30 ASCs Performing More Than 10,000 Procedures a Year

Here is a list of 30 ambulatory surgery centers across the country with an annual case volume of more than 10,000 procedures.

Advanced Endoscopy Center (Bronx, N.Y.). The Advanced Endoscopy Center opened in April 2007 as a joint venture between a group of physicians, Physicians Endoscopy and a local hospital in the Bronx. This single-specialty GI center performed more than 10,000 procedures last year. In total, 22 physicians use the facility — 10 of which own interest in the center. The Advanced Endoscopy Center is AAAHC-accredited and recognized as an ASGE Center of Excellence.
"We have a great team of physicians and staff, and they work really hard to make sure patients are processed efficiently and quickly," says administrator Steve Housberg. "Our average wait time is an hour and a half from start to finish, and we have state-of-the-art equipment."

Allied Physicians Surgery Center (South Bend, Ind.). This center opened in Feb. 2000 and has performed more than 10,000 procedures a year since 2003 — and more than 20,000 a year since 2007. More than 80 physicians perform procedures in the center's seven operating rooms and two minor procedure rooms. The center is AAAHC-accredited and specializes in orthopedics, podiatry, ophthalmology, pain, ENT, general surgery, gynecology and urology. Executive and clinical director Chuck M. Strasser, RN, CASC, says much of the ASC's success comes from a commitment by surgeons and staff to maintaining high patient satisfaction and excellent clinical outcomes and low infection rates.

Ambulatory Surgery Center of Spartanburg (Spartanburg, S.C.). The ASC of Spartanburg is a joint venture between Spartanburg Regional Medical Center and a group of 34 physicians and was opened in April 2002. The center's 52 surgeons do procedures in seven operating rooms and two endoscopy procedures rooms. The center has performed more than 10,000 procedures for the past six years, including 10,096 in 2011. The center's specialties are gastroenterology, ophthalmology, general surgery, orthopedics, ENT, podiatry, pain and gynecology.

Administrator Mike Pankey, RN, MBA, says block scheduling and leaving certain rooms open for last-minute cases have helped the center maintain its high volume. "We've been doing more than 10,000 procedures for awhile, so it's a normal routine for us at this point," he says. "As you're growing, block scheduling helps a lot and reviewing the block scheduling for utilization helps a lot." Mr. Pankey says that if a surgeon is not filling up their block, they will be moved out. He says this drives the surgeons to bring in more cases and compete to keep their preferred time slots.

Bend (Ore.) Surgery Center.
Bend Surgery Center opened in 1997 and moved to a new location in Oct. 2005. The center has been doing more than 10,000 cases a year for the past four years, including 10,388 last year. BSC is 100 percent physician-owned, with 38 owners and 60 users who specialize in orthopedics, general surgery, spine, ENT, ophthalmology, GI, pain management, plastics, pediatric dentistry, podiatry and oral maxillofacial surgery. BSC is Joint Commission accredited and a charter member of the Oregon Patient Safety Commission.

"We've continued to increase volumes over time and have been able to make changes to accommodate the increased volume," says administrator Neal Maerki. "We have a substantial per diem pool."

Berks Center for Digestive Health (Wyomissing, Pa.). This single-specialty GI center opened in Dec. 2001 and has done more than 10,000 cases a year since 2005. The center is a joint venture between 11 physician owners and Physicians Endoscopy. There are 13 gastroenterologists performing procedures in three procedure rooms.

Executive director John Gleason stresses creativity and adaptability as the key components to operating a successful ASC. Since the opening of the facility, hours have been extended to allow cases to end at a later time, schedules have been readjusted and turnover of procedures has been kept up in order to facilitate more procedures. "We are constantly considering ways to add additional procedures to the schedule so as to increase volume," says Mr. Gleason. "And our staff and doctors have been adaptable enough to change to meet the center needs for the schedule." He also says the facility is considering a move to a bigger facility to keep up with increasing case volume.

