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Building a Better Kind of Care

Rosanna Turner

For some people having surgery in a place other than a hospitalmight sound like a strange idea. But that's the intention behindAmbulatory Surgery Centers. Owned by the Vail Valley Medical Centerand local surgeons Vail Valley Surgery Center is an AmbulatorySurgery Center (ASC) which opened in Vail in 2002. VVMC recentlybuilt a second ASC facility at their Edward's campus which openedon June 11th.
Cutting costs and increasing efficiency
An ASC is designed for outpatient surgeries and procedures. In themedical world 'outpatient' means a surgery visit that takes 23hours or less from pre-operation to recovery. ASCs are becomingmore popular for a number of reasons. Due to lower overhead ASCstend to save money for both the patient and insurance companies.ASCs are designed to reduce hospital stays which could alsocontribute to cost savings.

Doris Kirchner president and CEO of the Vail Valley MedicalCenter said that twenty years ago a patient having surgery ontheir ACL (anterior cruciate ligament) would typically stay in thehospital for three days. Now someone having ACL surgery may go homeon the same day. By focusing on outpatient surgeries ASCs aredesigned to streamline medical operations and make things moreefficient.

Dan Feeney senior project engineer and VVSC Edwards projectmanager said the space was designed with efficiency in mind. "Ourgoal is to control health care costs and we want the clinical staffto be as efficient on a day-to-day basis as it can possiblybe."

In opening the Edwards' ASC Vail Valley Surgery Center is lookingto reduce costs without decreasing patient satisfaction or surgeryoutcomes.

"Outpatient surgery is on the rise" said Laura Millardadministrator of the Vail Valley Surgery Centers. "It contributesto cost savings increased efficiency patient satisfaction andphysician satisfaction. (It's) definitely a trend that'sgrowing."
Time to expand
When the first ASC opened ten years ago VVMC knew they wouldeventually expand. Once the Vail facility reached full capacity itmade sense from a business and financial standpoint to open asecond surgery center said Dr. William Sterett VVSC medicaldirector and orthopedic surgeon.

The Edwards building provides more space and gives patients wholive west of Vail the option of having their surgery closer tohome. The new facility is state-of-the-art and equipped with thelatest technology. Instead of curtains between beds in the pre-oparea there are glass doors that separate patients from oneanother providing a more personal atmosphere for patients doctorsand staff.

"We really focused on patient privacy when we built thisfacility" Millard said.

While not every patient is the right candidate for having theiroperation at an ASC Dr. Sterett said a significant number of hissurgeries could now be done in Edwards. At the Vail ASC orthopedicsurgeries are the most common procedure. VVSC will move theirgastrointestinal procedures exclusively to the Edwards building.Other common ASC operations include pain management podiatryophthalmology urology general surgery and ear nose and throatsurgeries. Breast cancer patients at the Shaw Regional CancerCenter will now be able to have their surgeries next door at VailValley Surgery Center Edwards. 
'Health care without walls'
Dr. Sterett said statistically patients who have their operationat an ASC have the same surgical success rates as those who havetheir surgery at a hospital. However he thinks ASCs give doctorsand medical staff a chance to enhance the patient's overallexperience.
"Most patients who have surgery have one surgery their wholelife" Dr. Sterett said. "If they can come away from that and say'That was a great experience' that's the goal."

ASCs align with many patients' desire to spend as little time atthe hospital as possible.

"Patients want to get in get out get home and get on with(their) life...and still have a great outcome" Dr. Sterettsaid.

With the Supreme Court decision on the Affordable Care Actannounced recently debates about health care reform are not likelyto stop anytime soon. While there is no specific mention of ASCs inthe new law Kirchner said surgery centers offer alternatives forsurgical care.

"As we move to health care without walls hospitals as we knowthem today are historically going to be less and less the center ofcare" Kirchner said. "Surgery centers are one answer to that. Ibelieve that (ASCs) will help us decrease health care costs ingeneral."

Both Vail Valley Surgery Centers in Vail and Edwards reflect achange in the way we practice health care and hopefully for thebetter.

"There will be a stronger push for procedures done in anoutpatient setting instead of an inpatient setting" Dr. Sterettsaid. "ASCs are going to become a common way of life...Five yearsfrom now everybody will know what an Ambulatory Surgery Centeris."