Case Study: Specialty Surgery Centers

A Deeper LookWe 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 best-

practices. 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.

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APPROACH OVERVIEW

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

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

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.

SURGERY CENTERS

CHALLENGE

Today’s facilities need to work with tomorrow’s technologies. ORs should function for many case types to optimize the investment.

SOLUTION

Successful ambulatory surgery facilities are designed to maxi-mize 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 simula-tion modeling.

The Business of Surgery Centers

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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.

300 people are seen in ambulatory settings for every one person admitted to a hospital.

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Implementation

Serving an International Client

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 post-

procedure. 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

generator, fire pump/water storage tank to accommodate the

storms expected each hurricane season.

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.

• 16,200 SF renovation, 1,570 SF addition

• Class “B” Operating Room

• Two Cardiac Catheterization Lab Special Procedure Rooms

• Three private Pre-Op rooms with patient toilet, lockers and nurse station

• Seven private PACU rooms with private patient toilets, nurse station and nourishment area

• Café seating for Family Waiting

Project Information

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Who We AreARRAY-ARCHITECTS.COM

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.

Array’s Knowledge Communities

We believe strongly in sharing our expertise and knowledge with others. We invite you to explore each of our thought leaders and share your thoughts with the healthcare design community.

Click here to visit our Thoughts page.

Click hereto learn more about our approach to surgery centers for a national client

Design by the Numbers, by Laura Silvoyexcerpted 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

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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