Birmingham (Ala.) Outpatient CareCenter. This center has been open since 1984 and performed more than 10,000 procedures in 2000, 2004 and every year since 2007. The center's 94 physicians performed 13,671 procedures in 2011. The center is managed by Surgical Care Affiliates and specializes in ophthalmology, pain management, orthopedics, ENT, gynecology, podiatry, urology, plastics and dermatology.

"Our dedicated team is a good mix of the best and brightest teammates with decades of experience in outpatient surgery as well as newcomers with fresh ideas and new perspectives on best demonstrated practices," says administrator Dennis Rowlen. "They, along with talented physicians committed to doing their part in maintaining the process, allow us to provide wonderful care to our patients in a highly efficient environment."

Centennial Surgery Center (Voorhees, N.J.).
The physician-owned Centennial Surgery Center was established in Sept. 1999 by a group of 16 physicians. The center now has more than 60 physicians, four operating rooms, two endoscopy rooms and two short procedure rooms and has done more than 10,000 procedures a year since 2004. The center specializes in orthopedics, general surgery, urology, gastroenterology, colon/rectal,
plastics, pain management and podiatry.

"We are an organization that is continually looking to find better and more efficient ways to provide the highest quality of care," says Steve Barainyak, MBA, CASC, executive director. "Sometimes we find that what we are currently doing is the best approach to providing the best service we can, but every once in a while we find something that helps us to tweak the system and make it even better. I think this more than anything else helps us to continue to operate smoothly with the volume of cases we perform."

Center for Ambulatory Surgery (West Seneca, N.Y.). Equipped with four surgery suites and five endoscopy suites, this 18,000-square-foot center does more than 15,000 procedures every year. The center is a 50-50 equity partnership between 16 physician-owners and The C/N Group, which provides management services, including all administrative functions of the facility. The AAAHC-accredited center specializes in orthopedics, gastroenterology, general surgery, ophthalmology, gynecology, podiatry, urology and reconstructive surgery.

Charlotte (N.C.) Surgery Center. This SCA-managed center opened in 1984 and has been performing more than 10,000 procedures since 2007. The center opened with just three operating rooms but has since expanded to include seven operating rooms and one procedures room that enable the center to incorporate pain management and orthopedics. The center currently has 95 physicians who specialize in foot and ankle surgery, gynecology, hand surgery, ophthalmology, orthopedic, ENT, pain management, plastic surgery, podiatry and gastric banding.

"We have a highly dedicated team that live our core values every day," says administrator Rick Brisson, RN. "Through a lot of hard work, initiative, motivation, creativity and teamwork among our physicians, teammates, anesthesia staff and support staff, we are able to optimize our schedule and capitalize on every opportunity to gain volume. No case gets left behind!"

Cincinnati Eye Institute Surgery Center (Cincinnati, Ohio). This AAAHC-accredited center opened in 1985 and features six ORs and three procedure rooms in a 17,000-square-foot surgery center. The center has performed more than 10,000 procedures since 2007. The center's 25 physicians specialize in cataract, retina, plastics, glaucoma, cornea, YAG laser and argon laser procedures. Cataract surgery makes up about 70 percent of the center's cases each year. Todd D. Albertz, director of surgical services, says training and educating staff has helped to maintain success at the Cincinnati Eye Institute. In regards to maintaining volume, he says using technology to strategize open block time has been essential.

Cypress Surgery Center (Wichita, Kan.). The AAAHC-accredited Cypress Surgery Center was founded by medical director David Grainger, MD; Michael Brown, MD; and Bruce Tjaden, DO, and opened in Nov. 2000. Since 2008, the center has done more than 10,000 procedures a year, including 11,350 last year alone. The center has more than 70 physicians on active staff who perform procedures in six ORs, three procedure rooms and two GI suites. The center specializes in orthopedics, gynecology, ENT, ophthalmology, gastroenterology, urology, oral and maxillofacial, general surgery, plastics and pain management.

