Surgery Center Archives - HCO News

Blue River Surgery Center Wraps in Kansas City

HCO News Staff — Thu, 18 Jul 2024 11:42:01 +0000

By HCO Staff

KANSAS CITY, Mo.—Hammes, a national real estate consulting, development, investment and management firm, recently completed the Blue River Surgery Center in Kansas City. The new 22,500-square-foot ambulatory surgery center, which is now open to patients, includes five operating rooms and two specialty procedure rooms for orthopedic, gastroenterology and other multi-specialty cases.

The Blue River Surgery Center was developed on behalf of Surgery Ventures, powered by HCA Healthcare, in collaboration with more than 20 physician partners. The facility, located at 1350 East 104^th Street, is located in a fast-growing area in south Kansas City and complements HCA’s existing care delivery network in the region.

Hammes is currently developing a second surgery center in the Kansas City area in partnership with Surgery Ventures and physician partners. It is located in the suburb of Lee’s Summit, Missouri, and is expected to open in early 2025.

“It has been rewarding to support Surgery Ventures with the rollout of multiple ambulatory surgery centers throughout the country,” said Justin Shea, Principal of Hammes Partners. “We are excited to see the impact these new surgery centers have in terms of greater access to quality outpatient care in the communities they serve.”

Hammes partnered with ACI Boland Architects and JE Dunn Construction on both the Blue River Surgery Center and the future Lee’s Summit Surgery Center.

Founded in 1991, Hammes is a vertically integrated real estate solutions platform specializing in healthcare real estate strategy and planning, project management, development, investment, and property management.

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Modernize Your Strategy When Planning a New Ambulatory Healthcare Facility

HCO News Staff — Tue, 14 Sep 2021 11:42:23 +0000

By Patricia Shpilberg and Jessica Anderson

The old cliché that “healthcare is always changing” rings truer now than ever. Advances in medicine and technology, combined with lessons learned from the pandemic, continue to shift the way care is delivered. They also impact how ambulatory facilities are being designed, whether you’re building or renovating an on-campus medical office building, surgery center, community provider clinic or other type of practice.

Focus on an Outcomes-Driven Approach

These days, providers distinguish less between inpatient and outpatient environments, and instead plan for universal design across the continuum of care. To ensure the desired outcomes, it’s critical to align strategy, business objectives, design and user buy-in. A diligent planning process, facilitated by experienced healthcare design experts, ensures that spaces are adaptable and can accommodate fluctuations in patient volumes while also incorporating sufficient standardization for constructability and consistency.

An outcomes-driven planning strategy yields many benefits, including:

Speed: Accelerates site and facility concept creation and the schematic design process
Predictability: Minimizes unbudgeted design and construction costs and project delays
Growth: Data-driven space programs support expansion without overbuilding
Flexibility: Adaptable spaces balance revenue-generating and support areas
Productivity: Efficiencies in FTEs, decreased steps and increased throughput improve staff and physician productivity
Experience: Patient-centric environments enhance the patient experience

Functional Planning Considerations

A functional plan can mean the difference between a profitable facility completed on-time and on-budget and one delayed by overruns and unforeseen costs. The planning process must establish key drivers including service line mix, preferred care model, staff workflow, planned capacity and a room-by-room space list.

Here are some important questions to address:

Will volume or provider FTEs drive the exam room count?
How will growth and/or additional capacity be addressed?
What kind of care model will be deployed in the facility, and what are the design implications?
Will telehealth or other technologies be integrated into the service continuum?
Will there be centralized or shared services for patient, building and/or staff support?
Do specialty rooms specific to any services need to be included?

Based on information gathered, a functional narrative is developed detailing operational parameters and optimal space utilization. This helps inform a concept plan that addresses patient care workflows, location of services, number of exam and procedural rooms and how they all fit together.

Space Planning Essentials

The space planning process includes conceptual layouts to determine key adjacencies and relationships for the building programs as well as how the plan works within the context of the site.

Key considerations include:

Can interventional services share support areas such as prep, recovery and staff support?
How will circulation paths in the building accommodate staff, patients and materials?
How will public areas and waiting spaces be addressed?
Will there be adjustments made as a result of lessons learned from COVID?
How can future growth and expansion be accommodated?
Are there mobile units to be considered in the site development?

Careful, flexible planning is vital to meeting current and future clinical needs and creating a roadmap to profitability. For example, MedCraft recently worked with the leaders of a new ambulatory center seeking to substantially lower construction costs without reducing surgical capacity. After reassessing anticipated needs and revising project scope, a design alternative was developed that provided an initial savings of $1.7M in upfront costs.

