October 4, 2023

Paying attention to every tiny aspect of ASC design is a time-consuming but necessary undertaking for surgical leaders.

EFFICIENT JOINT With just two ORs, White Fence Surgical Suites ASC has performed nearly 15,000 total joints cases over the past decade.

Considering all the effort you put into the major, headache-inducing aspects of an ASC design and build — the endless delays, the never-ending regulatory hurdles, etc. — it’s understandable that you might scale back on the “less essential” decisions. It’s important to keep in mind, however, that the smallest details can often have major implications.

Just ask Adolph Lombardi, MD, FACS, president of JIS Orthopedics, the practice that runs White Fence Surgical Suites ASC in New Albany, Ohio. Dr. Lombardi sees no decision as too small and points to three key decisions that helped pave the way to White Fence performing more than 14,500 total joints cases over the past decade at its super-efficient two-OR ASC.

Portico from the storm. Dr. Lombardi and his team were well into the design process when they remembered that their patients would often be arriving at the ASC in the midst of harsh Ohio winters and torrential seasonal rainstorms. So they made a seemingly minor but key decision to add a drive-through portico outside of the center’s doors. “We were thinking about the convenience of not having to trudge through the rain or the snow in the parking lot,” says Dr. Lombardi.

Dual pre/post-op bays. Dr. Lombardi and his team knew all about the space constraints surgery centers often face. That’s why they focused on efficiency when designing the layout of the 7,500-square-foot ASC, with a specific emphasis on avoiding redundancy. For example, to avoid wasting limited space, White Fence’s seven pre-op bays also serve as the PACU for patients prior to their discharges.

Dr. Lombardi says many newer facilities tend to want to build bigger than their needs, which leads to more staff, more equipment and extra — but often underutilized — rooms. “Why open your center with four to six ORs if you aren’t 100% sure they will always be in use?” he asks. “We have two ORs and a procedure room and everything is always running.”

Multiple opinions — on everything. Dr. Lombardi advises leaders in the process of designing an ASC to get their doctors together and examine everything from the minute details of their instrumentation and implant preferences to the 30,000-foot strategy for the center. “Find out what makes them tick,” he says. More than a decade ago, when Dr. Lombardi did this at White Fence, the gathered surgeons looked at every single instrument they’d be using to do total joints and said “yay” or “nay” to each.

By keeping that guiding principle top-of-mind throughout the process, surgical leaders will be well-positioned for success.

Bob Pluckebaum/Cushing Terrell
GOOD HANDS Calming but stimulating spaces, as opposed to traditionally cold and sterile environments, can reduce patient anxiety about their upcoming procedures.

The person in charge of all construction projects for one of the largest nonprofit healthcare networks in New Jersey knows what’s important to please surgical patients and providers alike.

Robert Peake is vice president of facilities management and real estate for Atlantic Health System, which employs 18,000 people and accommodates more than 4,800 affiliating physicians. He says surgical facility design should start with the people who will work in the perioperative suite every surgical day.

“We design space by collaborating with surgical teams to provide them with space where they feel comfortable, safe and able to perform complex surgery,” he says. “Temperature and humidity control, lighting and placing equipment so it’s accessible are crucial for the room to be safe, comfortable, efficient and functional for the entire surgical team.”

That knowledge and insight is particularly important when outfitting a new orthopedic surgical space, as the specialty poses unique challenges. The procedures can be long; the tools used are powerful; the work performed on the patient can be traumatic; substantial amounts of saline and other fluids need to be managed; and, because of all this, infection control measures must be intricate and effective. Ultimately, facility design can directly impact surgeon performance, according to Mr. Peake.

Then there are the patients who desire facilities that feel warm and inviting rather than cold and institutional, says Mr. Peake. An environment that reduces patient anxiety can help with clinical outcomes.

Putting it all together by successfully addressing both patient and provider needs is gratifying once a project is complete, says Mr. Peake. “It’s incredibly rewarding when we complete a project to hear the clinical team comment on how the space helps them provide extraordinary care, that they enjoy working in that space, and that they appreciate the fact that we actively engaged with them in the early stages of design,” he says.

Navigate this complex process with support, resources and financial management to accomplish this goal and plan strategically for the future.

Stryker-L37 Creative
The state-of-the-art SmartCare Palm Harbor Ambulatory Surgery Center in Florida.

Once an ambulatory surgery center (ASC) owner or medical group has decided to make the move to renovate or build a new facility, the planning process starts in earnest and the choice of vendor partners becomes a critical step. Looking at the first decisions to make – the location, the type of specialties to be offered and the capital equipment investments required – the smart OR leaders will evaluate the support they will receive throughout the entire process.

It takes a dedicated team of experts to focus on the myriad of details during these initial planning stages. But it is just as important to receive support and resources for the financial challenges to make the business successful. Stryker offers a custom solution for each ASC project and its unique needs.

Providing access to Stryker’s deep portfolio of products and guides who understand the landscape as well as ongoing support throughout the process makes building and growing an ASC business an achievable goal – and creates the foundation for the future, too.

SmartCare Surgical Partners in Palm Harbor, Florida, worked with Stryker to launch a new world-class facility in Palm Harbor, Florida, following the most current trends in outpatient care. Under the direction of Vladimir Alexander, MD, founding partner of Alexander Orthopaedic Associates and CEO of SmartCare Surgical Partners, this ASC was able to combine a host of orthopedic services, including hip, spine, foot and ankle, shoulder, elbow, and hand and wrist surgeries, with a high-quality patient experience.

The patient-centric, state-of-the-art multi-specialty center was launched in the winter of 2020. Dr. Alexander’s COO, Dr. David Penollo, noted, “The partners were looking to elevate their patient experience to the highest standard of care – and partnering with Stryker made that possible. The convenience of working with one company to reach their goals allowed for a comfort level that made the 18-month journey successful.”

Building and growing an ASC comes with many financial challenges. Stryker offers customized, flexible financial solutions, and works with each ASC build or renovation to ensure that the equipment and the technology roadmap meets the needs of the business.

These can include cash flow optimizing agreements, which offer the option to pay variably for the use of equipment based on procedure volumes or consumable purchases. Deferred payment programs can help with equipment investments and budgets, and leasing options are also available.

Another important element of the Stryker ASC Business is the team of experts who navigate change. The program also calls for regular business reviews, which help evaluate how the facility is currently operating – with the new upgrades or a new build – and how best to plan for future growth.

For more information go to Ambulatory Surgery Center (ASC) | Stryker

For a video of the Palm Harbor ASC journey go to https://www.youtube.com/watch?v=wHKYuHDXkPI