She did just that with the renamed Spivey Station Surgery Center, which opened in April 2009 at its new location in Jonesboro, Ga. The 25,000-square-foot facility houses three operating rooms and four pain management rooms, which allows the staff at Spivey Station to perform more than 5,000 cases annually with the capacity to perform 15,000. The new center offers state-of-the-art technology and amenities that go beyond the everyday surgery center including a telesurgery room, updated electronic medical record system, patient gowns that warm themselves, a complimentary business center for waiting family members, interactive games for kids and an in-house prescription dispenser.
Ms. Mena was able build Spivey Station Surgery Center with a $3 million budget for new equipment expenditures. This was achieved, under-budget, through having a strong vision of what purpose the equipment would serve, working closely with vendors and looking to the future.
To build, or not to build
The former Surgery Center at Mt. Zion had to consider whether or not to invest the $1.5 million in physical plant improvements or to build at a new location. Complicating the decisions was that the owners of the ASC, a joint venture between physicians and Southern Regional Medical Center, didn’t own the building the center was in.
The layout and location of the building provided another consideration. According to Ms. Mena, the former location was “land-locked.” “There was no ability to expand our space,” she says. Serious patient flow problems could not be solved by simple renovation, and the center was unable to expand the parking lot to better serve their patients, who were having difficulty finding parking spots.
The Surgery Center at Mt. Zion decided to invest in the center on more than just the clinical level. Southern Regional purchased 90 acres of land 2.5 miles away from Mt. Zion’s location. This $11 million investment gave the center the opportunity to create a joint-ventured real estate company.
“Essentially, our investors have the opportunity to make money on both the operational side and the real estate end,” Ms. Mena says.
Currently, the investors have a 7-year tax shelter, which has provided a “nice return on investment,” according to Ms. Mena.
“Operationally, our center is doing well,” she says. “We’ve had a good return so far and were able to retire our old debt.” Because of this, Spivey Station was able to secure a new lien of credit, providing them with a $3 million budget to buy new technology and equipment for the center.
Market considerations
The next step in developing Spivey Station was deciding what equipment and amenities should be included in the new location, so Ms. Mena examined the current market in healthcare.
“Deductibles are going up for patients,” she says. “As a result, patients are spending their own money, and for healthcare, this means patients are becoming savvy, selective consumers.”
Ms. Mena also notes that the future of healthcare will be a “more educated, consumerized market,” with patients, rather than physicians, becoming the primary decision makers when it comes to choosing where they will seek healthcare services.
For these reasons, Ms. Mena wanted Spivey Station to offer more features centered around customer service and consumer quality. She kept this in mind when selecting new equipment for the center and took the opportunity to carefully evaluate the products she was going to use.
Ms. Mena required that the new equipment would fall into three categories — it must offer cost savings, must resolve a patient safety issue or must be a revenue generator.
“We searched for items we felt could deliver in one or all categories,” she said.
Equipment considerations: Cost savings
Going paperless offered Ms. Mena the chance to employ some new technology at the ASC as well as reducing some of her supply costs.
The Spivey Station center uses an updated version of the electronic health records program used at the Mt. Zion location. It has also allowed Ms. Mena to set up a completely paperless IT infrastructure at the center, reducing office supply costs such as printer ink and paper.
“We were able to reduce [our staff] by one full-time equivalent employee by going paperless,” she says. The new EHR program has also allowed the center to reduce the number of hours worked by the staff, hours that were originally allocated for filling and collating paperwork.
Ms. Mena reports that her staff was about to cut down the paper costs from $10 per patient to $4.40, a savings that translates to an additional $100,000 in net income for the center.
Other cost-saving technology Ms. Mena added to the center includes Voice Over Internet Protocol phones that eliminated a traditional phone bill, a high-efficiency sterilizer that uses less water and other changes that cut down on utility costs and made the center environmentally friendly.
“Our lights are on a computer. The center literally shuts itself off at night,” she says.
Ms. Mena cut down on the linen costs at the center by investing in self-warming patient gowns, Arizant’s Bair Paws System. “We were spending a tremendous amount of money trying to keep our patients warm,” she says. “We’d use nine blankets for each patient before he or she would leave the center.”
With the new patient gowns, a heating unit plugs into a single-use patient gown. Patients are able to control the heat on the unit, a feature Ms. Mena says that they love. “When you come to a center, control is immediately taken away, which creates anxiety,” she says. “Patients want that remote. It gives them control, allows them to focus and reduces anxiety. Plus, it gives the patients the impression that we really thought about their experiences at the center.”
In addition to higher patient satisfaction, the self-warming gowns allowed Spivey Station to cut down to one sheet per patient, which significantly saves on their laundry costs. “Medical laundry charges by weight,” she says. “Sheets are much lighter compared to blankets.”
Angela Kidd, principal, director of operations and medical equipment planner for Strategic Hospital Resources, worked with Ms. Mena in acquiring the new equipment for Spivey Station. She notes that the self-warming patient gowns provided another benefit in cost savings when the vendor provided the plug-in remote control units for free.
“Oftentimes, a vendor will ‘loan’ the equipment to a center if you buy their consumables, like the patient gowns,” Ms. Kidd notes. Ms. Kidd, whose company helps surgery centers and hospitals acquire new equipment, says that this type of arrangement is one to consider when working to keep equipment costs reasonable.
Equipment considerations: Patient safety
One patient safety area Ms. Mena was able to address with new equipment was medication management.
Like most centers, Mt. Zion was keeping track of its drug supply manually. Based on the volume of patients and medications the center kept on hand, Ms. Mena had concerns over a possible pharmaceutical error.
