Relocating Our ASC Achieving success in the face of tragedy BY ROBERT B. NELSON

Relocating an ASC is not easy. I can say this quite confidently as my facility completed a relocation in 2017. It was a substantial

amount of work—and this was on top of a tragedy that tested the resolve of our entire staff and demonstrated firsthand the importance of careful planning. My ASC, Island Eye Surgicenter,

was formed in 1998 in Carle Place, New York, on Long Island, by a group of forward-thinking physicians. They understood the need to move their pro- cedures out of the hospital to a setting that was more efficient and allowed them to take control of their case vol- ume, quality, efficiency and outcomes. They developed a three-operating room (OR), open-access, freestanding center and performed the first cases in December 1999. As we grew over the years, our suc- cess brought challenges. The ASC’s space was not designed to accommo- date the exponential increase in volume we experienced, and the growth that we were projecting. We also had inad- equate parking. That became a major constraint for developing the business. In 2003, we undertook a major construction project that created more space for the ASC and significantly expanded parking.

By 2015, we found ourselves at a crossroads again: around 95 percent utilization of our ORs (performing about 7,500 cataracts a year) and with- out much ability to further expand our location. We knew we had to make a critical decision: stay in our building and accept that we would not be able to accommodate new surgeons and cases or open a de novo center. The ASC’s

fully, we worked regularly with accoun- tants and a legal team familiar and com- fortable with New York’s complicated certificate-of-need process. While we waited for the state’s response, we moved ahead with designing the new facility. We wanted to move quickly once we heard back from the state, assuming our plan was approved. We found an architect with specific experience in developing oph- thalmic ASCs. We thought such exper- tise would be essential as such a firm would help us ensure we made wise choices concerning workflow, patient flow (vital in a high-volume center), safety, equipment locations and other critical decisions.

partners felt it was necessary to have a facility that could effectively meet the growing patient and physician demand. This would require a new center. The partners voted to build a six-

OR facility, doubling our ORs and improving our overall clinical offering to the surgeons on staff. Our new loca- tion would be a facility in Westbury, New York, just about half a mile from our existing location. In addition to doubling our ORs, we would triple our usable facility space to 25,000 square feet and more than triple our number of parking spaces on 3.5 acres of prime real estate.

Key Considerations for Relocation Once our partners agreed to building the new facility, I embarked on the planning process. The first step was completing the paperwork, financials, preliminary plan and legal documentation required by our state department of health for the new building and relocation. Thank-

It took the state almost a year to get an answer from our state health department, finally giving us the green light to develop a full set of construc- tion documents and start moving the relocation and construction process forward. We were ahead of the game thanks to the work already completed with the architect. We made sure this architect’s and our vision would be translated successfully by selecting a construction company experienced in health care as well. While we planned to bring some equipment from the old ASC to the new center, we also decided to replace some old equipment with vitally needed new equipment to accommodate the increase in space. Our materials man- ager spent months going between the two sites, taking inventory of what we had and needed, determining lay- out of the various rooms and mak- ing decisions concerning organization and storage. Thanks to her impressive work, we had a very detailed plan for

The advice and opinions expressed in this column are those of the author and do not represent official Ambulatory Surgery Center Association policy or opinion. 8 ASC FOCUS NOVEMBER/DECEMBER 2018|

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