Foundations for Success in New Construction

An army of expert partners, a strategic outfitting plan and staff-centered focus are the cornerstones of a new build.

New surgery center construction is not for the faint of heart. It’s a complex, multilayered process riddled with confusing rules and regulations, unforeseen obstacles and a seemingly endless series of unexpected extra costs and extended deadlines. But with the right approach and, more importantly, the right partners by your side, you can minimize the hassles and maximize the enjoyment of a successful build. Here are three keys to making it happen.

Enlist ASC experts in every aspect

As obvious as this may sound, it’s advice that falls on deaf ears all too often. Building a surgery center is a unique and highly specialized process filled unexpected twists and turns. From attorneys specializing in regulatory and licensing rules to the contractors who handle the build itself and everyone in between, you want to stack your team with people who have prior experience in the ASC space. It all starts with the architects who design the building.

“Ambulatory surgery centers are complicated projects, and a lot goes into creation of an OR suite because we’re working within an extremely technical, highly regulated environment,” says Joseph Sziabowski, AIA, president and CEO of Hardaway | Sziabowski Architects, a niche architecture firm headquartered in Newton, Mass. “Hiring an architecture and engineering team that’s done it before ensures there’s less of a learning curve for the project.”

Mr. Sziabowski’s firm, which specializes in healthcare facilities, has designed more than 150 ASCs, many of which were housed in buildings that weren’t intended for what they became. “Many of the projects we’ve done, especially those in more urban areas, have been fit-outs in existing buildings,” he says. “These aren’t buildings that have been designed to accommodate a surgery center, so there are very specific things your design needs to take into account.”

What types of things? The utilities, for starters. Let’s say you’re outfitting a space that had previously served as an office building. Your standard office building, says Mr. Sziabowski, might have around four watts of electricity per square foot. As you can imagine, a surgery center requires a lot more power. You need to determine whether the base-building electrical can provide the power you need and, if not, whether there is a way to bring some additional power into the building. Regardless of whether you’re retrofitting an existing space or building from the ground up, you want your architect and engineering partners to have experience with ASC-specific details. “You need a partner who understands the building’s needs in terms of the water, sewer and sprinkler systems,” says Mr. Sziabowski. “If you’re building a 10,000 square-foot-surgery center, you’re not going sprinkle 100,000 square feet of building.”

If you’re building a 10,000-square-foot surgery center, you’re not going to sprinkle 100,000 square feet of building.
Joseph Sziabowski, AIA

Like your design and engineering team, having other key players with ASC experience pays dividends. “It really helps to work with a contractor who has done this type of work before, especially in certain states like Florida where the Department of Health is very particular,” says Mr. Sziabowski. “It helps a lot if the contractor has dealt with the state’s inspectors before and knows their predilections and what they’ll be looking for. That way it isn’t a surprise the first time an inspector comes through.”

Plan equipment purchasing strategically

Layering the equipment into the design-and-build process requires careful collaboration between stakeholders, architects and vendors. In an ASC build, key stakeholders such as owners and surgical facility leaders get involved in the process and often work directly with major equipment manufacturers, notes Mr. Sziabowski. In turn, the major players in the equipment world have greatly expanded their services and help with the design process, offering general consulting and financing help and even throughput analysis. “Vendors will get involved early and stay involved throughout the entire process,” says Mr. Sziabowski.

“They’ll do drawings, provide cutsheets and other information about the equipment that we’ll then layer in our drawings. We’ll go back and forth with the vendors and our engineers to determine the necessary power, water, ventilation or exhaust requirements for the various pieces of equipment.” This type of collaboration works well, but Mr. Sziabowski says he’s seen newer startup ASC clients get into trouble when money is an issue, and they rely heavily on resellers that are a bit out of their depth. “These resellers have good products and solid service, but they tend to lack the upfront design assistance capabilities the major vendors have,” he says. “As you’re approaching a deadline, you often need that expertise because there can be some significant differences with things like the water requirements between sterilizers.”

Another critical function of equipment purchasing during the build: the right timing. “You want to make sure the equipment is arriving when it needs to be there, but not too soon because there’s never a place to put everything on a small site,” says Mr. Sziabowski. “Delivery times need to be coordinated so everything can be plugged in, properly set up and installed, and ready to go when the inspections start to happen.”

Keep staff front and center

Between the aesthetically pleasing, comfort-driven design features of the lobby and efficiency-inducing layout of care suites, patient experience gets top billing at newly built ASCs — and rightly so. But don’t overlook the importance of your staff during the design phase. After all, a happy and efficient staff is ultimately what will make or break patient satisfaction. “When it comes to staff experience, it’s not only about building a center that looks inviting or comforting for the people, but also one that functionally works really well,” says Mr. Sziabowski. “The design should make it easier for the staff to do their jobs. It should account for proper ergonomics and features that make tasks more efficient and seamless for everyone.”

That last bit about efficiency sounds like solid advice for everything — from creating policies and procedures to multidisciplinary communication — that happens after the center is built, too. Doesn’t it? OSM

Note: This three-part article series is supported by Stryker.