Guest Editor: Break Ground and Dig In

It's often obvious when you outgrow your current space. At one of my former hospitals, the surgical schedule extended way too late in the day, surgeons weren't happy, and patients and staff complained about delayed case starts. I begged the administration to approve the addition of several much-needed ORs, but couldn't get their buy-in.

Finally, I approached my director of nursing for help, and she told me exactly what type of information and data I'd need to present in order to get upper management to greenlight the project. I followed her advice and, just like that, my wish was granted. The experience taught me a valuable lesson about managing surgical construction: You need allies in your corner, and you need to do your homework.

From determining how many new ORs we needed and where the rooms needed to go, to figuring out how the project would affect other areas of the hospital, every phase of the renovation journey was a learning experience for me.

After lots of discussion between myself, our charge nurse and the head of sterile processing, we opted to make one of our ORs into part of sterile processing and construct two brand-new ORs in an adjacent space that had served as our medical records area. Our pre- and post-op departments would receive facelifts, and the procedure room where endoscopies were performed would be converted into a pre- and post-op patient room.

Well, there were plenty of challenges along the way. During the renovation, I stood up to a pushy architect who tried to tell me what to do. I dealt with a maintenance manager who, two weeks into the project, left for vacation and effectively said, "Good news! The project is all yours."

In the middle of the construction, I found out a two-foot concrete pillar that held up the floor above it had to be removed one piece at a time. (The largest piece being approximately the size of an egg!) Then, weeks into the process, an electrician asked if there was a reason plugs were placed 18 inches off the floor in one OR and 30 inches off the floor in another.

As I reflect on my time heading up the project, I wish I would have known about the guidelines established by organizations such as AORN and the Facility Guidelines Institute, but I'm proud of the work that I did.

If you're a surgical leader who is involved in a new facility project, make sure you're heavily involved from Day One in the entire design and construction process. You know what patients need, and you're the resident expert on surgical processes that have to be mapped out and everything that happens behind the scenes.

A surgical leader's perspective would've saved a lot of time, money and headaches for a facility that was constructed in my hometown. In this situation, the center was originally built without a sterile processing area. Needless to say, the builders scrambled to do some major remodeling before the project was even finished.

I've been intimately involved in the renovation and new construction of surgical facilities, and excited to introduce this issue. In the following pages, you'll learn about how to outfit facilities for specialties ranging from ophthalmology to orthopedics, get insight into current market trends and find out how COVID-19 has impacted new designs.

Whether you're breaking ground for a brand new surgery center or overhauling an existing hospital outpatient department, ask plenty of questions, get to know the construction and design team, and use all the resources at your disposal. Finally, be prepared for everything. In the world of surgical construction, anything is possible. OSM