100 TJRs down & booming patient demand — Mercer County Surgery Center has major expansion plans on the horizon

Orthopedic surgeon Michael Ast, MD, moved to the Lawrenceville, N.J. area several years ago, bringing with him the goal to offer outpatient total joint replacement the region.

"I had been watching [factors like] length of stay over time and data was coming out showing it was safe, reproducible and could be done well from a quality and cost standpoint," Dr. Ast remarks.

Dr. Ast's mission to bring TJRs to Lawrenceville quickly became a reality, with Lawrenceville, N.J.-based Mercer County Surgery Center celebrating its 100th total joint replacement last month.

In 2014, Dr. Ast, along with other ASC physicians, started planning the surgery center's TJR program. The legwork involved in getting a successful program off the ground was quite extensive, with Dr. Ast noting it took nearly a year from the initial planning process to the ASC having its first TJR under its belt. Staff members had to undergo training on the procedure's ins and outs, planners had to establish relationships with home care agencies and the team had to run through several trials before accepting its first patient.

"We planned for a long time to do the procedure both correctly and safely," Dr. Ast says. "We did three or four [TJRs] and had the same nurse, same physical therapist and same other staff members every time to improve our efficiency and make sure quality was good."

Starting off at a relatively steady pace boded well for the surgery center. The success of the TJR program propelled Mercer County Surgery Center to launch its spine program in November 2016. Patient demand for spine and TJRs is high and the surgery center's current facility has a fairly substantial limitation impeding its ability to boost volume — surgical sterilization capacity.

"This has been the biggest impediment to our volume. We are watching volume grow organically and it is outgrowing the size of our center," Dr. Ast notes. "We are going to build a new surgery center across the street, which will basically double the size of our current center."

Mercer County Surgery Center plans to open the new facility in April 2018, which will be approximately 14,000 square feet. With the newfound space and updated amenities, the surgery center projects it will continue increasing its volume. Equipped with a similar sterilization capacity as hospitals, Dr. Ast notes the new facility will be dedicated, in part, to short-stay TJR and spine surgery patients.  

Like Mercer County Surgery Center, surgery centers in New Jersey and throughout the country are successfully performing TJRs, and many tout a low infection rate and optimal patient outcomes at a reduced cost. In Dr. Ast's opinion, more ASCs adding TJRs is beneficial to the healthcare system.

"Once every ASC in America is doing total joints, all of us will be doing it better," he says. "There is a standard we should hold ourselves to to make sure patient safety and quality metrics are the most important aspects."

More articles on surgery centers:
Monticello Community Surgery Center CEO Andy Poole on how ASCs benefit from increased price transparency
MedStar Health opening orthopedic surgical facility with ASC — 3 insights
ASC leader to know: Dr. Gregory Horner of ASCA

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