INNOVATION THROUGH PARTNERSHIP
Ambulatory Surgery Centers
In today’s rapidly evolving healthcare landscape, efficiency, innovation, and superior patient experience are paramount.
Our ambulatory surgical center (ASC), featuring four state-of-the-art operating rooms, demonstrates the unique advantages of the design-build approach. This methodology integrates planning, design, and construction into a single streamlined process, enabling faster project completion, enhanced collaboration, and cost certainty.
By utilizing multicomponent prefabrication and Design for Manufacture and Assembly (DfMA) principles, the LS3P | Thomas team can simplify and standardize components for efficient manufacturing and assembly, reduce on-site construction time, minimize disruptions such as noise and congestion, and accelerate the delivery of operational facilities. These efficiencies allow healthcare providers to meet urgent community needs more effectively while maintaining patient care standards.
The resulting patient-centered facility is designed to optimize workflows, enhance provider productivity, and prioritize the well-being of patients and families. Natural daylight, efficient layouts, and state-of-the-art technology create a healing environment that supports comfort, safety, and operational excellence.
Ambulatory surgery centers face recurring challenges: inefficient workflows, facilities that lack flexibility, and construction delays that inflate costs. As patient expectations and regulatory demands rise, the need for an innovative, adaptable solution has never been greater.
In today’s rapidly evolving Healthcare Landscape, providers face mounting pressures to address growing patient demands, rising operational costs, and stringent regulatory requirements. These challenges necessitate innovative, adaptable solutions that streamline facility design and construction while maintaining high standards of patient care and operational efficiency.
HEALTHCARE ACCESS
There is a growing demand for outpatient medical facilities across the Southeast, fueled by rising populations, evolving healthcare delivery models, and increasing patient expectations. In North Carolina specifically, the anticipated expiration of the Certificate of Need (CON) process by 2025 presents a unique opportunity to address critical gaps in healthcare infrastructure.
COST AND EFFICIENCY
Healthcare organizations often face financial constraints when planning new facilities. Striking the right balance between cost-effective construction, operational efficiency, and thoughtful
design is critical to meeting budgetary and performance goals. Effective design choices—such as modular layouts, efficient workflows, and sustainable materials—not only help control upfront costs but also reduce long-term operational expenses, creating facilities that are both functional and financially sustainable.
ADAPTABLE PLANNING
Evolving healthcare regulations and advancements in medical technology require facilities to be designed with adaptability in mind. Planning for future needs and compliance without inflating initial project costs presents a significant challenge.
CARE SPACE DESIGNS
Successful ASCs need to address both patient and provider needs in harmony. Their design should prioritize efficient patient flow and a comfortable, welcoming atmosphere while also fostering a positive staff experience.
By incorporating features that enhance staff productivity, reduce fatigue, and support workplace satisfaction, these facilities create environments conducive to seamless operations and the delivery of exceptional care.
MUSC R. KEITH SUMMEY MEDICAL PAVILION LS3P
Ambulatory surgery centers are a valuable investment for the community – playing a crucial role in a broader network of care that supports human health and well-being. The development of an ASC involves collaboration among the healthcare system, caregivers, contractors, architects, and individuals seeking outpatient care.
COLLABORATIVE EXPERTISE
With over 60 successful projects across 11 states, the LS3P | Thomas team combines unmatched healthcare expertise with a proven design-build approach. Our track record reflects our ability to deliver innovative, precisiondriven solutions that exceed client expectations, ensuring every project meets the highest standards of quality and efficiency.
SIMPLIFICATION THROUGH D/B
Our design-build strategy streamlines project delivery by integrating planning, design, and construction into a single, cohesive workflow. By leveraging our adaptable ASC prototype, which starts with a baseline floorplate meeting FGI minimum standards, LS3P | Thomas eliminates complexity and accelerates timelines. This approach simplifies decision-making, supports seamless expansions, and reduces stakeholder burden while creating cost-effective,
patient-centered environments tailored to diverse healthcare needs.
EFFICIENCY & SPEED-TO-MARKET
Efficiency is at the core of our prototype’s success. By leveraging operationally optimized layouts, streamlined approval processes, and advanced prefabrication techniques, we significantly reduce project timelines while maintaining cost certainty. This is achieved through meticulous planning, strategic vendor partnerships, standardized components, and predictable material sourcing.
Additionally, proactive risk mitigation strategies—such as early identification of potential cost overruns and real-time budget tracking—helping projects stay on target financially. Our prototype accelerates development schedules by approximately three months, delivering projects 33.5% faster compared to traditional design-bid-build models.
This expedited approach minimizes disruptions and creates a smoother, more seamless experience for patients, providers, and stakeholders.