Administrator Sandra Hartloff, who took over for veteran administrator Judy Graham late last year, attributes the center's success to the great staff. "It all has to do with the staff, and we have working managers that are directly involved," she says.

Dearborn (Mich.) Surgery Center. The Dearborn Surgery Center was established in June of 2005 and has been performing more than 10,000 procedures a year since 2006 — averaging 12,500 per year. The center's 94 practicing physicians specialize in endoscopy, orthopedic, general surgery, ENT, ophthalmology, gynecology, plastic, urology, vascular, podiatry and pain management.

"The efficiency that the DSC has is based upon the unified goal that the physician is a key customer," says Ricardo D. Borrego, MD, MSBA, medical director. "Turnover differentiates us from hospital-based services, and patient satisfaction keeps us motivated. To clarify this, our patients' satisfaction and safety are our core values but the difference is most facilities stop short of recognizing that the physicians' satisfaction is key to continued success. Our differentiation is always starting on time, maintaining consistent low turn over times and expediting the patients without any feeling of being rushed."

Eastside Endoscopy Center (Bellevue, Wash.). This AAAHC-accredited center has been performing more than 10,000 procedures a year for the past four years including 10,516 procedures in 2011. This single-specialty GI/endoscopy center has 10 practicing physicians that specialize in colonoscopy, upper endoscopy and flexible sigmoidoscopy. A new center in Issaquah is scheduled to open later this year. Michelle Steele, BSN, CGRN, nurse administrator, attributes the center's success to streamlined processes, skilled staff that are cross-trained, team work and the use of propofol and CO2 for insufflation.

Eastside Endoscopy Center (St. Clair Shores, Mich.). The Eastside Endoscopy Center opened in April 1996 and has been doing more than 10,000 procedures since 2008. The AAAHC-accredited center is a joint venture between eight physician owners and St. John Hospital and Medical Center in Detroit. Between two locations, the center collectively has six procedure rooms and 12 physicians performing procedures. Administrator Beth Miller, RN, CASC, says paying special attention to patient and referral physician satisfaction, being patient-oriented and offering cost-effective services have all facilitated the growth of the facility.

Fayetteville (N.C.) Surgery Center.
This multi-specialty center opened in 1982 and has been doing more than 10,000 procedures a year for more than a decade, including 12,719 last year. The center has expanded to include 11 operating rooms, three procedure rooms and an overnight recovery care center. The center's 105 physicians specialize in orthopedics, ophthalmology, ENT, gastroenterology, podiatry, gynecology, pain management, neurology, urology and plastic surgery. Administrator Teresa Craven attributes the center's success to the great staff and committed surgeons. The center is managed by SCA.

Fort Sutter Surgery Center (Sacramento, Calif.). This multi-specialty center has been doing more than 10,000 procedures for the past four years, including 10,823 last year. The center's 49 physicians and 30 anesthesiologists specialize in gastroenterology, gynecology, spine, ophthalmology, oral surgery, orthopedics, plastic, pain management, podiatry and urology. The center is managed by SCA.

"We have dedicated staff that know their jobs really well," administrator Dale Bowman says. "We like to say that we are a "well-oiled machine" that keeps everything moving. We are a values-driven organization, and the number one "value" is clinical quality. We want each patient to know that they are important and cared for. Teamwork is another "value" that plays a huge role in our success. Everyone must work together to focus on efficiency and productivity."

Gateway Surgery Center (Concord, N.C.). This multi-specialty center opened Jan. 1, 2006 and has been doing more than 10,000 cases a year for the past four years, including just under 11,000 last year. The center's 72 physicians specialize in ENT, orthopedics, gastroenterology, general surgery, pain management, urology, gynecology, ophthalmology, pediatric dental, plastic surgery and podiatry. Executive director Craig Bryan attributes the center's success to its motivated staff, efficient facility design and effective schedule management.

