June 18, 2025

Facility Construction and Design Orthopedics

By: Outpatient Surgery Editors

Published: 6/17/2025

Share:

THIS WEEK'S ARTICLES

Massive Site to Revolutionize Ambulatory Surgery in Sacramento

The Next Generation of Local Health Care

Rapidly-growing Ambulatory Surgery Center Builds a New, Expanded Location - Sponsored Content

Make a High-liquidity Investment in Your New ASC

Staff Your New Facility With an ASC Mentality

 

Massive Site to Revolutionize Ambulatory Surgery in Sacramento

UC Davis Health’s 48X Complex will ‘preliminarily’ house 14 ORs, 59 pre-op/post-op bays and much more.

RenderingHELP IS ON THE WAY This rendering shows the scale of the four-story, 226,228-square-foot 48X Complex, which is set to open next month. | UC Davis Health

As the old saying goes, “go big or go home.” UC Davis Health has selected the first option. Slated to open for patients next month, the four-story, 268,228-square-foot 48X Complex, named for its location at the intersection of 48th and X Streets in Sacramento, Calif., is intended to address the shortage of outpatient OR capacity at the system’s main hospital.

The $589 million outpatient surgery center will house a “preliminary program” of 14 ORs, 59 pre-op and post-op bays, 14 single-occupant extended stay recovery rooms, 96 clinical exam rooms and 19 clinical treatment rooms. Here’s the layout of the four floors:

  • First floor (64,402 square feet): Extended recovery unit, diagnostic imaging, phlebotomy, retail pharmacy, building support, sterile processing department, café
  • Second floor (75,793 square feet): Perioperative services, interventional radiology, compound pharmacy
  • Third floor (49,041 square feet): Surgery, transplant, orthopedics, neurosurgery
  • Fourth floor (50,803 square feet): Vascular, urology, surgery, wound management clinics

Construction on the facility, which is nearly 500 feet long (as the health system notes, greater than the length of a football field), began in November 2022. Its ORs are designed to accommodate robotic technology, and an MRI suite will enable laser-guided procedures. The 48X Complex even will include multiple hyperbaric chambers for wound care and other medical conditions.

UC Davis Health says the visual and design theme of the building is inspired by the Sacramento River and its surrounding environment. It’s designed for seismic safety compliance to ensure safety during earthquakes.

At a press conference last year to update stakeholders and the media on the project’s project, David Lubarsky, vice chancellor for human health sciences and CEO for UC Davis Health, said the 48X Complex will be “one of the largest outpatient surgical centers in the U.S. in terms of the number of operating rooms and procedure rooms.” Diana Farmer, MD, chair of the UC Davis Department of Surgery, added, “The addition of this state-of-the-art outpatient surgery center in Sacramento represents a transformative shift in our clinical approach, enabling personalized, patient-oriented, scheduled care to meet regional needs and enhancing our world-class care.”

You can take a virtual tour of the landmark facility on YouTube.

The Next Generation of Local Health Care

St. Tammany Health System Surgery Center sets a new outpatient surgery standard in Louisiana.

Tammany ASCINSPIRING SIGHT The St. Tammany Health System Surgery Center features numerous art installations, including this stunning work by local artist Zac Maras. | Tim San Fillippo/St. Tammany Health System

Opened two weeks before the end of 2024, St. Tammany Health System Surgery Center is a $75 million, 126,000-square-foot same-day surgical facility in Covington, La., described by its founders as “the most technologically advanced of its kind in the Gulf South” and “the next generation of local health care.”

Located adjacent to the health system’s Paul D. Cordes Outpatient Pavilion and adding to its “already robust presence” along a main transportation corridor, St. Tammany says the facility is the newest component of a growing outpatient campus. The center was designed with local surgeons’ input to meet current and future demand for same-day procedures in what St. Tammany calls “the 23-hour arena.”

