Precise environmental control where it really matters: your operating rooms

Operating rooms (ORs) are among the most complex environments in any hospital. They function as tightly controlled ecosystems where temperature, humidity, air pressure, airflow, and air quality must remain in precise balance to support safe and efficient surgery.

When these conditions are maintained within required ranges, ORs protect patients, support clinical teams and enable reliable surgical operations. When control degrades, risk increases quickly. Case starts are delayed, room turnover slows, compliance exposure grows, and operational continuity is disrupted. Because ORs consume up to 6x more energy per square foot than other spaces in the hospital, maintaining stable conditions and aligning them to workflow and scheduling also delivers meaningful economic benefit by reducing energy use during non-critical periods and adjusting conditions to the needs of each procedure.

As hospitals scale to perform dozens or even hundreds of surgeries each day, maintaining environmental precision becomes more difficult and more consequential. Small deviations that once had limited impact can now ripple across tightly sequenced surgical schedules, affecting throughput and utilization across the OR suite. In this environment, precise control of operating room conditions is foundational to safety, efficiency, and performance.

Optimal conditions for safe and efficient surgery

ORs have the highest rate of infections of any other spaces in healthcare. Patients are more exposed than in other parts of the hospital, making environmental stability essential to protecting sterile fields and reducing the risk of surgical site infections. In fact, operating rooms account for approximately 20% of all healthcare associated infections, underscoring how closely patient safety is tied to environmental performance.

Safe and efficient surgery depends on a small set of environmental conditions working together, continuously and predictably, throughout every procedure and turnover. When these systems perform as intended, surgical teams can focus on the patient rather than the room.

• Temperature stability, typically within referenced ranges such as 68–75°F, maintained under real heat loads
• Humidity control, commonly cited in the 20–60% RH range, protecting sterile conditions while avoiding condensation or static risk
• Differential pressure, maintaining positive pressure to prevent contamination from adjacent spaces
• Ventilation performance and effectiveness, performance is often measured in air changes per hour (ACH), with typical OR targets in the 15–20 range. Effectiveness is the ability to design ventilation patterns to safely remove contaminants during procedures
• Filtration performance, frequently including HEPA filtration, with validated performance over time

Individually, these parameters are well understood. The operational challenge arises from managing them together across multiple rooms, through continuous turnover and variable utilization.

When environmental drift turns into utilization loss
Most OR disruptions don’t start with major system failures. They begin with gradual drift. A room’s temperature moves out from its optimal range. Pressure stability degrades after repeated door openings. Ventilation performance slips between scheduled checks. Each change is subtle on its own but collectively they erode the controlled environment that surgical teams depend on.

When drift is identified late, the impact becomes far more visible. Rooms fail readiness checks. Staff are forced into manual verification with case starts delayed. The result is lost OR utilization and avoidable friction in one of the hospital’s highest value environments. Preventing this outcome requires earlier visibility and faster response, not more manual checks.

Smart, connected ORs enable continuous readiness

Smart, connected controls are transforming how OR environments are managed by shifting environmental performance from reactive intervention to continuous readiness.

Metasys building automation system (BAS) provides direct control of room-level systems, while OpenBlue provides real-time insight across the entire portfolio of ORs. Together, they support a more disciplined operating model in which readiness is repeatable, predictable, and scalable across all surgical spaces.

This continuous readiness ensures that performance scales to maintain the stringent environmental conditions required during surgery. Yet ORs are not in active use around the clock. Traditional setback approaches often rely on static schedules or single-point inputs such as occupancy sensors, and they typically depend on manual intervention when unplanned events occur. As a result, rooms may not be ready when needed, forcing clinical staff to step in or revert to full conditioning, which undermines energy savings and increases operational friction.

OpenBlue Operating Room Optimization (ORO) eliminates these limitations by using multiple inputs to determine the appropriate operating states of each room. Instead of a single trigger, ORO integrates surgical schedules, real-time occupancy data, configurable thresholds and overrides, and continuous BAS feedback to adjust conditions dynamically and maintain compliance. This approach has delivered up to 40% energy savings in OR environments without compromising safety.

Digital dashboards provide real-time visibility across the OR suite, while automated notifications confirm when temperature, humidity, pressure, and airflow are within required limits. This reduces manual checks and shortens the time between room turnover and case start, helping surgical teams operate with greater confidence and efficiency.

Case study: measurable impact in a major U.S. healthcare system

At a major U.S. healthcare institution, OR performance was constrained by environmental drift, limited visibility, and reliance on manual checks. These challenges led to delays, excess energy use, and operational strain.

Johnson Controls implemented an OR optimization solution using Metasys and OpenBlue to deliver real time visibility, automated environmental control, and integrated readiness monitoring across the OR suite. The hospital improved compliance and room availability while reducing manual intervention and energy waste, achieving approximately $5,000 in annual savings per operating room without disrupting clinical workflows.

OR readiness is a performance strategy

Operating rooms sit at the intersection of patient safety, surgical throughput, compliance exposure, and cost control. Precise environmental control is foundational to reliable surgical performance.

Johnson Controls designs and supports solutions purpose-built for healthcare, helping hospitals protect patients, reduce risk, and maintain continuous readiness across the spaces where care depends on it, 24/7.

FAQs

Why is environmental control critical in operating rooms?
Operating rooms are highly sensitive environments where temperature, humidity, pressure, airflow, and filtration directly affect sterility, patient safety, equipment performance, and surgical throughput. Even small deviations can disrupt a sterile field or force case delays.

What environmental conditions are required for safe and efficient surgery?
Key requirements include stable temperature (typically 68–75°F), controlled humidity (30–60% RH), positive pressure to protect sterile zones, adequate air changes per hour (often 15–20 ACH), and HEPA level filtration. These conditions must be maintained continuously.

How does Johnson Controls support OR performance?
Johnson Controls provides HVAC controls, automation, and digital solutions purpose-built for healthcare. These solutions help hospitals protect patients, reduce risk, maintain compliance, and support continuous OR readiness across the spaces where care depends on it.

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