This was accomplished by reconfiguring the existing OR suite and prep/post areas to create two OR and two GI procedure rooms rather than constructing two dedicated gastroenterology (GI) procedure rooms plus four operating rooms (OR), as initially planned. MedCraft also created expansion plans for two future multi-purpose ORs that could easily and cost-effectively be constructed over a weekend.

Leveraging an Expert-Led, Cross-Functional Team

Ensuring buy-in, effective change management and successful implementation of new operating models requires engaging key stakeholders throughout the planning process. Organizational leaders establish overall strategic direction, define care models and determine project scope, while service line users offer insights on how they currently use space and would ideally use it going forward. Physicians, nurses and other clinical staff provide input on how future environments could improve productivity and their ability to provide high-touch patient care.

User group sessions provide valuable opportunities to discuss ideas, test guidelines and generate consensus. Healthcare design experts serve as highly effective user group session facilitators, bringing the unique skillset needed to finesse dynamic personalities, encourage the free exchange of ideas and maintain the guidelines established by leadership.

According to Dr. Adil Baig, Yuma Regional Medical Center, Primary Care, “The user group meetings were an effective way to provide input and incorporate feedback from our administrative dyad team, ensuring we utilized the space in the most efficient manner possible from an operations and clinical perspective.”

Achieve Results with Winning Solutions

Another recent project demonstrates the value of engaging an objective partner who understands facility planning, has strong knowledge in clinical operations and is highly experienced in innovative healthcare design. The MedCraft team identified several opportunities for improvement for a clinic whose initial goal was to replicate its existing “hub and spoke” model, which featured centralized registration and core functions along with dual entry exam room corridors distributed to preserve clear patient lines of sight.

By re-envisioning and refining the clinic prototype while maintaining key operational drivers, MedCraft helped the facility:

Reduce construction costs by 27%
Exceed target goals
Provide access to new and expanded services
Increase provider and staff satisfaction
Become a preferred practice location for many of the health system’s physicians, leading to expanded hours for specialty care

Whether you’re designing a large medical office building or a community-based provider clinic, functional outcomes-based planning can help you meet all your operational and clinical goals – from patient and staff safety, to clinician productivity, to future growth.

Patricia Shpilberg, serves as Vice President of Planning & Development, and Jessica Anderson as Director of Physician Services, for MedCraft HealthCare Real Estate.

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Flagship Adds Additional North Carolina Property to Portfolio

HCO News Staff — Wed, 22 Jan 2020 14:00:02 +0000

By Eric Althoff

HICKORY, N.C.-Healthcare real estate development firm Flagship Healthcare Properties has acquired a Class A medical office building and ambulatory surgery center (ASC) at 214 18th Street SE in Hickory, the firm announced recently. The 45,390-square-foot property has been fully leased to healthcare operators OrthoCarolina and Frye Surgery Center.

OrthoCarolina has leased 32,522 square feet of the Hickory property, representing 72 percent of the total healthcare space. The remaining 28 percent-12,868 square feet-will be utilized by the Frye Surgery Center.

“We are pleased to acquire this first-class facility that houses two prominent healthcare providers,” Gerald Quattlebaum, senior vice president of acquisitions for Flagship, said in a statement regarding the buy. “We have a long-standing relationship with OrthoCarolina and have a tremendous amount of respect and admiration for what they do. We look forward to working with both tenants and expanding those relationships in the Hickory market.”

At the Hickory property, OrthoCarolina will offer patients physical therapy, an urgent care facility, as well as an MRI clinic. The healthcare firm’s offices will also be set up to deal with hand surgery, joint replacement, spine care, physiatry, and sports medicine. The offices will also be staffed with medical professionals just like Dr. Sanjay Desai hand surgeon to ensure that patients are treated exceptionally well.

The Frye Surgery Center, which operates as a department of Frye Regional Medical Center, falls under the umbrella of Duke LifePoint Healthcare. At the Hickory ASC, the Frye Surgery Center will offer services at four surgical suites, with specialty care focused on cardiothoracic, neurosurgery, vascular, oncology, oculoplasty, dental, orthopedic, ear nose and throat, plastic and reconstructive, urological, general, gynecology and podiatry.

Flagship bought the Hickory facility under the aegis of its real estate investment fund, Flagship Healthcare Trust, through whom the company has also purchased other healthcare properties in North Carolina within the past year. Flagship has announced it is providing property and asset management services as part of the deal, which was financed by First National Bank.

