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COVER STORY


The waiting area of Key Whitman Surgery Center in Dallas, Texas. Eckert Wordell designed the ASC.


Design Considerations for an ASC


Choose an ASC architect and work closely with your state health department and full team BY SAHELY MUKERJI


W


hen Key Whitman Surgery Center in Dallas, Texas, had the option of either renovating or building new, it decided to opt for the latter and insisted on an experienced healthcare architect who specialized in ophthalmology. “Our lease was terminating and instead of renovating our center with a license from 1983, we decided to build new,” says Dan Chambers, executive director of the ASC. “The cost was higher for renovating, and it’d shut us down for a period of time, which would translate into loss of revenue.” Chambers, Nikki Hurley, direc- tor of nursing/director, and Jeff Whit- man, MD, owner of the ASC, looked at sites, picked one in Dallas and decided to relocate their ASC. “Our relocation under Medicare guide- lines didn’t need a new PTAN [Pro- vider Transaction Access Number]


8


because we were already approved by Medicare and all the payers,” Cham- bers says. “We needed a state license and a new Medicare inspection, our ancillaries remained the same, and we just changed the address. This was a unique advantage.” With the site they picked, how-


ever, they had to use the developer’s contractual architect who was expe- rienced in office buildings but not surgery centers, Hurley says. “We insisted on bringing in a specialized architect to work with the contrac- tual architect at our own expense,” she says. “After the initial build, one of the ORs had to be reconfigured, and the specialized architect, Eckert Wordell, reviewed the issues, rede- signed the OR space and completely rectified the issue within 24 hours.” The HVAC system took up a large space that was not factored into the


ASC FOCUS SEPTEMBER 2019 | ascfocus.org


original design, Chambers explains. “So, we took some of our storage area and converted that into the OR.” HVAC systems in a regular office


building are nowhere near what is required for an ASC, says John Mar- asco, principal of Marasco & Associ- ates Inc. in Denver, Colorado (turn to page 12 for “Role of HVAC in Infec- tion Prevention”). “The air exchanges, filtration levels, humidity and tempera- ture controls in the ORs, preop, recov- ery and sterile corridors are all much more comprehensive in an ASC than in a traditional office space.” When renovating, humidity and temperature control were an issue for Chesapeake Eye Surgery Center in Annapolis, Maryland, says Maria Scott, medical director of the ASC and president of Outpatient Ophthalmic Surgery Society. “We built our own ASC in 2002 and, in 2014, we reno- vated to double the amount of space,” she says. “One of our biggest problems was that our ORs were near windows,


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