Welcome to the new Outpatient Surgery website! Check out our login FAQs.
November 3, 2021
Publish Date: November 2, 2021   |  Tags:   Facility Construction and Design


Make Your New ASC a Destination for Care

The Promise of an ASC Cath Lab

How This ASC Prepared for a New Future in Orthopedics - Sponsored Content

Can Artificial Intelligence improve Care at GI Centers?

Can Your ASC Succeed With Spine Surgery?


Make Your New ASC a Destination for Care

The design of the new HSS Florida facility combines function and form.

VISUAL RELIEF Patients and their caregivers who are awaiting surgeries at Hospital for Special Surgery Florida enjoy a calming view instead of staring at walls.

As an ever-increasing number of surgical procedures continue to move to ambulatory surgery centers (ASCs), newly constructed outpatient facilities are going all-out to entice potential patients with sleek and modern designs in addition to excellent care.

A great example is the $26.5-million Hospital for Special Surgery (HSS) Florida facility in West Palm Beach, a 55,037-square-foot work of art that opened in 2020 with the singular purpose of providing a total patient experience under one roof. In addition to a state-of-the-art ASC where patients have joints replaced and undergo other elective procedures, the facility — a joint venture with Tenet Florida Physicians — offers diagnostic testing, comprehensive rehabilitation and sports performance programs.

A highlight of the facility is its aesthetic appeal, which designers put on full display. HSS Florida leverages the natural beauty of its location to put patients at ease from the moment they enter. The spacious lobby uses a combination of natural light and stunning views of the Atlantic Ocean to set the tone.

Ryan W. Simovitch, MD, a sports medicine and shoulder surgeon who serves as associate medical director of ambulatory services at HSS Florida, says the leadership team was adamant about designing a welcoming environment. That's why the waiting area, which includes a calming color scheme of pastel blues and grays and a wall meant to resemble driftwood, features floor-to-ceiling windows that offer sweeping ocean-facing views of intracoastal Palm Beach Island. The design sets a serene scene that carries throughout the entire facility, says Dr. Simovitch.

HSS Florida also adhered to another key principle of ASC design by creating ORs specifically designed for expansion and growth opportunities. Case in point: The two operational ORs — a number that is expected to grow — are oversized and expansive in order to accommodate anything from complex total joint replacements to straightforward knee scopes. The ORs are equipped for robotics cases and outfitted with 4K audio/video systems that enable surgeons to broadcast live surgeries for teaching purposes, says Dr. Simovitch.

A lesson provided by this facility: If you're in the early stages of planning a new ASC or in the thick of the design phase, a focus on future growth should be included.

The Promise of an ASC Cath Lab

Patients at QMG Surgery Center reap the benefits of quicker, more efficient options for cardiac catheterization.

Cath IN AND OUT In states that allow it, cardiac catheterizations at freestanding outpatient facilities are much more convenient and timesaving for patients.

While some facilities await more data on the efficacy of doing cardiology cases in an ASCs — or wait for authorization to even do so in numerous states — others are jumping into this growth opportunity headfirst. Quincy (Ill.) Medical Group (QMG) Surgery Center is a prime example of the latter.

QMG's new multispecialty ASC includes a catheterization lab where its physician-owners perform cardiac procedures that are convenient and cost-effective for patients. QMG cardiologist Wissam Derian, MD, FACC, CCDS, says catheterizations have evolved to the point that patients can often safely have the procedures done and go home the same day.

During catheterizations, a thin flexible tube is inserted into the arteries of the patient's heart, and dye is injected to visualize blockages. While the procedure has traditionally been performed from the large artery in the leg, cardiologists have begun to utilizing the radial artery in the wrist in about 90% of the cases, according to Dr. Derian. "This reduces the risk of complications and the length of stay for the patient," he explains. The best part for QMG patients? They are ready to return home about two hours after a diagnostic cardiac catheterization.

QMG plans to add other procedures such as left and right diagnostic and interventional heart catheterization, pacemaker and ICD generator exchanges, loop recorder insertion, and extraction and transesophageal echocardiogram with cardioversion in the near future.

All patients are carefully screened to ensure the procedures are appropriate for them in an outpatient setting. "Patient safety is our number one priority," says Dr. Derian. "There is much research that goes into any approved procedure, and we will always follow appropriate guidelines for any procedure performed in our facility."

How This ASC Prepared for a New Future in Orthopedics - Sponsored Content

The Minneapolis/St. Paul ASC, looking to offer more surgical services in subspecialties, partnered with Stryker to create forward-thinking, smart solutions for comprehensive orthopedic care.

Summit Credit: Summit Orthopedics

The expansion of ambulatory surgery centers (ASCs) across the country is on the rise as existing facilities are looking to expand to capture new markets. Some take the step to build brand-new centers to serve their communities, while others are expanding existing businesses. No matter what path they take, as facility leaders look to improve their footprints in the local area, they have the option to turn to partners that can help them make the best decisions to prepare for the future.

