Case Study: Specialty Surgery Centers A Deeper Look We work with each of our clients to determine their customer experience goals at the beginning of each project and then use those target outcomes as a road map for the design process. Our team has a culture of striving to bring maximum value to clients and basing design decisions on documented bestpractices. With EDAC-accredited staff, we strive to positively inform our projects with current evidence. And, we strive to contribute to the growing body of evidence supporting our profession. An evidence-based design approach must be built into the project structure and requires the involvement of interdisciplinary team members.
The Business of Surgery Centers SURGERY CENTERS
APPROACH OVERVIEW
CHALLENGE
Array focuses its efforts - from planning and programming, to design and delivery - on each individual client’s mission and short/long term goals. We endeavor to bring our expertise to positively affect the patient experience as well as the client’s bottom line and ability to succeed in
Today’s facilities need to work with tomorrow’s technologies. ORs should function for many case types to optimize the investment.
their niche market. Working with the Okyanos Heart Institute (Freeport, Bahamas), it became clear that they approach their work with the same fervor and excitement we do. Their mission, “Providing world-class healthcare requires world-class medical leadership and experience,” is a statement we can appreciate and strive to design to those expectations. Collaborating with the Okyanos team meant
SOLUTION Successful ambulatory surgery facilities are designed to maximize flow. At Array, we develop separate and distinct circulation areas for both patients and staff, introduce intuitive wayfinding to enhance and streamline the patient care process, and then test our designs through simulation modeling.
collaborating with physicians, consultants, contractors and medical equipment planners from across the region and the world. With construction and equipment installation occurring currently, the Institute is built to US, European and Bahamian surgical center standards, and is led by Dr. Howard Walpole, a prominent U.S.-educated interventional cardiologist. At Okyanos, the focus is on offering a highly personalized patient and family experience to facilitate maximum treatment, recovery and benefit.
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300 people are seen in ambulatory settings for every one person admitted to a hospital.
THE PROJECT DETAILS The Okyanos Heart Center project consists of the renovation of the entire third floor and a portion of the second floor totaling 17,770 SF at the First Commercial Center office building in Freeport, Bahamas. The third floor will serve as the new Ambulatory Surgery Center and includes a Class “B” Operating Room, a Cardiac Catheterization Lab Special Procedures Room, Pre-Op, PACU, Staff Breakroom, Business Office administrative areas and Family Waiting/Café. The second floor includes administrative office spaces, a Conference Room capable of video conferencing as well as storage/receiving areas. A new exterior ground floor entrance, elevator, lobby and electrical rooms will be added to the building as well. The new elevator will link the third floor clinical areas with second floor administrative and storage areas as well as serving as a discharge for patients directly to the exterior parking area. The addition is being designed to provide for a future covered drop off canopy and new drive lane to the new elevator lobby entrance. Procedures will require the patient spending at least a day in the facility so the finishes will address the desire to create a “home-like” feeling in the spaces, allowing for patient and family comfort during their stay.
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Implementation
Project Information • 16,200 SF renovation, 1,570 SF addition
• Seven private PACU rooms with private patient toilets, nurse station and nourishment area
• Class “B” Operating Room • Two Cardiac Catheterization Lab Special Procedure Rooms
• Café seating for Family Waiting
• Three private Pre-Op rooms with patient toilet, lockers and nurse station
Serving an International Client
generator, fire pump/water storage tank to accommodate the storms expected each hurricane season.
Medical procedures , such as those not typically found in the US and Europe, include utilizing stem cell technology by harvesting from the patient via liposuction, stem cell processing and administering to the damaged coronary system. Patients receive VIP service from the time they arrive to their departure postprocedure. The VIP/Concierge service is supported in the facility via private recovery rooms with well-appointed finishes supporting a healing environment. Quality is validated with certification by the Accreditation Association for Ambulatory Health Care which ensures facilities meet or exceed nationally recognized standards. Engineering support systems are inclusive of full emergency power back-ups, with chilled water/HVAC system backed-up by PAGE 4 | case study: specialty surgery centers
Patient and Staff Flow Best Practices Circular pattern of patient flow through the clinical and surgical areas allows staff to most efficiently schedule procedures and utilize the pre-op and recovery areas. The design of all-private recovery rooms supports this efficient flow as well as supports best practice infection control measures. A clear separation between the sterile core and non-sterile environments allow staff to effectively manage each day’s case load and provides patients a quiet space for waiting, recovery and education away from the surgical space. A discreet drop-off and pick-up layout also allows for a separation of patients being admitted and those being discharged.
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Who We Are ARRAY-ARCHITECTS.COM
Design by the Numbers, by Laura Silvoy excerpted from Array Architects’ blog The role of Industrial Engineers does not traditionally involve work in the architecture or healthcare industries. Presently, however, given the high rate of healthcare costs in America, the industry is experimenting with a marriage of process engineers and architects to create more cost-effective environments with higher quality care. One recent example of architectural optimization in healthcare was conducted under the auspices of Array Architects for a large outpatient surgery center in the southeastern United States. To accommodate a growing volume of patients, this health system is going to open several satellite facilities across the country, testing a smaller community-focused model that would serve as a template for their growth. These smaller facilities will require a set amount of pre-operative care spaces (PRE-OP), post-anesthesia care spaces (PACU), and other necessary support areas to function. This study centered on the use of discrete event simulation modeling for layout and process planning purposes. When architects are designing new healthcare facilities, they typically follow accepted design guidelines and client recommendations regarding the amount of space necessary in a specific facility. Due to the space utilization of the current facility, Array and the client were both interested in challenging these
We Are Healthcare Architects We are a team of architects and designers with unique backgrounds, but we all have one thing in common - we share a strong desire to use our expertise and knowledge to design solutions that will help people in moments that matter most. This focus makes us leaders in our field. There’s a degree of compassion, empathy, and sensitivity that goes into every project that we touch. It’s designing a nurse station with sight lines to every patient. It’s building a Behavioral Health facility without corners, so that patients are safe. It’s translating the operational needs through the technical details to fine tune the lighting system in a neonatal unit so caregivers can match the lighting to each baby’s stage of development. It is a deeper understanding, honed through relationships spanning decades. Together, we discover optimal solutions with our clients. It is our four decades of specialization that allows for effective communication, collaboration and precision in the complex, changing world of healthcare.
conventional guidelines by designing a space that most efficiently and precisely matched their specific function. In addition to this alternative space plan, the client was also interested in altering the current patient flow to improve the patient experience. In the current system, patients are transferred from Stage I recovery rooms to discharge recliners (Stage II) as they transition through the levels of recovery. The newly proposed model would allow the patient to fully recover in the PACU, with family members present, without moving to another location. The challenge would be to accommodate patients in the PACU for the duration of their recovery without causing backup in the ORs. These requests were translated into two major goals: 1) establishing an adequate number of recovery and PRE-OP rooms necessary to support the new patient recovery configuration without adding patient waiting time and 2) determining whether the space was large enough to support future growth in the form of an additional surgeon and patients. As a simulation model would be the best tool for finding a solution to this problem, Array engaged their healthcare systems engineer to study solutions.
Click here to read the complete article on surgery center simulation modeling.
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to learn more about our approach to surgery centers for a national client
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