FUTURE-READY ADAPTABILITY
Our modular prototype evolves with healthcare needs, offering flexible, multi-specialty design, patientfocused layouts, and balanced staff environments. It accommodates specialty-specific requirements, adapts to regulations, and integrates new technologies for a future-ready solution. Scalable layouts and expansion planning prioritize efficiency and compliance without major modifications. Tailored for specialties like ENT, orthopedics, and ophthalmology, the prototype streamlines design-build with modular configurations, optimized workflows, and specialty-focused considerations. This forges a sustainable, adaptable solution for modern ambulatory care.
Implement flexible design solutions that can support a multispecialty ASC.
Foster balanced work environments that support staff.
Provide functional, efficient, and patient-focused clinical areas.
Enhance operations through strategic design solutions.
Promote the overall wellness of patients, providers, and families.
Our ASC prototype is best suited on a single-elevation site, spanning approximately three acres.
We understand that every site presents unique opportunities and challenges. The following recommendations provide a guideline for property assessment and acquisition to best support the function and layout of this prototype.
Considerations for Site Optimization:
1
LS3P | Thomas’ approach is grounded in this understanding, allowing us to tailor adjustments during the design development phase to position proper implementation of the prototype on each site. Secure, accessible routes for optimal mobility
4 Covered drop-off zones
7 Dedicated access for material loading and unloading
2 Minimum overall length of route into the ASC
5 Separate covered patient pick-up zone
3 Connect accessible route to handicap parking where feasible
6 Exterior signage that highlights the client’s brand
8 Generator and dumpster enclosures designed to complement the building’s exterior
9 Parking ratios tailored to ASC standards, staff needs, patient turnover, and zoning regulations
While there isn’t a one-size-fits-all approach to ambulatory care, LS3P | Thomas has selected two footprints for our prototype, balancing operational efficiency, patient flow, and adaptability to future healthcare needs.
MODULAR DESIGN
What does a healthcare facility need? It must seamlessly meet the diverse needs of patients, families, and providers while delivering high-quality care in a supportive, efficient environment. This requires a carefully designed ecosystem where every element works in harmony to enhance the overall experience and prioritize operational success.
To support these goals, our modular design incorporates standard modules for pre-operative and PACU care, enabling rooms to be used interchangeably based on patient volume and needs. Clinic areas are crafted with higher-end aesthetics to foster a welcoming atmosphere, while cost-effective materials, such as tilt-up walls and sustainable fixtures, create long-term value. At the core of this framework, a dedicated sterile area provides accessible supplies to each of the four operating rooms, and a semi-sterile corridor creates safe, defined pathways for patient transportation.
MARKETING BOOKLET USE
MARKETING BOOKLET USE
OPERATING ROOM
PRE/POST OP
CLINICAL SUPPORT
STERILIZATION
STAFF AREAS
LOBBY
ADMINISTRATION
TOILET ROOMS
CIRCULATION
SEMI-STERILE
Standard Floor Plan
Our 15,500 SF option includes 4 pre-op rooms, 4 post-op rooms, 2 operating rooms, and 2 procedure rooms that can be seamlessly converted into operating rooms as needed. The design also incorporates essential support spaces and staff areas to promote optimal functionality and efficiency.
ADMINISTRATION
ANESTHESIA
BUILDING CORE
CLINICAL SUPPORT
DECONTAMINATION
DISCHARGE LOBBY
LOUNGE / LOCKERS
NURSE STATION
OPERATING ROOMS
PATIENT INTAKE
PRE/POST OP
RECEIVING / MATERIALS
RECEPTION
RESTROOMS
SEMI-STERILE CORRIDOR
STERILE CORE
STERILIZERS/PACKAGING
WAITING AREA
Enhanced Floor Plan
Our 19,500 SF option features 8 pre-op rooms, 8 post-op rooms, and larger operating rooms designed to accommodate a variety of procedure types. Enhanced guest and staff spaces create a spacious, boutique-style facility that prioritizes comfort and efficiency.
ADMINISTRATION
ANESTHESIA
BUILDING CORE
CLINICAL SUPPORT
DECONTAMINATION
DISCHARGE LOBBY
LOUNGE / LOCKERS
NURSE STATION
OPERATING ROOMS
PATIENT INTAKE
PRE/POST OP
RECEIVING / MATERIALS
RECEPTION
RESTROOMS
SEMI-STERILE CORRIDOR
STERILE CORE
STERILIZERS/PACKAGING
WAITING AREA
Pre/Post Op Rooms & Staff Support Areas
Pre-post-op rooms flank the staff core providing direct line of sight from each nurse station to patient rooms. Staff support spaces are centrally located. With a consistent layout, the pre-/post-op rooms can be used interchangeably depending on the patient volume. The wall of windows to the south allows natural daylight to flood the interior spaces.