“We are honored to be the real estate partner chosen by the sellers, and warmly welcome these new investors to the Flagship REIT family,” Charles Campbell, CEO and co-managing partner with Flagship, said of the sale.

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Charles D. Knight

HCO News — Mon, 28 Feb 2011 20:34:51 +0000

Cannon Design, a nationally ranked architectural, engineering, interior design and planning firm, has named Charles D. Knight, AIA, CID, LEED AP, as Principal. Knight brings over 25 years of experience to the firm as an architect with a focus on social needs. In his new role, he will be responsible for the leadership of the Phoenix office and the advancement of the firm’s healthcare practice. Knight’s portfolio of work has been focused upon creating and financing socially responsible sustainable medical campuses, children’s hospitals, hospice facilities and private sector communities.

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Trade Files: HDR Inc.

HDR Inc. has evolved into a powerhouse healthcare construction/architecture firm and for the past 18 years, Doug Wignall, the company’s international director of healthcare, has been along for that ride.

“We are clearly the largest [healthcare architectural firm] in the United States and I would guess that we probably are in the world,” says Wignall.

On the whole, HDR Inc. has more than 185 locations worldwide and counts more than 7,800 professionals. It holds the number five spot in Architectural Record’s 2010 “Top 25 Design Firms” rankings and is number 11 on Engineering News-Record’s 2010 “Top 500 Design Firms” list. About two-thirds of HDR’s work is in the U.S., says Wignall, but it also has a strong international presence with offices in London, U.K.; Abu Dhabi, Dubai; and five offices in Canada.

Healthcare is the largest business class within HDR’s architecture segment, which has about 40 offices and is likely responsible for more than half of the work done within the architecture group, Wignall says. Science and technology are the company’s other two primary business classes, and include projects such as research, academic, and pharmaceutical facilities. HDR’s third specialty is its civic group, which includes projects such as prisons, jails and courthouses and civic projects.

“I think the underlying thing about our firm in general is that we primarily focus on complicated or complex building types,” says Wignall. “We do, as we like to say, ‘the tough stuff.’”

Employee Ownership Key

Initially founded in 1917, HDR operated under a classic principal-owned design firm model for its first 60 to 70 years. Bougues SA, France’s largest construction firm, acquired HDR in 1983 and ran the company until 1996, when employees purchased HDR back.

“In the early years, buying ourselves back, we were laden with some debt because we had to come up with the money that was internal of the individuals who worked here,” says Wignall. “At that point in time, our growth really was organic.” For the first five years under employee ownership, HDR added staff and expertise, and opened up small offices where it saw potential markets, he says. “But for about the past decade, we’ve been acquisition-focused. I would say that now probably 95-plus percent of our growth is acquisition-based. We actively look for it.”

HDR does not pay corporate taxes since it is structured as an S corporation; Taxation occurs when employees turn in stocks upon retirement. “What that does, is that gives us about a 30 percent break to be able to invest in our company,” says Wignall. “That 30 percent is money we use to invest in the company through acquisitions. We do it continuously. We have probably four or five acquisitions in the works right now, and that is typically the way it always works.”

Wignall said that the company looks at several criteria when evaluating potential acquisition candidates.

“First and foremost, the first and primary thing we look for is cultural fit. If you don’t have a good cultural fit, if you don’t have the same philosophical viewpoint, it’s not going to work no matter what,” says Wignall. “And then we look for geographic diversity, getting into locations where we are currently not. We also look to expand our expertise. There might be a firm that specializes in a very specific thing that is related to one of our business classes, so we may look for that. And then also we may look for new, to expand horizontally our service line of expertise, as well.” Geographically, he says, the company is looking for opportunities abroad and a few targeted stateside regions where it does not currently have a strong foothold — primarily Florida and the Northeast.

Wignall started working at HDR as an intern architect while a student at the University of Nebraska in Lincoln and joined the company full-time straight out of school. He never left.

“I’ve never worked anywhere else,” he says. “I started out, as all young architects do, on the boards drawing documents for projects. The first sort of turn my career took, I was more of a design-centric individual so I spent the first part of my career designing healthcare facilities. I was the lead designer on multiple projects all over the U.S. And then from that, I started to focus more on the business development end of things, until I aspired to into the role that I am now, which is running the healthcare program.”