The facility includes 12 surgery suites, 24 private pre-op rooms, 18 recovery rooms and 15 rooms with overnight-stay capabilities, along with a sterile processing department, imaging, lab, pharmacy, physical therapy, food service, environmental services and more. An array of pediatric and adult surgeries, including orthopedic and gynecological procedures, hand surgery, ENT surgery, breast reconstruction and many others, are performed at the center.

“This surgery center has long been a strategic goal of ours, and I am brimming with gratitude for all those people — and, trust me, there are a lot of them — who helped us to once more deliver on our promise of providing world-class health care close to home for our Northshore friends and neighbors,” says St. Tammany President and CEO Joan Coffman. The center employs more than 100 people when fully staffed, including a round-the-clock presence from the health system’s anesthesiology department, while opening capacity for more complex surgical cases at the flagship St. Tammany Parish Hospital located two miles south.

“From the robotic systems that will assist our surgeons, to the advanced surgical instrument processing equipment installed therein, to the robust IT presence throughout, every square inch of this building incorporates technology and innovation on a scale unmatched in the community,” says STHS Chief Medical Officer Patrick Torcson, MD, MMM, FACP, SFHM. One of many interesting touches at the center is that all wet areas, including patient bathrooms, are equipped with blended indigo and white LED lighting that kills a wide variety of viruses and bacteria.

Another distinguishing aspect of the ASC is its first-floor space, which is outfitted with multiple installations from artists with the St. Tammany Health Foundation’s Healing Arts Initiative, including a large-scale lobby mural.

 

Rapidly-growing Ambulatory Surgery Center Builds a New, Expanded Location
Sponsored Content

Bluegrass Specialty Surgery Center and Growth Ortho partner together with Stryker ASC on a new build expansion project in Lexington, KY.

Bluegrass Surgery CenterCredit: Bluegrass Specialty Surgery Center, Lexington, KY.

Bluegrass Specialty Surgery Center (BSSC) and Growth Ortho, a managed service organization, partnered on a new build expansion project to increase BSSC’s surgical capacity and to provide the surrounding Lexington community with greater access to the highest-quality outpatient orthopedic care.

Located less than one-half mile from its original (3) operating room center, the expanded (8) operating room surgery center is on more than 8 acres of land, covering 30,000 square-feet, and is the largest freestanding orthopedic surgery center in Kentucky.

Nicole Johanson, COO Growth Orthopedics, said, “Once we determined that we needed to expand, it was all about finding the right partners.” BSSC selected Stryker ASC as their vendor of choice for the majority of their capital equipment because Stryker could provide a simplified, comprehensive, scalable solution tailored for new build ASC expansion projects.

Victor Marwin, MD, MBA, said, “The decision to go with Stryker for our expanded ASC was easy. Stryker’s portfolio is certainly comprehensive and the ability to utilize one vendor, one team, in that planning process, simplified everything and we’re very happy with it.”

Stryker’s new build expertise provides a repeatable and proven solution to those building a new surgery center and their management company partners. Stryker can provide a primary point of contact with new build expertise, a streamlined intake process for equipment selection and flexible financing solutions to meet budgetary needs. Stryker’s standardized approach simplifies the procurement and start-up process for new facilities, saving valuable time and resources.

“When it comes to Stryker’s ASC solution, it’s absolutely replicable. It simplifies everything. You don’t have multiple folks involved. It makes it easier to scale,” Nicole Johanson added.

Click here to learn more about how Stryker partnered with surgeon owners and their managed services organization to bring their new build expansion project to life.

For more information on how to build and grow your ASC with Stryker, click here.

 

Make a High-liquidity Investment in Your New ASC

Water quality and management is often overlooked when new surgery centers are built.

Poor water quality within the sterile processing department (SPD) at an ASC can negatively impact sterilization of surgical instruments, producing corrosion, deposits, stains or rust. That can lead to delays or even cancelations of procedures when OR staff open trays that contain damaged or unclean instrumentation.

Jonathan A. Wilder, PhD, a water quality expert who serves as managing director of Quality Processing Resource Group in Bala Cynwyd, Pa., says many surgical facilities simply don’t understand the finer points of water quality or incorrectly assume they already have the right infrastructure in place.

