How to Build a World-Class ASC

A laser-sharp focus on the right priorities and a team of experts to help you achieve them will set you up for long-term success.

It’s easy to feel confused and overwhelmed by the complex processes and requirements of a new ASC build, but stakeholders can remain focused by keeping one core principle front and center in the decision-making process: the patient experience.

Central focus

“The patient must be at the center of every decision you make,” says Christine Jackson, RN, BSN, executive director at Lighthouse Surgery Center in Hartford, Conn. “Even before you choose a location and break ground, you need to be thinking about how those early decisions will impact the patient.” Ms. Jackson elaborates on this point with an example of something that occurred during the planning process for Lighthouse.

The team of stakeholders initially found land that appeared to be an ideal space to build a surgery center. The problem? Its proximity to a medical life raft should something go wrong. “The land was all the way across town,” says Ms. Jackson. “We eventually settled on a property right across from the hospital.”

Throughout the design and build, Lighthouse stakeholders put the patients and their family members at the center of every decision they made — from adding frosted glass to protect patient privacy to extensively testing the comfort of the furniture in the lobby.

Beyond the patient

While the patient and their caregivers should absolutely remain the central focus of an ASC build, be careful not to lose sight of how the decisions you make in the design phase will ultimately affect your staff when the surgery center is up and running. “We always go beyond and ask ourselves what the decision will look like for surgeons, nurses and even vendors,” says Rod Carbonell, RN, BSN, MHA, chief development officer for Constitution Surgery Alliance (CSA), a developer and operator of ASCs headquartered in Avon, Conn. “When it comes to your throughput, the design inefficiencies won’t remain hidden for long. If you misdesign something in the center, it will eventually reveal itself.” Mr. Carbonell uses an example of a facility that performs total joints to illustrate his point. These centers, he notes, often store many thousands of dollars of implants alone, and providers don’t want those items in general storage. “Nurses can’t be required to walk 60 yards across a facility for something they need for every case,” says Mr. Carbonell. “In these cases, facilities may want to consider creating an implant-specific warehouse that’s adjacent to the ORs.”

Strategic partnerships

The more experts you can lean on during the design process, the better off you’ll be in the long run. “It takes experts who have seen poorly designed facilities to create well-functioning surgery centers,” says Mr. Carbonell.

It takes experts who have seen poorly designed facilities to create well-functioning surgery centers.
Rod Carbonell, RN, BSN, MHA

From architects and mechanical engineers to HVAC technicians and electricians, try to speak with a variety of experts who are involved in the building process. “During the construction, you want to pay meticulous attention to extremely granular details,” says Ken Rosenquest, CSA’s executive vice president and chief operations officer. “Examine the layout of the electrical system and check every outlet and light socket. Look at where the hand sanitizers will be placed and visualize how this will fit into the nurses’ workflow.”

When it comes to beneficial partnerships, Ms. Jackson reminds leaders to think about the long-term implications even if hiring a certain vendor exceeds short-term budget limits. For instance, Lighthouse attributes a lot of its early success to work a consulting firm did with its insurance contract negotiations. “It was a significant expense, and we asked ourselves, ‘Is it worth this large chunk of our budget?’” she says. “But ultimately this firm was worth its weight in gold. They were experts in payor negotiation, and they negotiated strong contracts that lasted two, three and four years.” In an industry where reimbursements are decreasing and supply chain costs are increasing, solid contracts with your commercial payors are a must, adds Ms. Jackson.

Finally, as obvious as it may sound, it’s critical for stakeholders to build with enough space. As Mr. Carbonell puts it, “One key aspect of ASC design that has never changed and never will change is storage, storage, storage.” Mr. Rosenquest echoes that sentiment, adding that it’s almost always better to err on the side of too much space when designing a new surgery center. “You want to a build an ASC that’s expansion-ready, with room to grow for the future,” he says. “If it comes down to it, overdesign spaces like your sterile processing department and leave room for additional sterilizers you can add at a later date.”

An ASC build is never easy. But with the right vision, the right priorities and the right team in place, the process will go a lot more smoothly and your chances at long-term success will improve exponentially. OSM

Note: This three-part article series is supported by Stryker.