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Trends in ASC Design Consider these practical, cost-cutting ideas INTERVIEWED BY ROBERT KURTZ


ates in Mount Dora, Florida. M


Q: What are the most significant factors influencing ASC design today? Michael Gordon (MG): Efficiency, concerning layout and cost. Pay close attention to the traffic flow to ensure it meets the needs of staff and patients. You must also be careful of overbuilding. Base your design on realistic projections, not optimistic projects. Over-anticipate the number of procedures surgeons will bring and you may build a facility that costs more to operate than the reve- nue you generate. Another important factor is how


larger equipment and more complex surgical procedures impact operating room (OR) size. If you plan to per- form joint replacements, for example, you will need an OR with at least 500 square feet. Fail to plan ahead and you will end up with a design that does not meet your surgical needs. One other factor is the future. Consider the continued migration of procedures into outpatient set- tings. When planning for today, are you also thinking about how you will accommodate tomorrow’s caseloads? We try to take into consideration the ability for a center to be expandable without greatly affecting or shutting down operations.


Q: What are the top design considerations ASC owners should not overlook? MG: If an ASC is not designed to properly maintain indoor air qual-


ichael Gordon is founder and president of Gordon & Associ-


Q: What advice would you offer to ASC owners when designing a facility that can accommodate future growth? MG: You do not want to shut the facility down for an expansion. The time spent shut down can cost more than the expansion. Understand what areas will likely require expansion, including infrastructure that cannot be added in the future, and lay them out accordingly. If you plan to even- tually add more patient care areas— ORs, preoperative


and recovery—


ity or if traffic flow is not conducive to maintaining a clean/dirty sepa- ration, you can put your patients in jeopardy. Continuously look at all infection control and safety issues as you design. Limit the amount of traffic that goes from dirty to clean areas so someone cannot easily bypass safeguards and contaminate a clean space. Inventory control is another big


issue for ASCs. Hospitals have stor- age everywhere and often do not know what is on their shelves. This approach is not optimal for an ASC, which must effectively control its inventory in a much smaller space. Do not put all storage in your ORs. Plan for where you will store your carts and effectively prepare them for the next day’s procedures. Also, do not forget to consider how


your ASC will safely and efficiently receive and distribute deliveries.


30 ASC FOCUS SEPTEMBER 2019 | ascfocus.org


put them on the outside wall and have the sterile corridor stop at the outside wall, ending it as an exit. This placement allows you to mir- ror image the spaces during expansion without having to affect internal func- tions within the ASC. When you finish the addition, all you need to do is open a door and you will be ready to use the new space. This is an over-simplifica- tion but the concept is viable.


Q: How do you develop an ASC design plan with a limited budget? MG: While there is no way to cut costs below the minimum required to meet building codes and earn cer- tification, avoid splurging on osten- tatious materials and amenities. Not only are these unnecessary expenses, patients often do not like them as they can give a perception of expen- sive care. We try to communicate four messages with our designs: the ASC has been here for a while, it will be here tomorrow, it is current with technology and surgical practice and patients are welcomed.


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