Opening a new outpatient surgery facility – whether it’s an ambulatory surgery center (ASC) or hospital outpatient department (HOPD) – can be a daunting task, especially when starting from the ground up with new construction, unestablished processes, and a staff that is not familiar with the nuances of delivering outpatient surgical care. Thoughtful planning and a deep understanding of the ASC world are crucial.
I’ve been involved in many of these projects and regularly consult for facilities that are about to open a new center (or need help streamlining an existing one). One big thing I’ve learned is that when dealing with a new build, the construction planning stage is one of the most critical, yet often overlooked, elements. Overbuilding can prove costly when space sits unused, so the design and workflow of the building need careful consideration during the planning stage.
This can be challenging to get right, especially when the project is led with a hospital perspective, since ASCs and HOPDs function quite differently than hospitals. I was recently hired to do an in-depth operational assessment of a new HOPD build. My responsibilities included reviewing the construction design and ensuring ASC-specific processes were in place so that workflows would run smoothly for the center’s opening. Here are a few takeaways from the engagement:
Utilize Space Effectively
A typical ASC requires much less space than a hospital. This facility had drawn up a 200,000 square foot expansion plan for a new site to be located across a sky bridge from the main hospital. The expansive floor plan included 36 bays—nearly double what is needed for an ASC. After reviewing the construction design and walking the site, I helped the team craft a new floorplan to reconfigure patient placement, instrument processing, staffing areas, and supplies. Although a significant amount of space was left unused, these changes allowed the center to save money by eliminating the need to stock additional rooms with supplies and staff.
Establish ASC-specific Processes
Ensuring ASC-specific processes are in place is essential. I worked with the team at this hospital to help with such things as staffing ratios and setting PAR levels for different supplies to maximize efficiency and keep costs down. I also reviewed and adjusted the existing hospital policies so that they were relevant to an ASC. In addition to assessing the center’s readiness prior to completion, my work continued for months following the opening to assess ongoing operations including helping the staff to prepare for an upcoming Joint Commission survey.
Cultivate an ASC Mindset
If your staff is new to the outpatient environment, educate them on the "ASC mindset," which is vastly different from a hospital mindset, especially in terms of patient flow. Ensure that they understand not just how an ASC differs from a hospital, but also why it does and how this has revolutionized the surgical experience for patients.
As the migration of procedures from inpatient to outpatient settings continues, we’ll see more ASC and HOPD construction, and getting it right will be essential in an increasingly competitive environment. If you’re planning a new build or would like an in-depth operational assessment of your existing facility, SourceMed ASC Advisory Services can help.
Contact me at Ann.Geier@sourcemed.net to learn how our team of experts can help your outpatient facility maximize efficiency, profitability and compliance.