COVER STORY
necessitates a longer recovery, the bay will help minimize disturbances. If a famous individual or pediatric patient comes in for surgery, the bay will pro- vide enhanced privacy. "We have even spoken with some gastroenterology phy- sicians to see if they would like to use the room as an endoscopy suite.”
Considering your future can help
you make smart building choices, Blanck says. If you envision possibly recruiting a high-volume surgeon who will want to use a femtosecond laser, but your ASC's design cannot easily accommodate the technology, adding that surgeon might prove challenging. “On one hand, I said do not over-
While surgical volume should dictate the number of ORs you build, Clayton suggests that developers strongly con- sider the value of at least building a sec- ond OR if growth is anticipated. "You can do the buildout of the second OR but not equip it. When the time comes for you to proceed with expansion, you will avoid the need to shut down the ASC and the resulting loss of the associated rev- enue as you build the second OR suite.”
Settling on the number of ORs is an important decision, but perhaps just as important is trying to ensure your clini- cal design and flow is optimized to your anticipated case types, Betts says. If you are planning to mostly perform cataract and yttrium aluminum garnet (YAG) procedures, which tend to be lower acu- ity and faster cases, room turnover and flow will take on much greater impor- tance than if you are mostly perform- ing retina and oculoplastic procedures, which tend to be larger and slower cases. “For those high-volume procedures,
you want to think about how to mini- mize the literal steps you need to take during your day to increase turnover efficiency," Betts says. “In addition, minimizing sharp turns during patient transfer is important. This is not only
for patients because they can get dizzy if you are swinging them around a lot of turns, but it will make movement easier for staff. Without sharp turns, you are less worried about bumping into doors or catching corners.” Try to keep the space between clin- ical departments at the bare minimum required to still maintain safety, Blanck says. “This is especially important for those types of cases which require you to run patients every 10 minutes or so out of an OR. You want your ORs and preoperative, postoperative and subster- ile areas as precise and tight as you can get them to maximize productivity.” Being a little creative in your design decisions can reap short- and possibly long-term benefits, Betts says. While traditional recovery bays are typi- cally separated by a curtain, Northwest Arkansas Surgery Center includes a completely enclosed bay. “I was think- ing about planning for the future. What if we bring in a retina doctor or even different specialties? What are some aspects that would allow us to be more appealing to recruiting other surgeons? The enclosed bay was a simple way to gain some flexibility.” The bay can serve multiple purposes, Betts says. If the ASC needs to provide patients with general anesthesia, which
18 ASC FOCUS OCTOBER 2020 |
ascfocus.org
build,” he says. “On the other hand, you need to try to think about your plans. Maybe you place an enclosed PACU bay on the other side of the wall from the sterile corridor. If you eventu- ally need a femtosecond room, you can cut through that wall, put up a door and now you have the space to accommo- date the laser.”
Before committing to building an ASC, Blanck recommends physicians consider whether investing in an exist- ing ASC is more practical. “A new center will typically take two to four years to design and build, get licensed and certified, and start generating cash flow. While you should be able to per- form Medicare cases, contracts with Medicare Advantage and commercial plans are not guaranteed. Investing in an existing ASC, if it is an option, can allow an immediate, strong ROI virtu- ally from day one.”
Once decisions are made and work
has begun, strive to keep changes to a minimum, Clayton advises. "Change orders quickly increase cost and cause project delays. Some will be necessary, but owners can get caught up in the excitement of having their own ASC. If not careful, they can quickly find them- selves with costly overruns that have now punched holes in the proforma and its profitability projections.”
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52
