POTSDAM, NY - Like many older, hospital surgical suites, ours is inefficient and crowded. We literally squeeze our outpatients into small registration and preop areas, and our four 38-year-old, 300-plus-square-foot ORs are much too small to efficiently house arthroscopic and laparoscopic equipment, C-arms and the other supplies we need to perform today's outpatient procedures. But realizing the need for bigger and better ORs was the easy part; the challenge came when we had to create a blueprint that was agreeable to everyone involved. With time, we found the answer in three guiding principles: Build consensus, promote ownership and design for flexibility.

Build consensus
We recently broke ground on an addition that, when complete, will essentially double the width of our surgical suite and allow us to function as an ambulatory surgery center rather than a converted inpatient unit. Before we did, however, we worked for nearly two years on the design. By far, our greatest challenge was gaining consensus on the plan. Even two surgeons in the same discipline had vastly different ideas about what they wanted, not to mention the fact that administrative concerns and cost and architectural constraints also factored into the equation.