Wignall also oversees the healthcare consulting group, comprised primarily non-architects such as former hospital CEOs, nurses and biotech personnel. “They are the ones who will come in and help healthcare facilities determine what their needs are and what direction they need to take with respect to that,” he says. “Their services are pretty diverse.”

Complex Projects of all Sizes

HDR has hundreds of projects in the works at any one time, Wignall says. He mentions two hospital replacement projects currently underway, although they are vastly far apart in scope: a 109,000 square-foot facility in Alaska and a 2.5 million square-foot health care campus in Texas.

The Alaska project is under construction in Barrow, Alaska, one of the northernmost cities in the world. Its remote location, the permafrost earth and lack of access make for a complicated construction process. The Indian Health Service there is funding the eight-bed replacement hospital, which will be quadruple the size of the previous facility and provide more exam rooms, patient beds, dental facilities, eye care and physical therapy.

“Once I got off the plane and met the people, I realized in the lower 48 — and most parts of the world for that matter — there is this air of self-reliance that we all tend to have, that we can get through anything alone, that we really don’t need anybody else,” says Wignall. “In that community, they all know that to get through life, and to get through a day sometimes, they are going to need each other to do it. There is this huge and overwhelming sense of community. This project, I promise you, is probably going to be one of the most special ones of my career. We are giving them a facility for a population that is in great need and it is going to be one that they appreciate for generations.”

On the other end of the spectrum is the $1.2 billion healthcare campus under way in Parkland, Texas. The project includes an 862-bed adult inpatient hospital, outpatient center, parking and central utility plant and a logistics building. “It’s a tremendous project,” says Wignall. “I truly believe this may be the last great American hospital that is ever built. It its very, very rare to see a domestic county hospital today to be 800 or 900 beds. It’s just a huge project.”

Big Picture Approach

HDR partners with product manufacturers to help design not only the buildings, but the products inside the facilities as well. Products can range from carpeting and fabric to steel-case modular nursing stations and signage providers and include a broad range of products applied to the healthcare environment. “I think we are one of the few, if not the only firm, that is involved at that level of detail in the healthcare industry, to where we are designing not only the buildings, but the products that you are experiencing inside the facilities as well, says Wignall.

HDR launched a pilot healthcare design studio at the University of Nebraska, Lincoln, last year that allows students to graduate with a degree emphasizing healthcare design. It expects to create a network of these design institutes/design studios at colleges of architecture, interior design, or possibly healthcare administration that are located near HDR’s major offices. The two-semester program includes classic design studio curriculum in the fall, followed by a research semester. The program provides HDR with qualified graduate students to assist with research on specific topics related to the healthcare design industry. The company is currently working on a couple of potential locations and will likely open its next studio in time for the fall semester of 2012.

Every year since 2008 has been a record financial year for HDR Inc., a feat Wignall attributes to its employee-owned structure and some good strategic direction positioning. “If you ask most companies, their staff today versus before the economic downturn in 2008, you would find major companies that are half the size that they were. We’ve had a reduction, I think, in staffing of around five percent,” he says.

Wignall explains that healthcare trends over history show that when a new president or leadership council takes control, healthcare becomes a political issue and development slows as the industry waits to see if changes are in the works. This is particularly relevant in light of the Obama healthcare overhaul plan.

“What we were preparing for in 2008 was positioning ourselves to not rely completely on the domestic U.S. market,” he explains. HDR diversified and went into Canada and abroad. It also invested heavily on the federal side, looking to win department of defense projects for the veteran’s administration. Although the planning was done in preparation for the presidential election, it happened to correlate almost perfectly with the economic downturn in October, says Wignall. “We got a little lucky, to be honest, because we were diversifying for a completely different reason. But it ended up saving us and that has allowed us to sustain ourselves for three years now while the domestic healthcare market is still kind of limping along, to be quite honest.”

Optimism Going Forward

A new president, the healthcare reform bill, difficulty obtaining loans, and a reduction in donations created a perfect storm of sorts to put a kybosh on the domestic healthcare market in general, according to Wignall. But he is seeing hints of recovery. Wignall now sees construction costs starting to increase and notes predictions of 8 to 11 percent increases next year. He expects the uptick, coupled with clarity on the reform bill, to result in an increase in healthcare construction by the end of next year.

“If you are asking me to look in a crystal ball, I look at things with a more theoretical perspective, he says. “If you follow the housing market, which is a broad consumer market, you will notice that most of the activity occurs not when the loan rates bottom, but when they start to come back up, because people wait and wait and wait for things to get to the bottom and then once they start to creep up is when they all get nervous. Its common human nature.”

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