Outpatient medical facilities, such as ambulatory surgical care and clinical centers, have been gaining in popularity over the last decade. The number of ambulatory surgery centers alone has grown 47 percent since 1996, from 2,425 to 3,570, according to Verispan Outpatient Surgery Center Profiling Solution in Newtown, PA. This trend is expected to continue as physicians seek opportunities to further improve access to their everyday operations by making personal investments in developing their own facilities.

One such example is the Virginia Eye Institute in Richmond, VA, which is the state’s first free-standing medical and surgical ophthalmic practice. Over the last two years, DPR has completed two projects for the expanding physician-owned institution: a new ground-up, 14,000-sq.-ft. ambulatory surgery center—the area’s first full-service facility dedicated exclusively to ophthalmic surgery—and a complex 4,500-sq.-ft. renovation to its existing facility, including a new airlock entrance to the front of the building, a Check-in/Registration area, Photography expansion, new Pediatrics and Retinal Exam area and expansion of the facility’s Optical Shop.”

Following the completion of the new surgery center, the Virginia Eye Institute asked us to work with them again on a second project,” said Lisa Lingerfelt of DPR, who added that although the nearly four-month renovation was not necessarily large in scope, it was “tricky with numerous challenges.”

The biggest challenge? According to Lingerfelt, the facility needed to remain fully operational during all stages of the renovation, and there was only one main entrance available that had to be shared by construction crews and facility patients, visitors and staff.

“Hundreds of patients flow through the building everyday, and a majority of them are elderly,” said Lingerfelt. “We maintained 100 percent traffic flow throughout the duration of the project, and it was impressive to watch the entire team, including subcontractors, who took time to help patients by holding open doors and showing elderly individuals into the building.”

Other challenges arose from unforeseen conditions that were not uncovered until after construction began. For example, an existing set of double doors was set to be demolished. However, shortly before the demo was scheduled, the team discovered that the beam above the double doors could not support the weight of the structure and that the doors themselves were actually providing the support. “We quickly installed a structural clip to hold up the structure before taking out the doors,” said Lingerfelt.

DPR also took a multi-phased, “over-lapping” approach to the project, working on the new airlock front entrance and Pediatrics and Retinal area, while simultaneously staging the other phases. For example, the waiting area of Pediatrics and Retinal was used as the primary staging space, so Check-in/Registration temporarily moved to the staging area when DPR began setting up partitions and renovating that portion of the project. Once Check-in was complete, Photography was relocated to the staging area during its turn. This approach allowed the team to turn over the Pediatrics and Retinal ahead of schedule so that doctors could begin seeing patients as early as the first week of September, nearly four weeks prior to final completion.

“It’s often the smaller jobs—with tighter schedules, lack of accurate as-built drawings and working in occupied spaces—that present the biggest challenges,” said Lingerfelt. “At the end of the project, the owner personally thanked each member of the DPR team—amazed that we not only pulled it off but did it with such success. There were very few complaints from the staff and almost none from the patients, and in the end, we were under budget enough to give some money back to the customer.”