Greensboro (N.C.) Surgery Center. The Surgical Center of Greensboro opened in Dec. 1983 and has been doing more than 10,000 procedures since 2003, including 13,035 last year. The center's recovery care center opened in 1988 and provides overnight care to patients who need additional care following their procedures. The center's 94 physicians specialize in general surgery, gynecology, neurosurgery, ophthalmology, oral and maxillofacial surgery, ENT, otology and neurotology, pain management, cosmetic and reconstructive surgery, podiatry, urology and vascular surgery. The center is managed by SCA.

"By working together on staffing, supplies, equipment needs and patient flow we have created a model that pushes for continuous improvement and service excellence for the patients and physicians that we serve," says administrator Jennifer Graham, RNFA, CNOR. "Our teams are focused on clinical quality and take personal accountability for each patient that walks through our doors."

Kemp Surgery Center (Everett, Wash.). The Kemp Surgery Center was opened in Nov. 1997 by the Everett Clinic and has done more than 10,000 procedures a year since 2001, including more than 16,000 in 2011. The center's primary focus is on gastroenterology, though the facility also handles cases in ENT, orthopedics and urology. The center is owned by the 300-physician multi-specialty Everett clinic and is accredited by Medicare. Medical director Nick Marassi, MD, says the ASC focuses on providing great service to surgeons and physicians as well as patients. The center also offers state-of-the-art equipment for surgeons in the facility to utilize in order to maintain high quality care.

Kentucky Surgery Center (Lexington, Ky.) This AAAHC-accredited center opened in Dec. 1986 and has been doing more than 10,000 cases a year since 2007. This physician-owned facility is 28,000 square feet and has seven ORs and three procedure rooms. Started by a small group of surgeons and anesthesiologists, the center now has more than 100 surgeons on staff and specializes in orthopedics, ENT, gastroenterology, general surgery, plastics, podiatry, dentistry, pain management, urology, vascular, colorectal and pulmonary surgery.

Administrative director Glenda Beasley, RN, says maintaining high case volume has been possible because the staff and physicians provide quality patient care with excellent patient outcomes. "Raising the bar with expectations of only providing care that can be parallel to none is the goal of the center on a daily basis," she says. "Every team member must buy into the notion of bringing their top performance and positive attitude everyday to maintain success on every level."

Lakeland Surgical and Diagnostic Center (Lakeland, Fla.). The AAAHC-accredited Lakeland Surgical and Diagnostic Center opened in April 1996 as a joint venture by the Watson Clinic and the Lakeland Regional Medical Center. The center is owned by the two largest physician groups in the area and the largest regional medical center and runs six ORs in three locations. The center has been performing more than 10,000 procedures since 2001 and hit more than 20,000 in 2010. The center's specialties include endoscopy, pain management, eye, cosmetic surgery, reconstructive surgery, general surgery, eye, gynecology, orthopedics, urology, radiation oncology, podiatry and ENT.

Memorial Mission Surgery Center (Chattanooga, Tenn.). The Memorial Mission Surgery Center opened in 2003 and performed 11,000 total cases in 2011. The center, which opened in 2003, is owned primarily by GI and orthopedic physicians, as well as two general surgeons and one ENT. The center is owned 70 percent by physicians and 30 percent by the local health system.

Menomonee Falls (Wis.) Ambulatory Surgery Center. This AAAHC-accredited center opened in 1994 and is a joint venture between a community hospital and two large medical groups. This multi-specialty center has done more than 12,000 cases since 2002. The center's 45 active physicians do cases in gastroenterology, general surgery, orthopedics, pain, ENT, gynecology, podiatry, ophthalmology, urology and plastic surgery in five ORs, four minor procedures rooms and a laser room. Executive director Dianne Wallace, RN, BSM, BMA, says the center's plan for continued growth includes recruiting more physicians.

