Staying on Task

today's surgicenter magazine (TSC) sat down with William R. Massingill (WM), AIA, NCARB, chief executive officer of Polkinghorn Group Architects Inc., to discuss the best practices in ensuring a project stays on task and runs smoothly from conception to completion.

TSC: What are the top three aspects center owners should consider for their center’s design?

WM: Outpatient-surgery needs vs. code-required needs, flexibility, and patient and physician comforts.

Outpatient-surgery needs vs. code-required needs: Depending on the specialties which are to be performed at a facility, code-minimum requirements for ambulatory surgery centers (ASCs) may not be adequate for the use of that facility. For example, an endoscopy-oriented or pain-oriented facility will probably need more pre-op and PACU beds than code-minimum (or even than, say, for an orthopedics-oriented facility) due to the high turnover rate of the rooms where those procedures are conducted.

Flexibility: Since the operating rooms (ORs) in a facility may be shared between different surgical specialties (i.e., orthopedics, eye surgery, etc.) and the procedure rooms may be shared between different non-surgical specialties (i.e., endoscopy, pain, etc.), ORs and procedure rooms should be laid out such that they can accommodate multiple use in lieu of being specifically-tailored to one specific use, if at all possible. Even if a facility is designed and constructed for one particular specialty, remember that other specialty physicians may some day be recruited and may have different particular needs than those of the original physicians.

Patient comforts/physician comforts: For patients (and those accompanying them on the day of their visit), a facility should be designed such that the waiting room and other visitor-use spaces depict as comfortable as possible so that it doesn’t appear institutional (like a hospital) and helps ease any apprehensions those visitors may have on the day of their surgery.

For physicians, a facility should be designed so that there’s a “side door” where physicians can enter the facility without coming in contact with visitors and that there is a comfortable staff lounge and staff changing area (with “creature comforts” such as cable TV and Internet access) for their use prior to them gowning up for surgeries.

TSC: What tips would you offer to best stay on budget during a project?

WM: In addition to the selection of a qualified design or A/E (architectural/engineering) team which has experience in outpatient surgery in addition to general healthcare, two other consultants are critical (or at least helpful) in keeping a project on track budget-wise: (1)a qualified project management consultant with particular experience in outpatient surgery development) is helpful in assisting the owner in selecting the A/E team, the construction team, an equipment-planning consultant, and others whose input can ensure the success of a project, and (2) a qualified construction manager (or general contractor with pre-construction services included in their scope) is helpful during the design phase to keep the project’s overall budget in line with its initial budget as the design documents are completed and as construction is completed.