WATERBURY, CONN. - For many years, surgeons performed in- and outpatient cases in the same ORs at Waterbury Hospital. As the outpatient case load increased to about 65 percent of total volume, however, this co-mingling of cases became increasingly problematic.

Wait times for outpatients became too long, and sometimes, we bumped or delayed outpatient cases for more urgent procedures. At first, we considered renovating our 'vintage' OR suite, but we quickly realized that the downtime during construction would cost us cases and market share. Ultimately, we constructed a new outpatient surgery center attached to the hospital. The facility's proximity to the hospital enables us to perform some high-acuity cases and use the hospital's radiology service. About 3.5 years from inception, the $9.9-million, seven-OR Reed ASC opened. We now do about 16 cases a day but project up to 35 once the transition is complete. Here are some of the important things we learned during the past four years: