orm_june-2024 - 10

AMBULATORY SURGERY CENTERS
BY BRENDAN DOOLEY
Built to grow: Key elements of outpatient facility planning
re you part of the ambulatory
surgery center (ASC) construction
boom? If so, you're not
alone. Approximately 116 new facilities
opened in 2023, according to Becker's
ASC Review, and more are planned for
and underway in 2024.
A
This trend shows no signs of slowing.
Fortune Business Insights projects
the US ambulatory surgery center market
to grow from $46.62 billion in 2023
to $75.20 billion by 2030-a compound
annual growth rate of 7.1%. According
to the American Ambulatory Surgery
Association (ASCA), ASCs perform
23 million different surgical procedures,
particularly those of lower complexity
and acuity. The number of Centers for
Medicare & Medicaid (CMS) covered
procedures for ASCs continues to rise,
opening opportunities in specialties that
so far include orthopedics, pain management,
ophthalmology, gastroenterology,
dermatology, and urology.
Driving this surge is a growing preference
for ASCs among payors and patients
alike. According to ASCA estimates,
per-procedure reimbursement
cost is " roughly half that of hospital
outpatient departments. " Further boosting
the ASC market, CMS recently increased
ASC reimbursements by 2.8%.
For patients, ASC advantages include
not only lower out-of-pocket expenses,
but also convenience, comfort, and
more personalized care.
As construction in ASCs accelerates,
how can providers, clinician stakeholders,
and administrators ensure new
facilities are ready to adapt to the demands
of today, 2 years from now, and
beyond? The following offers a closer
look at some of the key elements of
constructing a new ASC with the future
in mind.
Space planning, inventory
storage
Space is often the most important consideration
when planning a new ASC.
Thanks to growing demand and favor10
OR
Manager | June 2024
able reimbursements, ASCs can outgrow
their footprints before they actually
open.
In addition to which services to offer
and how many providers will use the
facility, basic considerations include
estimates of procedure volumes and
inventory storage requirements. If your
ASC is affiliated or partnering with a
larger network, historical data from the
organization can inform the necessary
market research. Otherwise, reach out
to state healthcare agencies, accrediting
bodies, provider associations, local
hospitals, and medical suppliers for
help. Site visits to other ASCs can be a
reliable, real-time source of information.
days per year. This ASC must keep a
minimum of 7 days' worth of item X
on-hand at all times-5 days between
weekly deliveries and 2 days as a buffer.
Annual demand for item X is 1,200
cases. Based on these figures, maintaining
7 days' worth of inventory requires
4.8 cases per operating day, or
33.5 per week (1,200/251 = 4.8 x 7).
If one case of item X measures 2 cubic
feet, 33.5 cases stacked in a single
slot will require 67 cubic feet of storage
space. For smaller items, bin size
required to hold days-on-hand inventory
can inform estimates.
The budget
must account for
items ranging from
state-of-the-art
technology to
supplies like tongue
blades and even
the furniture in
patient reception
areas.
Internally, incoming physicians and
staff may have specific needs and expectations,
as well as recommendations
for efficient workflow and design
of patient care and storage areas. How
much space to devote to storage depends
on annual demand for supplies
(which can be established by comparing
historical usage data with estimated
procedure frequencies), how much inventory
must be on-hand, how often
stock is replenished, and the sizes of
the items.
For example, consider a new ASC
that operates 5 days a week, or 251
Run this calculation for all essential
inventory to estimate storage requirements
and future growth needs, then
adjust from there. For example, a more
frequent replenishment schedule can
help maintain desired on-hand inventory
levels for ASCs with limited storage
space.
Promoting standardization
Standardizing on supplies can help reduce
waste and opportunities for mistakes
while simultaneously improving
efficiency throughout the operation,
from case picking to opening supplies
for a procedure and turning over rooms.
For example, ASCs can choose among
a variety of surgical skin preparation
products, each with its own guidelines
for use and specifications on which clinicians
receive training. Narrowing options
on the shelf to just one or two
products not only limits potential for errors,
but also decreases the time clinicians
spend in the storeroom evaluating
their options.
The same principles apply to capital
equipment. For example, standardizing
on the same mayo stand for all ORs
could help an ASC specializing in spine
and joint procedures avoid errors and
delays that might result from stocking
multiple types of stand covers.
A group purchasing organization
(GPO) or distributor partner can help
with standardization efforts. They offer
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