Summit Orthopedics (MN) made the move to expand their surgical specialties and focus on state-of-the-art technology to better serve the Twin Cities. Summit is a physician-owned and physician-led independent orthopedic practice governed by a board of directors of Summit surgeon shareholders. With four ASCs and approximately 860 employees on board since it was founded in 1999, Summit has worked to provide the community with an ever-increasing range of surgical services, including total joints.

In February 2021, Summit Orthopedics forged a new path to focus on the future as it began a new, multi-year partnership with Stryker's ASC business.

It was important to Summit's leadership team to continue to evolve their practice and not become complacent, which is why their focus shifted to specializing in all musculoskeletal procedures. Looking to expand into orthopedic sub-specialties, including spine and hand surgeries with each being offered in a separate ASC location, Summit wanted to work with one partner to make their vision a reality.

Summit Orthopedics' surgeons and leadership were also looking for the latest in technology, as well as the most forward-thinking solutions provider, to become a partner. Summit is dedicated to its vision of medical innovation, quality of care and commitment to exceed patients' expectations and help patients achieve a healthy, active lifestyle. Their ASC environment, featuring the products and innovations introduced with the new Stryker partnership, offers a cost-effective, convenient, patient-friendly setting to treat a range of orthopedic needs in state-of-the-art surgery centers.

After a rigorous RFP process, Summit chose Stryker's ASC business because of their ability to present a single point of contact, a shared vision, cost efficiencies and the ability to standardize across multiple sub-specialties. Most importantly, Summit chose Stryker's ASC business because the physicians were confident in the products and robotics.

Stryker's ASC business was launched in 2020 to meet the unique needs of ASCs across the country. Whether building a new ASC, renovating or expanding into new specialties, like Summit Orthopedics, Stryker's ASC business has a dedicated team to help ASCs meet their goals. The Stryker and Summit partnership has made great strides since it initially launched earlier this year as Summit Orthopedics and Stryker continue to look to the future.

Note: For more information about Stryker's ASC business, please go here.

Can Artificial Intelligence Improve Care at GI Centers?

Multicenter provider uses the technology to improve the effectiveness of its colonoscopy screenings.

While much of the promise of artificial intelligence (AI) in health care remains theoretical in nature, one prominent digestive care provider is putting the innovative tech into practice to improve the accuracy of its colonoscopy screenings.

Gastroenterology of the Rockies, a digestive care provider with multiple centers in Colorado, recently became the first provider in the Centennial State to use AI technology to help identify colorectal polyps. The AI system, which the provider says is the only approved system of its kind in the U.S., allows physicians to scan every visual frame of a colonoscopy procedure in real time to identify polyps that could be missed by the human eye.

The system, which even alerts providers to abnormalities it detects, offers a dataset of over 13 million polyp images. That dataset will continue to expand over time to improve performance and detection rates, says the provider.

"We are extremely excited about how this new artificial intelligence can help us detect and remove polyps," says Ramu Raju, MD, adding that he and other physicians at Gastroenterology of the Rockies have already seen a higher detection rate. "Our patients have been reassured that our procedures and their care are more accurate than before."

Although Dr. Raju is extremely bullish on the promise of AI, he's quick to point out that it will never replace the precision and skill of the gastroenterologist. Rather, he sees great potential in the combination of skilled physicians and the technology. "I believe it will have a significant impact and certainly help us in our ongoing work to eliminate colorectal cancer," he says.

Can Your ASC Succeed With Spine Surgery?

Answer this critical question before embarking on outpatient's most sought-after new specialty.

Tremendous physician buy-in, widespread payer acceptance and proven data that the procedures can be performed safely and efficiently in an outpatient setting are causing a lot of surgical facilities to evaluate the addition of spine procedures to their case mix. Before you even consider adding spine to your ASC, answer the following question as honestly as possible: Are you motivated for the right reasons?

If you are fixated on creating a scalable, high-volume service line, perhaps think it over again, says Robert S. Bray, Jr., MD, a board-certified neurological spine surgeon and CEO and founding director of DISC Sports & Spine Center in Newport Beach, Calif.

"We've made a lot of money doing outpatient spine, but we have never focused on running through cases simply to make money," says Dr. Bray. "We have always emphasized quality first, and any financial benefits we currently enjoy are solely the result of trying to learn from each case and go into the next one better prepared to provide meticulously analyzed, outcome-based care that's better than the care patients would receive elsewhere."

Dr. Bray acknowledges that it's completely natural to be excited by a financial opportunity when a trend emerges in the outpatient market. However, he says, providers need to understand that spine is a completely different endeavor than, for example, ENT or GI. "Spine isn't the type of specialty where you can go in and just start moving cases," he says. "It costs a lot of money to do this well."

How much money? Roughly speaking from an equipment standpoint, a facility looking to perform outpatient spine procedures would need a C-arm ($160,000 and up), special spine tables ($45,000 to $100,000 each), surgical microscopes ($150,000 to $275,000 each), instrumentation ($35,000), retractors ($15,000 to $20,000 each) and instrument trays that are specific to the facility's surgeons and case mix.

Dr. Bray says you need to properly evaluate whether case volumes and margins would justify these costs. For instance, during his own analysis, Dr. Bray uncovered that he needed to exceed 300 cases per year to scale margins enough to cover equipment costs.