COVER STORY Tips to Consider

Jared VanderWeele, principal and senior architect at Eckert Wordell, offers the following advice to ASC owners looking to build an ASC or convert an exist- ing space into a surgery center.

1. Identify a medical busi- ness consultant

2. Identify an architecture firm with ample ASC ex- perience

3. Make sure the architect will be with you through the whole process rather than handing off a plan

4. Assign an internal proj- ect manager

5. Conduct code research and compliance evalua- tions early and throughout the process

6. Plan for the future as well as your needs today (more land for expansion is not always available later)

7. Know and plan for your specialty mix

8. Include your staff early in the process as they are a valuable source of information

9. Hire an architecture firm with integrated mechani- cal and electrical engineer- ing services.

For example, an experienced architect will know how to plan for the appropriate number of pre- and postop bays based on surgical vol- ume and staffing rather than assum- ing the minimum number of bays per OR as noted by code is appro- priate. “By planning for number of cases, the ASC is able to move patients through the care cycle effi-

A staff corridor in Key-Whitman Eye Center in Dallas, Texas, designed by Eckert Wordell.

ciently reducing the risk of develop- ing a pre-postop bottleneck,” Vander- Weele says. “This also requires a keen understanding of flow—patient and staff—utilizing dedicated public and private pathways with support and functional spaces located off the clean corridor for improved staff utilization, efficiency, and access to supplies and resources.”

Planning for a high-functioning ASC also requires that the design team knows the impact of technol- ogy and case mix, VanderWeele adds. “If the providers are planning to use a Femto laser in the ASC, the archi- tect needs to know the equipment, its usage and the power requirements that will impact the layout of the room. Additionally, the type of spe- cialty ophthalmic surgical—cataract versus retina versus glaucoma ver- sus plastics—that will be performed changes how the ORs are designed.” Proper design is critical to the infrastructure of any specialty ASC, Marasco says. For example, ophthal- mology has a high turnover. “There- fore, the prep and recovery, equip- ment storage, Femtosecond laser, space, sterile space all have to be considered,” he says. “A two-OR ophthalmology ASC is very differ- ent from a two-OR orthopedic ASC.


And they should be or else something is wrong.”

When you have multi-specialties,

it gets even more complicated. “For a long time, we had ophthalmology and ENT together and those couldn’t be further from each other in an ASC setting,” Marasco says. “They cater to different demographics and dif- ferent procedures. So, your architect needs to understand your specialties to design your space accurately.”

Dos and Don’ts For their new building, before even sitting down with the architect, “we visited a number of ASCs to look at the advantages and disadvantages and the nuances that made the workflow,” Chambers says. “We tried to incorpo- rate new ideas and efficient workflow concepts from what we saw.” Scott and her team visited six dif-

ferent ASCs to see their plan and their flow. “Go watch others in action,” she advises. “It helps.” Pay attention to your waiting area.

“We often don’t give enough space to waiting rooms and pre- and postop areas,” Scott says. “Consider that a lot of times there is more than one per- son waiting for one patient, so your waiting area needs to be large. In the pre- and postop areas, patient privacy

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