Installing conduits for surgical gas, telephone, electricity and broadband is one of those details that is often overlooked in building a new ambulatory surgery center, says Chris McMenemy, vice president for administration at Ortmann Healthcare Consultants in Columbia, S.C. While it is relatively easy to install conduits during construction, when walls are still open, it is far more difficult and expensive to do so afterwards. Ms. McMenemy lists eight mistakes made in installing conduits in a de novo ASC.
1. No broadband for IT. Someone may forget to add cable for broadband or doesn't plan for enough IT jacks. This one mistake has become a major problem now that ASCs have come to depend on Internet access. "Now it's impossible to run an efficient ASC without computer systems," Ms. McMenemy says.
2. No planning for future needs. "A little bit of planning can save you a lot of money," Ms. McMenemy says. "Sit down with a copy of your floor plan and make spots for every single place that you might want a computer or phone. Where might you add personnel later on, as your center ramps up?"
3. Not enough electric outlets. A generous number of electric outlets is essential because you can't have extension cords snaking around the floors. Since opening up walls to add more lines is expensive, after construction some ASCs drop down extra lines from the ceilings, but this approach may violate local construction codes.
4. Putting off a keyless access system. A keyless access system may be more expensive than keys, but these systems make it easier to go in and out of secure back-office areas, improving efficiency. Also, the system eliminates changing the locks if a disgruntled employee leaves with a set of keys or keys disappear. Keyless systems require electronic hook-ups that are more expensive to install later.
5. No phone jacks for the fax. When installing phone cables it can be easy to forget about connections for fax machines in the business office and for the credit card connection at the front desk.
6. No cable TV connection. Even if initially you don't opt for a television set in the waiting area or the staff lounge, you may decide to do it later. "Again, it's easier and less expensive to install the lines during construction," Ms. McMenemy says.
7. No space for the IT server. Sometimes the architect forgets to carve out space for the computer server. "An IT room may be left completely off the plans," Ms. McMenemy says. This room should be at least 4 by 6 feet, but a little larger one is desirable because a small room could overheat. A larger size and planning for ample air conditioning can help.
8. Awkward location of gas outlet. Physicians who will use the OR should discuss where to place gas lines there. Often the gas outlet is located directly across the room from the OR entry, so that it is accessible to the patient coming in head-first, but a podiatrist may want to bring the patient in feet-first. It's best to get it right the first time because changing gas lines may be even more expensive than changing electronic lines.
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