When carving out space for an ambulatory surgery center from existing building, designers need to be aware of a variety of needs, both regulatory and practical, says John Marasco, president of Marasco & Associates in Denver, Colo. Here he cites eight issues. "This list is not all-inclusive but should give a basic idea of some of the requirements," he says.
1. Fire protection. The entire building must meet construction requirements of the National Fire Protection Association, indicated in NFPA 101, 20.1.6.3. "Basically this means a proper fire separation must be provided between the ASC and any adjacent suites on each side, above and below," Mr. Marasco says. Installing a fire sprinkler system as well will significantly decrease fire rating requirements. "A sprinkler system is essential to the layout and functionality of a successful ASC," Mr. Marasco says.
2. Provide proper exiting. Proper exiting from the ASC space includes at least one exit directly from the ASC space through a 4 foot-wide door to the communicating corridor. If an elevator is used for access, it must measure at least 5 feet clear in each direction to comply with the Americans with Disabilities Act.
3. Allow for weather protection. An outside canopy or other protection against inclement weather should be provided at the patient pick-up area. It is also highly recommended to provide a canopy for patient drop-off as well, Mr. Marasco says.
4. Install pad for emergency generator. ASCs require use of an emergency generator, which means providing a pad location on the site for the generator. "Locate this pad as close as possible to the main transfer switches in the electrical room, because the wiring from the generator to the transfer switches is costly," Mr. Marasco says.
5. Maintain 13 feet between floors. The floor-to-floor span between the finish floor of the suite to the structural bearing point of the floor above should be at least 13 feet. "Anything less than that makes it difficult to coordinate ductwork, electrical and other components that have to be located in the plenum space," Mr. Marasco says. "This could add significant cost to the project."
6. Put in more exterior doors. It is highly beneficial, though not required, to have several other doors from the exterior of the facility providing access to spaces such as the gases room, mechanical room, electrical room, soiled holding room.
7. Provide a loading area. Building a loading area on the site for deliveries is highly beneficial though again, not required. Put in an exterior door near the loading area to gain access for deliveries into the receiving room.
8. Higher-grade HVAC needed. Requirements for the heating, ventilation and air conditioning unit is more stringent for most ASCs than for a medical office building. A surgery center needs specific ranges for temperature, humidity, air changes and double filtration, for example. HVAC units can be located either on the roof or on the site. If the unit is on the roof, you'll be required to install mechanical chases for ductwork through the upper floors.
Learn more about Marasco & Associates.
Read more about ASC development:
- 6 Questions to Ask When Adding a New Specialty to a Surgery Center
- 5 Ways a Surgery Center's Location Impacts its Business
- Developing a Spine Center: 3 Reasons Why Now is the Time