Lessons from an Outpatient Surgery Center

This technical note briefly reviews the problems that our firm, Johnson Engineering Associates (JEA), encountered with both design development and procurement procedures in the development of a small ambulatory surgical center associated with an existing orthopedic clinic in Laramie, Wyo. The project experienced hundreds of changes, some minor, and others of major scope. We were able to maintain successful control of the contract and construction, and delivered a completed facility within the contract period. Once the facility was occupied, we experienced heating, ventilation, and air-conditioning (HVAC) commissioning problems, complicated by the immediate and regular usage of the facility for surgical procedures. The levels of on-site support required of our firm, both during construction and for over a year after the owner occupied the facility, far exceeded the normal levels associated with commercial construction, or our expectations. Lessons learned by our firm and the owner are reviewed, with suggestions that may assist in the future in the design of similar facilities.