Michigan Endoscopy Center (Farmington Hills, Mich.). This AAAHC-accredited, single-specialty GI center opened in March 2003 as a joint venture between 16 physicians and Physicians Endoscopy and has been performing more than 16,000 procedures each year since 2006.The center's 19 physicians do procedures in three operating rooms and three procedure rooms.

Administrator Brien Fausone says MEC is a very busy surgery center, averaging 62 procedures a day and more than 80 on high-demand days. "We were a low cost/high volume provider with an outdated and cramped waiting room," he says. "In 2010, we made the decision to acquire an additional 3,000 square feet of adjacent space to build out a new waiting room and business office. The patient response — and more importantly, the physician referral response — has been overwhelmingly positive."

Midtown Endoscopy Center (Atlanta, Ga.). Midtown Endoscopy Center opened in 2001 under an affiliation with Atlanta Gastroenterology Associates and performs about 10,620 cases a year. The physician-owned center has 18 physicians, four ORs and is accredited by the AAAHC. Steven Morris, MD, managing partner, and Jana Baker, practice administrator with AGA, attribute the center's success to "skilled, experienced physicians and staff" and "attention to individual patient needs."

New York GI Center (Bronx, N.Y.). This single-specialty GI center opened in March 2007 and does 10,800 procedures a year. Since opening, the center has been accredited by the AAAHC, implemented electronic medical records and expanded to 18 gastroenterologists on staff. The current facility includes fives ORs, but an expansion planned for this year will add two additional ORs and enhanced facilities for staff and patients.

Northpoint Surgery and Laser Center (West Palm Beach, Fla.). This center opened in Sept. 1996 as a limited partnership with 13 physician owners an entered into a joint venture with National Surgical Care in 2003. The center has been doing more than 20,000 cases a year since 2006. The center houses five ORs, two endoscopy suites and a pain management center with its own waiting room, preoperative and postoperative room as well as a procedure room. This AAAHC- and AHCA-accredited facility now has 32 physician owners and 25 other physicians on staff who specialize in ENT, gastroenterology, gynecology, ophthalmology, retina, oral/maxillofacial, orthopedics, pain management and podiatry.

Northwest Michigan Surgery Center (Traverse City, Mich.). This AAAHC-accredited center open in April 2004 and currently does 18,000 cases a year. The center specializes in gastroenterology, ophthalmology, orthopedics, urology, plastic surgery, ENT and gynecology. The center recently renovated its patient waiting area adding 30 percent more space. The center also implemented Source Medical's Vision Electronic Health Record in the past year which has simplified documentation, decreased staffing requirements and provided access to quality assurance measures. Versus Technology is another tool to keep up with a large volume that the center will implement this March. The system allows staff to see how many patients are in the lobby, where and when they interacted with staff and where each patient is in terms of the visit progression. Jim Stilley, CEO, attributes the flexibility and commitment of our 80 physicians, 42 anesthesia providers and the 126 members of NMSC's staff to the success of the ASC's high case volume.

Physicians Endoscopy Center (Houston, Texas). This single-specialty center opened in Dec. 2002 and performs more than 13,000 cases every year. The center is a joint venture between HCA Ambulatory Surgery Division and several physicians who originally founded the center. Celebrating its 10th anniversary, the center currently has 18 physician owners and eight procedures rooms.

St. Cloud (Minn.) Surgery Center. This center has been in business for more than four decades and has performed more than 10,000 procedures a year since 1999. The center's 81 physicians specialize in oral surgery, ENT, general surgery, neurosurgery, gynecology, orthopedics, podiatry, urology and gastroenterology. The center is managed by SCA.

"We actually do our best in high volume times," says administrator Jeannette Stack. "[We have] dedicated, efficient and flexible teammates, positive attitudes, communication through monthly general staff and department meetings, use of preference cards in OR and PACU, high morale with little turnover of staff and a dedicated group of anesthesiologist that work as a team with our teammates."

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