Ambulatory Surgery Center Design Tips

The early phases of ambulatory surgery center design requires careful attention to detail. Unfortunately, common mistakes are often made during this stage, and they can have a negative impact on the center’s purpose and viability. Once the center is up and running, correcting these errors can be a difficult, if not impossible task. Unless, of course, you follow these design guidelines:

No provider wants to invest 18 months in planning and constructing an Ambulatory Surgery Center, only to find that six months after opening, it’s underutilized and less profitable than anticipated. Ensuring profitability and sustained success for any outpatient can be a challenge, but this is especially difficult with a poorly planned facility.

Industry benchmarks from 2021 reveal that an effective facility typically has a fixed/total asset utilization ratio between one to two, with an average annual profit of 20-25%.

But, what can be done during the planning process to mitigate potential issues and make your surgery center a top-performing facility that operates efficiently and profitably?

Well, it’s simple, the key to success lies in the physical layout of the space and how it incorporates the following factors:

• The combination of high-revenue and high-volume cases
• Alignment with the facility’s ownership structure and financial goals
• Alignment with market trends and directions
• Consideration of lean principles and operational flow and how they interact

By prioritizing these factors, it’s far easier to optimize the design and operation of your surgery center, resulting in better outcomes and increased profitability.

The shift in reimbursement policies has led to an expansion in the range of cases performed in Ambulatory Surgery Centers. While traditional procedures—such as ophthalmology and general surgery—still have their niche, orthopedic and spine cases are becoming increasingly common.

This change in case mix has a direct impact on ambulatory surgery center design. For example, orthopedic and neuro cases require larger operating rooms than general surgery cases, and these ORs tend to be more equipment-intensive with requirements for additional adjacent storage. However, case mix also affects:

• Patient volume
• Market growth
• Prep time
• Operating time
• Turnaround time
• Recovery time

All of these variables can impact the amount of space needed. Luckily, by creating a balanced case mix that includes high-volume cases like ENT, gastroenterology, and pain management as well as high-revenue cases like spine/orthopedics, podiatry, and urology, ambulatory surgery centers can minimize gaps in the schedule

When planning an ambulatory surgery center design, it’s important to consider who will own and manage the facility. Ownership entities may have different approaches to processing and storing supplies, which can impact the size and configuration of your footprint. For instance, a facility that utilizes an off-site sterile processing center and central storage will require less onsite storage.

The size of anesthesia group areas and the presence or absence of a Pyxis medication dispensation system may also vary depending on ownership structure. Additionally, different ownership entities will have different financial goals for the facility, such as branding and interior finishes that adhere to system standards.

By breaking down the potential ownership needs and goals, outpatient spaces can be optimized for proper functions and operations. So, it’s crucial to decide early on how sterile processing for the facility will be handled, which will ultimately impact the design of your building.

Just like any well-run enterprise, keeping a close eye on the market shifts is key to paving the way for future achievements. The design of ambulatory surgery centers follows the same principles, and there are three main drivers in the outpatient market:

1. Facility Regulations and Accreditation: The outpatient market is expected to grow as the Center for Medicare & Medicaid Services (CMS) expands the procedures that can be done in an ambulatory surgery center. However, some states have Certificate of Need (CON) laws that can affect demand for new facilities. To prepare for this growth, it’s important to estimate the number and types of procedures you will be performing (such as the orthopedic cases mentioned earlier) as this information will inform the size and number of ORs needed.
2. Payer Reimbursement Policies: To encourage more patients to go to ambulatory surgery centers, some payers are adjusting their reimbursement rates. If you design your facility to handle the types of cases that will be performed, it will increase utilization because you won’t have to wait for the right operating room or recovery bay to become available.
3. Consumer Preferences: After the recent pandemic, many patients view ambulatory surgery centers as a safer option for procedures. When payers shift cases to outpatient settings, some patients will remain loyal to their current system, while others may look for the best experience and outcomes. In certain demographic markets, a higher quality of interior design may make the facility more competitive in attracting the desired clientele.

As a helpful tip, by designing procedure suites that can be easily converted to operating rooms, you can be better prepared to handle increased patient volumes or shifts in the types of procedures being performed.

When it comes to building a surgery center, the transition from design to build is filled with costly obstacles in traditional construction models. Luckily, Apex helps you avoid these pitfalls, championing your project vision and maintaining a clear channel of communication during every stage of the process. Get in touch to learn more about our process and discover the advantages of our comprehensive approach.