Case Study: Academic Medical Center Wants New Outpatient Surgical Department to Operate Like an ASC

Case Study: Academic Medical Center Wants New Outpatient Surgical Department to Operate Like an ASC


A premier academic medical center planned to open a satellite outpatient surgical department, move less complex, lower-reimbursing orthopedic procedures to the department and create space in the hospital operating room for higher-reimburs­ing, inpatient cases. The hospital wanted the department to function similarly to an ambulatory surgery center (ASC), while delivering the same quality of care and innovation expected from the academic medical center. The hospital soon discovered the significant challenges surgeons and staff trained in academic medical centers face when expected to adjust to the lean and highly efficient processes of an ASC.


Avanza Healthcare Strategies (formerly ASC Strategies) was brought in on a one-day engagement to review the hospital's floor plans for the outpatient department while considering the hospital's objective of running the department like an ASC.


  • Identified where plans would not replicate an effective ASC experience and offered guidance for how to adjust them accordingly.
  • Made recommendations to streamline the development process.
  • Identified opportunities for improved efficiencies and multidisciplinary staffing.

Avanza was later brought back to help the academic medical center ensure its outpatient depart­ment would develop and operate like an ASC—from infrastructure, clinical and customer services perspectives.


  • Participated in facility, equipment, staffing and operations planning sessions, challenging the decision makers to explain the reasoning behind their choices and offering constructive criticism when necessary.
  • Reminded the decision makers that the outpatient department would house elective cases for healthy patients, and the equipment and staffing redundancies needed in the hospital weren't necessarily clinically or financially appropriate in the outpatient setting.
  • Facilitated physician information sessions to provide education and training on appropriate patient identification, selection and preparation.
  • Provided additional training and guidance to staff members and department leaders about the unique requirements and workflow necessary to provide efficient care in an outpatient setting.
  • Established a physician advisory panel to select the center's medical director and review procedures and surgery schedules prior to the opening of the center.
  • Collaborated on the design of a unique IT infrastructure, integrating it with the medical center's current IT system where needed, while eliminating aspects not relevant to the ambulatory setting.


Within a few months of opening, the department was fully accredited and four operating rooms were handling redirected cases. Surgeons and staff are comfortable with their new environment, and operations are running harmoniously. The department is not only a setting for the academic medical center to offload minor cases; it is also a revenue generator and a marketing opportunity because of its physical and operational appeal. With available space in its operating rooms, the hospital has boosted its revenue by attracting more acute inpatient surgeries.


The partnership between the academic medical center and Avanza was such a success that the hospital engaged with Avanza again, this time to plan and develop an 110,000-square-foot musculoskeletal center. Services provided at this standalone center include total joint replace­ment, spine, sports medicine, outpatient therapy including physiatric services, diagnostic imaging and comprehensive pain management.

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