a moving tribute to Dale Earnhardt."