As a result, the new location has an automated medication management system that keeps track of inventory and what medications are distributed. The center is also able to compile data along with other standards to maintain a close watch on their medications.
Obtaining this piece of equipment was not as easy. The machine Ms. Mena wanted was only available for hospitals, and she was not able to find a similar product at a surgery center price.
“Anyone can build the Taj Mahal,” she says, “but can you do it at an affordable price point?”
The solution was to work with the vendor to introduce them to the surgery center market to see if they could work out an affordable price.
Ms. Kidd says that part of her role was to gather this information to help Spivey Station to negotiate these price points. “We often ask our clients what their vision is five years out and what they want to accomplish,” she says. “Ms. Mena wanted to create Spivey as a site for new technology. We assisted by gathering information on this cutting-edge technology by going to the vendors and providing an overall package for the equipment.”
Equipment considerations: Revenue maker
While looking at new equipment for her center, Ms. Mena was able to find a few items that not only improved patient care but opened up new revenue opportunities for Spivey Station.
One such item was an in-house automated prescription dispensing machine. This allows patients to fill their prescriptions at the center rather than make a separate trip to a pharmacy on their way home from surgery. Additionally, the center is able to capture the revenue from the charge on the prescriptions.
Similar to the self-warming gowns, Ms. Kidd says that the center leases the equipment through the vendor and can buy medications through the vendor’s pharmaceutical companies. The secure machine reads the prescription and dispenses medication.
“It’s a neat concept,” Ms. Kidd says. “Using the EHR, the patient’s insurance information is entered in the machine, and customers can pay with a credit card.” She notes that this technology is not available in all states.
Another potential revenue maker for Spivey Station lies in their innovative operating rooms and state-of-the-art conference room. Ms. Mena, who also oversees the level two trauma center at Southern Regional, saw an opportunity to once again bring technology she saw in the hospital to the surgery center.
Southern Regional’s trauma center uses integrated operating rooms, which allow a surgeon to control monitors, surgical devices and lights all from one location. Ms. Mena was interested in using this item at the center. “However, these types of rooms are cost-prohibitive for surgery centers, and few companies are looking to the ASC market,” she says. Then, she found rooms manufactured by Stryker. Ms. Mena again went to the vendor and found IORs designed for surgery centers at a reasonable price point.
“By working with the vendor, we were able to find an operating room that delivered something applicable to our market and is very intuitive,” Ms. Mena says. She also notes that Spivey Station was able to build three Stryker operating rooms for the cost of one room at the hospital.
Ms. Kidd says that this kind of IOR was affordable and can enable the surgery center to reduce turnaround times with the procedures they perform. “Everything is set up right there [in the OR],” she says. “It’s a one-stop station.”
One of the operating rooms is designed with telesurgery capabilities. Various monitors and cameras inside the operating room and around the center can broadcast live surgeries to be used as an educational tool for physicians, staff and visitors to the center.
“We are looking into doing more with telesurgery as we move ahead,” Ms. Mena says.
Other features of Ms. Mena’s design for Spivey Station also open up opportunities for education at the center. The conference room, which seats 12, includes a “K.I. Genius” wall. The wall is removable and sound proof with reconfigurable surfaces including a dry-erase board and an electronic smartboard for presentations. The conference room can be opened up into the waiting room for seminars for up to 100 people.
The conference room also includes an audio/video system for presentations that can be broadcast over the television in the waiting rooms.
Ms. Kidd recently sat in on Spivey’s first telesurgery, which was broadcast in the conference room. “We were able to control the cameras from the white board and could see the surgery from many different angles,” she says.
The total cost of the conference room — including furniture, A/V system, Genius wall and other equipment — was around $40,000. “I wanted to build this at a price point any surgery center could afford,” she says. “This way it can be repeated.”
Spivey Station already has five seminars scheduled in the next year, Ms. Mena says. Additionally, the center plans on using the conference room for community outreach. “As surgery centers, because we are for-profit, we aren’t often viewed as assets in the community. That myth needs to be dispelled,” she says. Providing educational opportunities at the center is one way Ms. Mena feels this can be accomplished.
Becoming the future of healthcare
In order to address a more consumer-driven healthcare market, Ms. Mena designed Spivey Station as an inviting center for patients and their families. The waiting room includes a Wii gaming system, a private Internet café, and a copier and fax machine. A kitchen area is also available for families.
“We wanted to create a private place for families,” Ms. Mena says. “We wanted to provide a lot of activities so that family members aren’t stuck in a room, looking at a TV, reading three-year old magazines.”
In the short time Spivey Station has been open, Ms. Mena and the ASC’s staff members have made an effort to bring the community into the center. Through public and private events, 800 people have visited the new location.
“People are blown away,” Ms. Mena says. “They can’t believe that this place exists in their community.”
Ms. Mena has enjoyed watching others walk through the center. “We had a group of senior citizens come through from an assisted living facility nearby,” she says. “I was amazed at how quickly they got the concept of the new center.”
Ms. Kidd, who lives near the ASC, says that part of her enjoyment in working on the project was knowing that this facility was available so close to home. “If I had to have surgery, I would go there in a heartbeat,” she says.
The biggest reward of the new ASC for Ms. Mena has been watching the expressions of visitors and the staff as they interact with the new center.
“The employees have been amazing in how quickly they’ve latched on to the new technology,” Ms. Mena says. “We saw our first patent two months ahead of schedule.”
The community has also quickly spread the word about the new center and has been enthusiastic about it. “I feel like we’ve built something that doesn’t exist anywhere else,” Ms. Mena says.
Learn more about Spivey Station Surgery Center.