Operating & Procedure Rooms
By planning each procedure and operating room to be the same square footage, the conversion of a procedure to operating room is simplified. The sterile core to the north of each room offers efficient access. Additionally, this layout allows for expansion of one operating room into the sterile core without disrupting facility operations.
Our ASC prototype has been meticulously designed to meet the unique needs of a modern healthcare environment, with a strong emphasis on efficiency, safety, and flexibility.
Each system - mechanical, plumbing, electrical, and low voltage - incorporates best practices tailored to enhance operational performance while prioritizing the well-being of patients, staff, and visitors. Informed by lessons from the COVID-19 pandemic, these designs feature heightened ventilation standards, advanced filtration options, and adaptable airflow controls, particularly for high-risk areas. This robust, code-compliant approach positions the ASC to provide safe and resilient spaces, setting a standard for future-proofed healthcare facilities. The following sections provide a detailed breakdown of each system’s specifications and intended functions within the ASC prototype.
MECHANICAL DESIGN
The mechanical design fosters efficient, reliable, and code-compliant performance. The system incorporates a semi-custom direct expansion air handling unit with VAV units to deliver precise airflow control and optimized energy efficiency. Ventilation and exhaust systems are designed to provide adequate airflow in critical areas such as restrooms, sterilization rooms, and The plumbing design for the ASC prototype is tailored to meet the highest standards of functionality and compliance. Systems are installed according to Code, with the assumption of adequate water pressure on site, eliminating the need for a domestic booster pump.
Copper piping is used throughout, with a copper domestic riser located 5 feet outside the building for durability and reliability. Sanitary sewer systems utilize PVC piping except in the Central Sterile suite, where CPVC is specified for added resilience.
The Medical Gas System in each operating room is in accordance with FGI minimum requirements and includes Type L cleaned and capped copper with brazed wrought copper fittings, providing:
• oxygen outlets (2)
• vacuum outlets (3)
• medical air outlet (1)
• waste anesthetic gas disposal outlet (1)
Pre-op, post-op, and PACU rooms are equipped with one each:
• oxygen outlet
• medical vacuum outlet
Systems for deionized and reverse osmosis water and steam are assumed to be provided by the Owner Vendor and are not included in this design. This comprehensive plumbing system supports the critical operational needs of the facility while prioritizing compliance and reliability.
UNC HEALTH PANTHER CREEK ASC LS3P
ELECTRICAL DESIGN
The electrical system is robust and compliant with healthcare facility standards. It features a 1000A single service fed by transformers, located within 15 feet of the building at the power company’s discretion. Aluminum feeders connect the transformers to the electrical room, with healthcare-rated MC cable utilized outside the Surgery Suite as permitted by code.
Emergency power is supplied by a 300kW diesel generator, positioned adjacent to the main electrical room,
and supports critical systems, including operating rooms, HVAC equipment serving the ORs, and sterilizers. Clinical spaces such as operating rooms and PACU are illuminated with IESrecommended luminaires, promoting optimal lighting for healthcare settings, while mechanical and electrical rooms use industrial-grade LED fixtures.
Means of egress are designed to meet NFPA 101-2018 standards, and exterior lighting includes decorative canopy lighting and 10 exterior wall sconces, two of which are backed by emergency
power at key entrances. Electrical rough-ins are included for future building signage, while site lighting is excluded and assumed to be provided through an owner lease-back arrangement with the local utility. This comprehensive electrical design supports functionality, safety, and adaptability, meeting the unique needs of a modern ambulatory surgery center.
WAKEMED NORTH RALEIGH SURGERY CENTER LS3P | THOMAS
LOW VOLTAGE DESIGN
The low voltage design forges a seamless integration of essential systems to support operational efficiency and communication. The general contractor will provide pathways, including raceways, backboards, and outlet boxes, to accommodate structured cabling systems. These pathways are designed to support the installation of critical systems such as nurse call, security, and other low voltage requirements, which will be implemented by the Owner’s preferred vendor.
This streamlined approach allows flexibility for customization while creating the infrastructure to meet the facility’s technological needs.
UNC HEALTH PANTHER CREEK ASC LS3P
In evaluating the baseline design of the standard floor plan, which includes four operating rooms along with pre/postsurgical spaces, several potential upgrades—outlined on the adjacent page—have been identified to significantly enhance the facility’s overall functionality and long-term performance.
