ambulatory surgery by

8/16/2019 ambulatory surgery by

http://slidepdf.com/reader/full/ambulatory-surgery-by 1/25

lc

Ambulatory

Surgery

Graphic Standards

Programming and Schematic Design

June 1999



Ambulatory Surgery

Ambulatory Surgery 2

Table of Contents

Table of Contents

Function 3

Staff 4

Advantages of Movable Modular Casework 5

Functional Areas 6

Waiting, Reception, Admitting,

and Business Office 6

Pre-Operative Holding 7Scrub Area 8

Operating Room 8

Post-Anesthesia Care Unit

(PACU/Recovery Room) 9

Equipment Storage 10

Sterile Storage 11

Preparation and Packaging 12

Decontamination 13

Anesthesia Workroom 14

Satellite Lab 15

Satellite Pharmacy 16Staff Conference/Locker Room 17

Supervisor or Physician Office 18

Functional Program 19

Bubble Diagram 20

Block Diagram 21

Preliminary Plan 22

Schematic Plan 23

Future Trends 24



Ambulatory Surgery


Function

Flow of Patients

The patient enters the ambulatory surgery

unit, reporting to admitting for data

collection and the development of amedical record. The patient will move to

a dressing room or cubicle for changing

into hospital attire and then to a pre-

operative holding area for medication

and intravenous fluid administration.

If the unit contains laboratory and/or

diagnostic radiology services, these may

be performed at this time.

The patient is then moved to theoperating room, anesthesia administered,

and the surgical procedure performed.

Following surgery, the patient is moved

to the post-anesthesia care unit,

remaining there until ready to dress and

be discharged.

Function

The ambulatory surgery unit is

responsible for the surgical procedures,

or operations, performed on patients who

can be admitted, treated, and dischargedin the same day. Many types and kinds of

surgical procedures do not require

overnight hospitalization of the patient,

and these are carried out on an outpatient

basis. The primary benefit derived from

this unit is the reduction of costs to both

the patient and the hospital.

The ambulatory surgery unit may be

positioned as

· A completely freestanding or off-site

unit.

· A department within the hospital but

separated from the surgery

department.

· A suite of rooms, or shared rooms,

within the surgery department.

Because surgical procedures are

performed under the strictest sterile

techniques and infection control

practices, the design of the unit and the

flow of the patients, staff, and supplies

must be rigidly controlled.

Traffic Zones

The layout of the ambulatory surgery unit

is a similar but simplified version of the

surgery department, with additional areasfor administrative, family, and

ambulatory patient needs.

The ambulatory surgery unit includes not

only operating rooms, but pre- and post-

anesthesia areas, dressing rooms,

technical support and supply areas, and

business office and administrative staff

spaces.

The basic zones of traffic flow willconsistently include the following:

Unrestricted Areas

The unrestricted area is a public space,

such as the business offices and waiting

rooms, for visitors, families, and

administrative staff attired in street

clothing.

Semi-Restricted Areas

These areas, such as pre-operativeholding, require staff to be attired in

surgical garments including scrub suits or

dresses and hair covers.

Restricted Areas

The most restricted areas of the unit are

the operating rooms, requiring staff to be

attired in surgical garments and face

masks.



Ambulatory Surgery


Staff

Staff

Ambulatory surgery units typically have two lines of authority – physicians and nurses

– and a support staff.

Nursing Staff

Ambulatory Surgery Supervisor

The supervisor or director of ambulatory

surgery (usually an RN) will be in charge

of nursing procedures and practices and

also will be responsible for the business

aspects of the unit, such as budgets,

staffing, etc. This person generally has

had additional operating room

experience as well as advanced education

in nursing or management.

Circulating Nurse

This is a registered nurse (RN) working

within the operating room who

coordinates activity in the room for a

particular surgical procedure by opening

and furnishing supplies to the scrub nurse

from outside the sterile field, applying

dressings, etc. This position also assists

in the delivery of patient care such as

positioning the patient, skin preparation,

and assisting in anesthesia as necessary.

Scrub Nurse/Instrument Nurse

This registered nurse (RN) or surgical

technician maintains the sterile operating

field and organizes and passes sterile

instruments to the operating surgeon.

Physician Staff

Chief of Ambulatory Surgery

The chief of ambulatory surgery (an MD

or DO) will oversee the physicians and

the surgical procedures, as well as

medical recommendations for the unit.

Chief of Anesthesiology

The chief of anesthesiology (an MD or

DO) will supervise other anesthesiolo-

gists, nurse anesthetists, and anesthesia

technicians working in the unit. Thisposition is responsible for policies and

procedures regarding administration of

anesthesia.

Support Staff

Business Office Manager

The responsibilities of this position

include the management of patient data

gathering, maintenance of medical

records, and collection of medical

insurance payments and/or reimburse-

ments.

Support Staff

Other administrative and medical staff

will vary based on the size of the unit andmay include a unit secretary, receptionist

insurance clerks, admission clerks, and

vocational nurses.



