"We were outgrowing the old buildings," says John Byers, MD, the
center's medical director. "We also wanted to create something that
addressed the future of health care — providing low-cost and quality
care for our patients."
The surgeons decided to achieve that goal by launching a 23-hour
total joints program and implementing a bundled payment program
for performing joint replacements in a surgery center they owned
(osmag.net/MtU3Xh). They made slight changes to the building
plans for the Surgical Center of Greensboro to ensure the facility
could handle total joints and learned many valuable lessons during
the process.
• New buildings are recruitment tools. Why would surgeons who
perform joint replacements at the local hospital want to move their
cases to your center? That's a key question to answer early on in the
development process. Ask surgeons who are performing joint replace-
ment cases in your area for their must-haves, preferences and wish-
list items. Find out how they want their ORs to look, what tables and
attachments they like and the equipment they prefer to use. Surgeons
will be more likely to buy into a joints program if they have a hand in
customizing it to their needs.
• Allow for plenty of room. The surgeons who developed the
Surgical Center of Greensboro had one non-negotiable item on their
wish list: ORs that are large enough to perform joint replacement pro-
cedures comfortably and effectively. The ORs built in the new surgery
center are 600 square feet, much larger than the 425-square-foot
rooms in the group's old facility.
The larger ORs give the surgical team a "significant amount of
elbow room" and help accommodate the equipment used by the sur-
geons, says Dr. Byers. "The extra room gives us plenty of space to
move around boom-mounted video monitors and video towers," he
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