costly. Don’t rush, and take your time to review the plans; it will save you in the long run.” That is true from the architect’s
perspective, as well, says Mark L. Hansen, principal at Mohagen/Hansen Architectural Group. “I cannot em- phasize planning enough,” he says. “It takes four months to plan and design a facility and six months to build. The more planning you do, the more effi- cient you are going to be executing the project, and the more you will under- stand and quantify the comprehensive project budget. If you don’t take the time to adequately plan, you will find yourself behind the eight-ball and dis- cover more hidden costs as you move forward with the project.” Joseph Conahan, MD, managing
partner of Pocono Ambulatory Surgery Center in Stroudsburg, Pennsylvania, started planning the expansion and renovation of his surgery center about a year ago. “It is a big undertaking,” he says. “It takes a lot of time, money and planning, especially when you main- tain the original operation. It’s a very complex project. You want to build big enough for now and for the future but not overbuild.” The Pocono Ambulatory Surgery
Center Nurse Administrator Mary Hayden and Chief Surgical Technician Andy Gondel recently helped coordinate the 17,600-square-foot addition to the center. “We were in a 12,000-square-foot
building until two years ago,” Conah- an says. “We were approaching 8,000 cases per year and realized that we needed to expand. We had two ORs and two fairly new endoscopy units that we put in four or five years ago. The regulations had changed and we wanted to comply.” Conahan originally estimated that
the work could be done in about a year, but it took longer. “Staying operational while doing the renovation was tough,” he says. “It’s taken about a year, but we stuck to our principles and philoso-
phy: to provide quality care in the most comfortable atmosphere in a cost-effi- cient manner.” Smith
agrees that construction
while the facility remains operational is difficult on everyone. “Do whatever you can to mitigate the interruptions,” he says. “Try to plan well in advance for the impact and how any difficul- ties can be overcome. Expect the worst. No matter what, construction
Once the team is set, it needs to be
able to make timely decisions, adds Ken McDonald, owner of KMD Ar- chitects. “If the doctor can’t make the decision quickly, it drags out the proj- ect. There should be one or two people making the decisions.” Those people, however, have to be the right people, Smith cautions. “In- clude your staff when designing spac- es,” he says. “They have invaluable
You need to have trust in your architect, designer and contractor. It is imperative that you believe in them and trust what they tell you. Remember, they are the experts in their field and you are not.”
—Jed P. Smith, Massachusetts Avenue Surgery Center
in a facility is just like in a home— you never know what exactly is be- hind the walls, in the ceiling or under the floors.” When renovating and expanding a functioning surgery center, “it can be an extremely difficult task if you don’t have any available swing space to cre- ate an adequate phasing plan, which allows the surgery center to remain functional and profitable during the renovation,” Hansen says. In Albers’s case, the staff and management team made sure that ev- ery phase of the project transitioned well, she says. “People were in on the weekends setting up new areas for op- eration on that following Monday, and then, the contractors would take over other space.”
A consistent core team of staff is essential for a successful renovation project, Hansen adds. “You can’t have people coming in and out of the project process. The team has to be established and empowered to make critical deci- sions for the betterment of the surgery center, which will ultimately make the planning and the documentation pro- cess very efficient and cost-effective.”
input and you need to rely on them. Sometimes what seems a fairly simple design or functional change can have an enormous impact on the function- ality of the space. Keep in mind that physicians and owners are not contrac- tors, designers or architects. They may have the best intentions, but when you are remodeling or expanding, what you may want and what you may be able to have are not always the same. There are confinements to deal with; some are structural and some are mandated by regulations.”
Architect’s Point of View For an architectural firm, health care is one level of specialty, and understand- ing the specifics of a surgery center is another level of expertise, Hansen says. “With surgery centers, there are a lot more code requirements related to the Life Safety Code, the department of health requirements and Medicare and Medicaid reimbursements, as well as licensure requirements relative to how surgery centers are designed and operated,” he says. “When you’re deal- ing with a freestanding ASC, especial- ly a for-profit group, understanding the
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