His center's design team positioned the facility's 5 ORs used for total
joints as close as possible to the nursing station, so there would
always be adequate staff coverage among the rooms.
Coming up with the optimal clinical flow also meant spending time
figuring out how patients would move through the 2-story center,
where pre-op and the overnight recovery center are on the ground
floor and the ORs and PACU are on the second floor. Despite the
unique and challenging floor plan, the center's design team wanted to
make the perioperative pathway as efficient as possible for surgeons,
staff and patients.
"We placed the pre-op area directly below the ORs," says Dr. Byers.
"We also added surgeon consulting rooms right next to the stairs, so
surgeons can meet with family members as patients move into the OR
and then head right up to operate."
• Allow for extended stays. The surgeons perform joint replace-
ments in about an hour. When patients are wheeled to the PACU,
they've reached the first of 2 stops in their recovery process. Patients
stay in the initial recovery phase for about 30 minutes to stabilize
after surgery before moving to the second phase, where they work on
getting out of bed and moving around.
"Patients receive in-house physical therapy for 1 to 2 hours," says
Dr. Lucey. "The rest of the day involves some exercises and use of the
continuous passive motion machine. Patients are generally ambulat-
ing within 6 hours of the surgery."
Those who need additional care and time to recover are sent to one
of 10 rooms reserved for the center's total joint patients. Though
patients do not stay for more than 23 hours, the extended-stay recov-
ery area lets staff and surgeons monitor their post-op recovery until
they're ready to head home.
Having a space that can hold patients for several hours is key to the
M A R C H 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 2 1
