August 22, 2024

For ASCs and physician groups, redirecting injured patients away from ERs to their own centers can build volume, brand equity and, potentially, profit.

CITY STOREFRONT New York Bone & Joint Specialists’ recently opened Orthopedic Urgent & Sports Medicine Walk-In on Manhattan’s Upper East Side offers patients prompt care for their orthopedic injuries without an appointment. | New York Bone & Joint Specialists

“Say goodbye to endless waits in the emergency room — New Yorkers now have a fast solution for their urgent orthopedic needs at our Orthopedic Urgent & Sports Medicine Walk-In, conveniently located at 1198 Third Avenue on the Upper East Side.”

That’s the pitch on the website of New York Bone & Joint Specialists (NYBJS), which operates multiple full-service orthopedic surgery and sports medicine centers. As a growing number of orthopedic physician groups and ASCs nationwide have found, the concept of enabling patients to access acute orthopedic services at their practice’s own urgent care center instead of a hospital emergency room makes sense for the patient, the practice and the healthcare system.

“Injuries can happen anytime, anywhere, whether you're engaged in sports or everyday activities,” says NYBJS Co-founder Leon Popovitz, MD. “When people get injured or hurt, they deserve immediate attention.”

NYBJS’ Orthopedic Urgent Walk-In Clinic boasts a specialized team that treats patients with sports injuries, orthopedic injuries, joint conditions or “any ailments that require urgent orthopedic care.” Touted as Manhattan’s first ortho urgent care facility, it’s part of NYBJS’ newest “storefront” full-service Orthopedic and Sports Medicine Center — the practice’s third in Manhattan.

For ortho ASCs, opening their own urgent care facilities is an enticing way to expand their footprint and volume while growing their brand and value proposition in their communities. Consider the marketing power of NYBJS’ message when the facility’s opening was announced in January: “No other urgent care in Manhattan offers immediate access to an orthopedic specialist. Instead, all other urgent cares will give out a referral to an orthopedic doctor that requires making an appointment for a later date and yet another appointment.”

The value proposition of an orthopedic urgent care is crystal clear to healthcare consumers, who have readily embraced these facilities for other medical purposes: It’s less time, money and aggravation for patients who simply want their acute injuries treated promptly and effectively. For the practice, it’s a great way to funnel new patients who might require surgery to one of their ASCs.

As the healthcare system continues to adapt and evolve, the ortho urgent care concept could enable forward-thinking physician-owned ASCs to reap significant benefits while expanding their patient population.

Three keys to ensure your team adheres to a “human-centered” ASC build.

OPTIMIZING SPACE Perioperative staff in this outpatient orthopedic OR at Emory Musculoskeletal Institute can center the surgical table at an angle to improve traffic flow and patient access. | Greenwood Endoscopy Center

A human-centered approach to designing your ASC — a strategy that prioritizes and incorporates the individuals who will eventually work there — is the best way to ensure your facility will be able to make long-lasting, positive impacts on surgical teams and patients from the get-go and well into the future.

So says Anjali Joseph, PhD, EDAC, director of the Center for Health Facilities Design and Testing at Clemson (S.C.) University. Dr. Joseph has spent decades researching, testing and helping to implement healthcare design solutions that maximize efficiency and safety. Here are three of Dr. Joseph’s tried-and-true design strategies:

Focus on safe movement. “Through observing OR activities and studying the literature, we’ve found common design flaws that contribute to errors,” says Dr. Joseph. “These include frequent door openings, excessive movements in the OR and constricted space around the surgical table.”

The antidote to those problems, says Dr. Joseph, is a plan that emphasizes safe movement through features such as overhead booms that reduce floor clutter, angled surgical table placement that delineates functional zones and improves patient access for different team members and types of surgeries, strategically placed storage that reduces unnecessary traffic, and stainless-steel modular wall panels that allow for space reconfiguration.

Use VR and AR technology during the design process. Virtual reality (VR) and augmented reality (AR) technology is available for OR design exploration. The technology enables evaluations to identify design flaws that can be corrected before the build even begins.

“This technology enables teams to explore design elements such as room size and proportions, configuration of zones and sightlines for visual displays around overhead booms,” says Dr. Joseph. “Currently, many affordable VR headsets allow you to superimpose a virtual environment onto a physical space and move objects around as you would in a real space. As this technology evolves, I can see a point in the near future where designers and clinicians can evaluate virtual designs together.”

Always consider the patient experience. “Optimization of the patient experience is shaping outpatient care design,” says Dr. Joseph. It starts with nonclinical spaces. From the moment a patient arrives at a surgery center, they seek a warm and welcoming space for registration and private areas to be with loved ones.

