An ambulatory surgery center and minimally invasive surgery: lessons from experience

The author draws on the experience with a large privately owned freestanding surgery center to extract some principles that were felt to contribute to the growth and financial success of the center. Identifying the desired outcomes and the core processes that implement and facilitate those outcomes is critical. Concentration on these creates true value from the perspective of the patient, the physician, and the investor. This process, if implemented fully, affects everything from the architectural design of the entire building to the design of an individual operating room and the operational processes necessary to provide services. This process also has applicability to minimally invasive surgery because the rapid adaptation of more complex procedures to the outpatient environment, the interplay between expensive capital and equipment expenditures, and the reimbursement issues affects the growth of minimally invasive surgery in an ambulatory surgery center. This provides a unique opportunity to also rethink the ergonomic and design considerations of minimally invasive surgery.