This special issue is for you if you're about to construct, expand or renovate an ambulatory surgical facility. On behalf of us here at Outpatient Surgery Magazine and the experts in the medical construction, development and design business we consulted to create our annual opus to new surgical construction, we wish you much personal and professional success. Before you build and govern your own operating rooms, here are a few things those in the know should know.

• Don't go it alone. The experts in this industry have made more mistakes than you'll ever make. "Hire them to not make them again," says Tom Yerden, the president & CEO of TRY Health Care Solutions. "If you think hiring an expert is expensive, wait until you hire an amateur." As you'll see in "Assemble the Development Team That's Right for You" on page 27, it pays to surround yourself with people who are smarter than you are.
• Get it right the first time. Not just the building, but the people who occupy it. When your new facility opens, OR nurses and techs from different facilities and backgrounds will come together under one roof. They'll all know how to do everything, but they'll all do everything differently - from how they clean rooms between cases to how they sterilize equipment. Now's your chance to get everyone on the same page from day one, says Debbie Comerford, BSN, CNOR, a consultant with Facility Development and Management.
• ASCs, prepare for battle. True, there are more surgical centers (5,300) in operation today than general hospitals (4,700). While ASCs lead in thumbtacks on a map, hospitals do more than 60 percent of all surgery and wield considerably more political clout than surgical centers. So keep in mind the hospitals' battle cry: Hospitals remain financially squeezed by inadequate government payments for care, too many hospitals and for-profit outpatient centers that cherry-pick insured patients.
• Hospitals, get into the game. Hospitals are no longer sitting on the sidelines watching their surgeons and their outpatient cases leave in droves. Some would argue that the hospital-as-hub model will outlast the physician-led model that has defined this highly-fragmented industry for two decades. More and more hospitals are partnering with surgeons in startup or existing ventures (see "The Perils and Payoffs of Hospital Joint Ventures" on page 18), or building their own facilities dedicated to same-day surgery.

Whether you're a new owner or operator of a surgical facility or you've cut red ribbon before, we hope you'll find the advice we present to be practical and relevant to your project - whether it's on the drawing board or already on its way up out of the ground. Best of luck. And thanks for reading.