Industry expert Ann Geier provides an Ambulatory Surgery Center (ASC) mindset with a focus on efficiency.
How to design a new HOPD so that it follows an ASC workflow.
Operational Assessment conducted by ASC Advisory Services from SourceMed, now Surgical Information Systems (SIS)
Opening a new Ambulatory Surgery Center (ASC) or hospital outpatient department (HOPD) can be a daunting task, especially when starting from the ground up with new construction. When dealing with a new build, the construction planning stage is one of the most critical, yet often overlooked, elements.
Overbuilding can prove costly when space sits unused, so the design and workflow of the building are essential to a center’s success. The walls and structures need careful consideration during the planning stage. Building codes, which are vastly different for an ASC and HOPD in comparison to a hospital, must be addressed early on.
Hiring an ASC operations expert at the onset of the build, when plans are being drawn up, can help ensure a successful workflow and save substantial money.
This hospital decided to build a premier one-stop destination for comprehensive outpatient procedures.
A 200,000 square foot expansion plan was drawn up for a new site to be located just across the sky bridge from the main hospital. Service offerings would include outpatient surgery, medical imaging, physical therapy, and centers to treat cancer and digestive diseases.
The goal was to create the feel of an ASC while offering hospital services just across the skywalk in the event anything additional was required.
To ensure the new build would function the way an ASC should, the hospital project lead wanted an ASC operations expert to assess the center prior to completion. He turned to the SIS ASC Advisory Services team.
Nearly a year and half into construction, SIS Chief Nursing Officer Ann Geier, MS, RN, CNOR, CASC was hired to help get the HOPD up and running. Her responsibilities included reviewing the construction design and ensuring ASC-specific processes were in place so that workflows would run smoothly for the center’s opening.
According to the hospital project lead, “When building a new center, it is easy to overlook things, especially when you are seeing them from a hospital perspective. Because ASCs and HOPDs function quite differently than hospitals, we needed someone with deep ASC expertise to help set things up properly from the beginning.”
Since the new center was built with a hospital mindset, it was not considered during the planning stage that a typical ASC requires much less space than a hospital. This was an issue that Ms. Geier quickly pointed out when walking the construction site.
The expansive floor plan included 36 bays, nearly double what is needed for an ASC. Based on Ms. Geier’s recommendation, the floor plan was revised to save money and improve workflow. Ms. Geier worked with the team to reconfigure patient placement, instrument processing, staffing areas and supplies. Although a significant amount of space was left unused, these changes allowed the center to save money by eliminating the need to stock additional rooms with supplies and staff.
“Even though we had a lot of people looking at the floor plan, none of those folks had ASC experience so we ended up with more space than needed. Rather than simply pointing out what didn’t work with the space, Ann crafted a plan that enabled us to make better use of the existing space, created a better workflow, and saved money,” says the Director of Surgical Services.
Ms. Geier also served as a mentor to staff which included a new manager. For example, she educated the team on the ‘ASC mindset’ which is vastly different from a hospital mindset, especially in terms of patient flow. She helped with staffing ratios, setting PAR levels for supplies to ensure efficiency, and much more. Ms. Geier also adjusted the existing hospital policies so that they were relevant to an ASC.
“Ann was a huge resource for our staff. Her overall work ethic and how she interacted with the team was impressive. Ann was able to easily relate to and work with the variety of skill sets at our center which were mostly new to the outpatient environment. She modified her teaching style and tailored what she was explaining to the audience so that they understood specifically how an ASC differs from a hospital and why. Ann is truly a wealth of knowledge about the ASC world,” commented the Director of Surgical Services.
After the center opened, Ms. Geier was brought in again to assess operations. The visit proved useful as she spent significant time reviewing processes and helping the staff to prepare for an upcoming Joint Commission survey.
“Ann’s insight into ASC operations and attention to detail were just what our center needed. Our only regrets were not hiring her sooner and that we couldn’t keep her with us longer. Having her feedback and expert ASC insight were extremely valuable. I can’t imagine where we would be today without her assistance,” concluded the Director of Surgical Services.
A lack of internal ASC-specific expertise was hampering the timely resolution of existing deficiencies at an established center.
An outside ASC expert was needed, within a short timeframe, to help review policies and procedures for Standards' Compliance in a new ASC.