“Sterile waiting rooms that feel like airport lounges are giving way to more comfortable furnishings, softer lighting, grouped seating areas and even scenic views if possible,” says Dr. Joseph. “Reducing wait times is another patient experience imperative. Apps that enable patients to check in before their arrival and telehealth encounters for pre- and post-surgical care support this goal.”

The larger take-home point here is this: Always keep the needs and wants of patients and staffs top-of-mind in every aspect of your surgery center’s design.

Learn how a surgery center worked with an experienced partner to create a patient-centric facility focused on delivering high quality outpatient care in the Chattanooga, Tenn., community.

The Center for Sports Medicine & Orthopaedic Surgery specializes in orthopedic surgery, sports medicine, total joint replacement, spine surgery and interventional pain management. The state-of-the-art outpatient surgery facility spans 37,500 square feet on 4.3 acres of land. With a total investment of $18.5 million (plus an additional $6+ million in equipment and robotic technology), this cutting-edge ambulatory surgery center is revolutionizing specialized orthopedic care in the Chattanooga, Tenn., region. | Credit: Lindsay Lowe, Maycreate

Building an ASC from the ground up is no simple task. For those considering embarking on their own new build journey, learning from a center that has successfully navigated this process can provide valuable best practices and insights.

The Center for Sports Medicine & Orthopaedics Surgery Center (CSMOS), located in Chattanooga, Tenn., was faced with an increase in demand for outpatient orthopedic procedures, causing them to evaluate their current footprint and operations. The independent surgeon group and their administrative team made the decision to build a new surgery center from the ground up to improve access to care within their community. CSMOS was able to partner with Stryker on a comprehensive technology solution to outfit their new surgery center.

Click here to watch their story.

Here are some of the key lessons learned from CSMOS’ new build journey:

Stay focused on the patient: The patient should be at the heart of all major decisions that are made about the surgery center’s design and flow. By keeping the patient top of mind, efficiencies can be gained, resulting in a better overall experience for all involved.

Select a technology partner with experience: Stryker was selected as a technology partner because of their deep expertise in the new build process and the broad product portfolio the company can provide. When asked why Stryker was chosen, Becky Farmer, CEO of Center for Sports Medicine & Orthopaedics said, “Stryker, in my opinion, came in heads above everyone else we were interviewing, simply because it was very organized and easy to get in front of the physicians exactly what was being offered... they brought a lot of experience to help guide us. This is what I was looking for in a partner.”

Integrate cutting-edge technology: The team found that Stryker offered innovative solutions for orthopedic surgeries. Dr. Miller of Center for Sports Medicine & Orthopaedics said, “Stryker stood out as a partner for us because we felt like their wide range of products available to us from the pre-op area, to the surgery suite, to all the equipment, that we could just have one vendor that was high quality that could streamline our process.” One of these products was Mako SmartRobotics™, which combines three key components: 3D CT-based planning, AccuStop™ haptic technology, and Insightful Data Analytics, into one platform that has shown better outcomes for total knee, total hip and partial knee replacement patients, as compared to manual procedures.^1-3

Streamline communication: A critical key to success for any new build project is ensuring all parties stay aligned to an ever-changing timeline. According to Amy Smith, Administrative Director of Center for Sports Medicine & Orthopaedics, “the project was so big, we were afraid that if there were too many hands involved, that pieces of information would get lost in translation.” Stryker provided CSMOS with a dedicated Program Manager, to help keep their project on track and to provide peace of mind every step of the way.

Plan for the future: Opening was the first step for CSMOS, as they plan to continue to grow and advance their care offerings in the future. The partnership with Stryker will allow them to deliver on this vision, as Stryker is committed to continued investment in their portfolio of products and services with a goal of making healthcare better. According to Dr. Chad Smalley, Medical Director of Center for Sports Medicine & Orthopaedics, “Stryker's there for a collaboration for the long term and to drive the success of the facility as a whole.”

Stryker’s ASC business partners with new and expanding surgery centers like CSMOS to create a tailored solution designed to meet the unique needs of every facility.

References:
1. Illgen RL, Bukowski BR, Abiola R, et al. Robotic-assisted total hip arthroplasty: outcomes at minimum two-year follow-up. Surg Technol Int. 2017;30:365-372.
2. Kayani B, Konan S, Tahmassebi J, Pietrzak JRT, Haddad FS. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study. The Bone and Joint Journal. 2018;100-B:930-7.
3. Kleeblad LJ, Borus T, Coon T, Dounchis J, Nguyen J, Pearle A. Midterm survivorship and patient satisfaction of robotic-arm assisted medial unicompartmental knee arthroplasty; a multicenter study. The Journal of Arthroplasty. 2018:1-8.

For more information on Stryker’s ASC business, visit Ambulatory Surgery Center (ASC) | Stryker

For a look at the Chattanooga video, click here.

For more on the facility, visit here.