These options are thoughtfully designed to meet specific client needs—such as budget, site constraints, and operational requirements—while improving patient care through streamlined clinical layouts that enhance accessibility and reduce wait times. Optimized workflows are achieved with strategically placed support spaces, clear staff pathways, and modular configurations that minimize inefficiencies. Durability is infused through the use of highquality, resilient materials and construction methods that withstand the rigors of daily healthcare operations. Additionally, these designs offer flexibility for future expansions, allowing for evolution with changing demands.
Operational Requirements
» Upgrade procedure rooms to operating rooms
» Enlarge one operating room
» Stainless steel wall protection in ORs
Finishes
» Ceramic wall tile in locker rooms
» Pre-manufactured laminate headwalls in in PACU and pre/post-op
» Wood cloud ceilings instead of ACT at nurse stations
Plumbing
» Nitrous Oxide, Carbon Dioxide or Nitrogen/instrument air
» DI/RO water for sterilization
Openings
» Manual sliding ICU entrances instead of curtains
Electrical/Low Voltage
» UV light sterilization ceilings in ORs
» Low voltage cabling for all systems
» 48-hour emergency generator run time
» Lightning protection systems
HVAC
» Pre-fabricated operating room ceilings
» UV light sterilization in ductwork
» Hydronic HVAC upgrade
» BAS remote access control
» Active return control
» Venturi valves for ORs and sterile areas
Our ASC prototype is the culmination of insights and lessons learned from a range of successful healthcare projects.
By analyzing key elements—such as workflow optimization, patient-centered design, and innovative construction strategies—we’ve taken the best practices from these projects to create a highly adaptable, efficient, and forward-thinking solution. These foundational projects have informed our approach, allowing the ASC prototype to address the unique challenges of modern ambulatory care.
Sterile cores promote efficiency and safety
Spacious operating rooms transform the provider experience
Ample daylighting elevates the patient experience and encourages healing
Research-based room orientation, size, optimal table positioning, anesthesiologist positioning, and finishes
LEAN-driven clinic layout design, including on-stage/offstage exam room layouts
Finishes and fixtures reflect the high quality of care while curating a welcoming environment for healing
LS3P and Thomas Construction Group have been a trusted team for over 20 years. Our diverse portfolios illustrate a comprehensive, human-scale approach to healthcare design. This enduring partnership has led us to create an innovative ASC prototype that is not only efficient, but thoughtfully designed to meet the evolving needs of both patients and providers.
Chris Thorn LEED AP, CHC
THOMAS CONSTRUCTION GROUP
HEALTHCARE SECTOR LEADER
E CTHORN@THOMASCONSTRUCTIONGROUP.COM
P 910.662.4092
With nearly two decades of experience in acute care construction, Chris joined Thomas from the Pacific Northwest, where he led significant projects such as a $260 million Trauma II healthcare facility.
As Thomas’ Healthcare Sector Leader, Chris plays a pivotal role in guiding projects from feasibility planning through construction. With extensive experience and a proven track record, Chris ensures that every phase is executed with precision, safety, and efficiency. His expertise strengthens the team’s ability to deliver innovative solutions, meet complex healthcare requirements, and exceed client expectations, solidifying our commitment to excellence in healthcare construction.
Willy Schlein AIA, NCARB, LEED AP
LS3P
HEALTHCARE PRACTICE LEADER E WILLYSCHLEIN@LS3P.COM
P 864.272.1250
Willy serves as LS3P’s firmwide Healthcare Practice Leader, bringing over 30 years of extensive healthcare programming, planning, design, project management, and construction experience. His expertise spans a wide range of healthcare facility types and project complexities, making him a trusted leader in delivering innovative, patientfocused solutions that prioritize functionality, flexibility, and operational efficiency.
Previously, Willy was also President and Founder of Anthrotects, a firm he established to design the keystone services of a new “medical city” featuring a 300-bed hospital, cancer center, and MOB now under construction in Addis Ababa, Ethiopia.
Trusted partners, nationwide.
At Thomas Construction Group, we are ‘Always Building’— structures, relationships, and legacies. As a contractor with local roots and national reach, we excel in healthcare construction, delivering exceptional results through innovation and teamwork. Our mission is to exceed client expectations by fostering partnerships, leveraging expertise, and prioritizing quality and collaboration. This focus on people, process, and excellence positions us as a trusted industry leader.
LS3P is an architecture, interiors, and planning firm with 61 years of design excellence. Rooted in the Southeast with national reach, we combine large-firm resources with small-firm relationships. Guided by our vision, we create community-enriching architecture through design excellence, innovation, and collaboration. With extensive experience in healthcare design, LS3P delivers innovative solutions to enhance functional efficiency and long-term flexibility. Our holistic approach focuses on creating adaptable, inspiring spaces that promote healing.
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