“I’ve visited centers that believe they have water purification equipment, critical water plumbing or water quality monitoring systems in place when they don’t,” says Dr. Wilder. “Omissions on the part of architects, engineers and designers during the build often go unnoticed until after the fact, if at all. By then, costs to install or deal with the effects of the absence of the needed utilities are much higher, and workflow is impacted or halted.” He says those who are building new surgery centers must admit that they don’t know what they don’t know, and should have a water quality expert involved in the build from the start.

Once the build is complete and the right infrastructure and equipment is in place to ensure water quality, the job is not over. In fact, it’s never done. “Ensuring your water quality is suitable for reprocessing isn’t a set-it-and-forget-it proposition,” says Dr. Wilder. “It requires regular, consistent monitoring because conditions change and evolve both internally and externally to your center. You need to keep an eye on it and know how to correct problems.”

Dr. Wilder says ASC owners and operators should get to know the Association for the Advancement of Medical Instrumentation’s ANSI/AAMI ST108 standard released in 2023, “Water for the processing of medical devices,” or find an expert who is intimately familiar with it. “ST108 defines categories of water quality that should be used during each stage of sterile processing, provides risk analysis insight and assesses water quality based on a variety of factors,” he says. “It also details maintenance, monitoring and quality improvement procedures for your water treatment system and informs you on what actions to take during service interruptions and boil water advisories.”

It’s a good idea to have a water expert visit once a year to perform an independent assessment of water quality through lab analysis and system review. “Once you get a good-to-go response from that annual audit, you can follow the ST108 monthly and quarterly monitoring schedules yourself,” says Dr. Wilder. “But if things go wrong, have someone available to call on to demystify the situation for you.”

 

Staff Your New Facility With an ASC Mentality

Get employees with the right mindset in place from day one.

Eleven words should serve as a mantra when constructing a team for your new surgery center: Assemble staff with that “ASC mentality” as quickly as you can.

This focus is often overlooked by leaders seeking to get up and running ASAP. Your new hires should align with ASC culture, which differs from hospital culture. Ideally, you want staff who are cross-trained and open to the idea of performing tasks that might be out of their comfort zone, as opposed to staff who are accustomed to operating in narrow silos. At an orthopedic ASC, for example, employees often are called upon to do a little of everything, regularly stretching beyond their core competencies.

Brunswick Surgery Center in Leland, N.C., is one of many facilities that offers a blueprint. In 2024, it became the nation’s first ASC to achieve a designation as a Center of Excellence in all four orthopedic subspecialties (advanced hip and knee replacement, advanced spine, advanced shoulder, and advanced foot and ankle surgery) from Det Norske Veritas (DNV) Healthcare, an accrediting agency that is recognized by CMS. Administrator Cindy Burleson, MBA, says her center focused on hiring employees who had the right mentality, particularly in terms of building the culture of premium customer service the ASC desired. “We want to have the plastic surgery employee culture for orthopedics,” she explains.

To ensure it hires employees with the right mindset, the ASC bases job interviews on behavior-based questions as opposed to traditional topics such as likes, dislikes, strengths and weaknesses, which Ms. Burleson says don’t work for her ASC. Interviewers ask candidates about their past work experiences and performance and steer the conversation into situational scenarios through questions like, “Tell me about a time when your performance was below standards and how you corrected it.” Says Ms. Burleson, “You can tell a lot about someone based on how they answer that question and if they have a more negative or positive attitude toward work.”

Brunswick Surgery Center also leans heavily on peer interviews that provide existing staff with input on potential new hires. “If the staff has a hand in who gets hired, they will invest more in that person’s success,” says Ms. Burleson.

Another essential consideration in staffing a new ASC is flexibility right from the start. Ms. Burleson advises leaders not to hire too many new employees if patient volume isn’t high enough yet. “Start with a smaller staff and adjust as your center’s business ramps up over time,” she says. OSM

 

Related Articles