Designed With Total Joints in Mind

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Surgery centers with the right mix of form and function will keep pace with the hottest trend in outpatient orthopedic surgery.


Coastal Orthopedics in West Bradenton, Fla., recently opened an 88,000-square-foot headquarters that houses a 25,000-square-foot, six-OR ASC on the second floor with 25 pre- and post-op bays and six extended stay rooms. The ORs are between 400 and 450 square feet, plenty big enough for the robotic platforms that the facility added for the total joint procedures the surgeons perform.

The busy orthopedic practice performed more than 6,700 cases last year and anticipates topping the 7,000 mark this year. Case volumes in spine, total joints and pain management are all increasing. “We’ve been in desperate need of additional space,” says Jodi Santini, RN, BSN, CNOR, CASC, the ASC director at Coastal Orthopedics. “Our practice ran two smaller ASCs before we built this facility, and we were bursting at the seams.”

Coastal’s new expansive sterile processing department is “spectacular,” according to Ms. Santini. The department features two oversized instrument washers; two hospital-grade autoclaves and a third nearly new autoclave brought over from one of the practice’s former ASCs; a large sterile supply room where instruments are stored; and a rail system and wall bins to accommodate and improve the flow of instrument sets and trays. “Our SPD technicians are elated about the new space and the capability they now have to reprocess instrumentation,” says Ms. Santini.

The waiting room is designed with a modern flair with comfortable chairs, bar-height stools and tables, phone charging stations and two private consultation rooms where surgeons meet with patients’ loved ones to update them on the results of surgery. After surgery, an elevator takes patients down to a private discharge area on the side of the building, providing a more private way to exit the building.

Physicians at Eisenhower Desert Orthopedic Center (EDOC) in Rancho Mirage, Calif., perform more than 8,000 surgeries and 10,000 pain management procedures each year, a volume of cases that necessitated an expansion of its former clinical space. The recently completed renovation project created a 100,000-square-foot facility to accommodate the significant growth in case volume the practice has experienced in orthopedic, spine and pain management procedures over the past decade.

The new and improved EDOC tripled the total size of the previous space with 25,000 square feet dedicated to increasing the size and number of the operating rooms. Two rooms became eight, and the size of each expanded to 595 square feet, large enough to accommodate the capital equipment such as robotic platforms needed to perform complex procedures. Every OR is outfitted with two 80-inch wall-mounted ultra-high-def video monitors and three 36-inch 4K screens positioned on booms around the surgical table. 

“New technologies and equipment allow us to perform major procedures that have traditionally been done as inpatient in a less invasive way in the outpatient setting,” says Stephen J. O’Connell, MD, a fellowship-trained, board-certified orthopedic surgeon specializing in surgery of the hand, wrist and shoulder at EDOC. “We had the foresight to expand our footprint to accommodate what has been double-digit growth.”

The project also included a significant expansion of the sterile processing department, growing it from 560 square feet to 5,850 square feet, including two large walk-in sterilizers and rigid sterilization containers to protect instruments and maximize storage space.

“We took a proactive approach to setting up the space to prepare for future growth and accommodate the advancing tools and technologies in orthopedics,” says Dr. O’Connell. “The new space reduces our backlog of instruments and improves our overall workflow.”

The ortho-only facility is filled with staff who are expert in every phase of patient care. “Because they’re focused solely on orthopedics, we’re able to treat patients more efficiently and perform procedures that result in fewer complications and infections,” says Dr. O’Connell, who once performed 22 hand surgeries in two ORs in a single day. The facility’s joint replacement specialists can perform up to eight procedures in a day.

Orthopedic surgeons are tinkerers by trade and appreciate working with the latest technologies. “The new facility gives us all the tools we could dream of needing to perform procedures to the best of our ability,” says Dr. O’Connell. 

Improved patient care is paramount, but the practice’s surgeons did not ignore the intangible impact a new facility can have. The expanded EDOC is a visually stunning building. The front entrance and lobby were designed to be warm and welcoming, complete with a Starbucks and a tastefully done cafeteria. The waiting area is filled with luxurious seats to add to the comfort of loved ones waiting for patients. Pre-op beds can be lowered to make getting into them easier for patients, who are impressed by the high-tech look of the ORs when they’re wheeled in for surgery. The recovery bays are well appointed, and the 23-hour stay rooms resemble a luxury hotel. “We put a process and pride into speaking with patients throughout the design process,” says Dr. O’Connell. “The ‘wow’ factor is real — our patient satisfaction scores have been off the charts. When patients walk in the door, the building’s design emanates quality, success and experience.”

EDOC’s amenities not only help the practice attract patients, but also surgeons and frontline staff — no small benefit considering nationwide staff shortages in health care. The practice’s younger surgeons are impressed by the look and workings of the expanded facility. “Our senior partners have been working on designing and building this facility for a very long time,” says Dr. O’Connell. “The gratitude newer surgeons have expressed about performing surgery in a center to which few in the county can compare — one that’s luxurious but also functional and efficient — has been extremely rewarding. We feel very fortunate to have created a fantastic facility that will serve as our legacy in the local community for years to come.” OSM

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

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