Ambulatory Surgery


Advantages of Movable Modular Casework

Advantages of Movable Modular Casework

Ambulatory surgery units may vary widely in type of unit, square footage, method of

operation, and staffing, but each ambulatory surgery unit has certain functional areas in

common. The following pages describe the advantages of movable modular casework,

give a brief description of the functional areas of ambulatory surgery, and providetypical plan views of movable modular casework applications.

Materials Handling Components

Movable modular materials handling

components can be especially useful in

the operating room for supporting

effective and efficient delivery, storage,

use, and removal of supplies.

Specialized supplies can easily be

transported on demand from a centrallocation. Each component can become

mobile by combining it with a wheeled

component, quickly and easily making

the change from storage to mobile.

Specific components appropriate for use

in the ambulatory surgery unit include

· L carts.

· Crash carts.

· Lockers.

· Supply carts.

· Case carts.

· Process tables.

· Extra-deep modular shelving units.

Modular Furniture Systems

· Panel systems for administrative

areas offer the use of less space, the

flexibility to make changes easily,and increased worker productivity.

· The system provides cantilevered

work surfaces and efficiently

arranged workstations.

Movable Modular Casework

Movable modular casework offers the

following major advantages and

differences when compared with fixed

casework or millwork:

· All movable modular casework

components can be easily rearranged

or reused by the end user, allowingongoing changes with new

technology.

· Movable modular casework

components have been specifically

designed to meet the functional

requirements of ambulatory surgery

units.

· Components are sanitizable, and

every configuration can be

disassembled to easily clean parts.· Movable modular components can

quickly and easily be relocated to the

opposite wall in an operating room

when a specific procedure requires

that the operating table be turned

around.

· Additional components can be added

at any time.

Financial Advantages

The initial cost of movable modular

casework is competitive with fixed

casework or millwork. However, the life

cycle cost of movable modular casework

is far less than fixed casework because of

· Longer product life.

· Minimal maintenance cost.

· Continual reuse of the components

for new or different functions.

· Ability to install and reconfigure with

little downtime.

· Accelerated depreciation rate,

especially important to “for-profit”

organizations.

For preliminary budget purposes,

movable modular casework for anambulatory surgery unit has an average

price in the range of $276 to $414 per

linear foot.

This range will be affected by the density

of overhead and undercounter storage

components and the type of support

structure used (wall-mounted versus

panels).



Ambulatory Surgery


Waiting, Reception, Admitting, Business Office

Functional Areas

Waiting, Reception, Admitting,

and Business Office

A waiting area should be provided for

patients and families or companionsawaiting admission. The receptionist will

greet patients and originate the

paperwork.

Patients will then proceed to an admitting

interview area. “Admitting booths,”

which may vary from open-counter type

stations to closed cubicles, should allow

for acoustical privacy.

The business office staff is responsible

for the retrieval of the necessary

administrative, pre-diagnosis, and

financial information from the patient or

the patient’s family. This staff also will

handle accounts payable and receivable,

record keeping for reimbursing agencies

such as Medicare and other health

insurance companies, charges and

billings to patients, credits, collections,

and other facility operation expenses.

Work areas in the business office should

include file or chart storage, computer

stations, and general work areas.

Movable Modular Casework and Furniture Systems Applications

Movable modular casework and modular furniture systems components allow forfuture flexibility and change and may include

Plan View of a Waiting, Reception,

Admitting, and Business Office

Waiting and reception areas will range in

size from 20 to 35 square feet per seat.

Admitting and business office areas will

range in size from 85 to 110 square feet

per employee.

· Frame and/or panel system with

ability to change and reconfigure for

different functions.

· Integral computer support

components, such as keyboard trays,

turntables, etc.

· Integrated form trays and chart

shelves.

· Task lighting where needed.

· Overhead shelves for manuals and

reference materials.

· Above work surface counter or

transactional work surface.

· Cantilevered work surfaces.

· Lateral filing components.

· Unlimited electrical capabilities.· Comfortable, durable waiting room

seating.

53 linear feet work surface

64 linear feet overhead storage

800 filing inches

1500 square feet



Ambulatory Surgery


Pre-Operative Holding

Patients arriving for surgical procedures

are held in this area until the appropriate

operating room is ready.

Patients will change into hospital attire in

dressing cubicles before entering the pre-

operative holding area. An area should

be available to store patients’ clothing

and personal belongings.

This area also may be called pre-

anesthesia as patients may be given

medications or intravenous fluids under

close observation of the nursing staff.

A nurses control station and medication

preparation area are often an integral part

of this area.

Movable Modular Casework Applications

A pre-operative holding area can be

planned using movable modular

casework and may include

· Small workstation.

· Locker to hold patient care supplies.

· L cart, procedure/supply cart, or rail-

hung C frame storage unit placed

near each stretcher.

· Procedure/supply carts.


· Sink unit.

· Med prep area.

Pre-Operative Holding

Plan View of a Pre-Operative Holding Area

A pre-operative holding area will range in

size from 350 to 800 square feet.



40 filing inches1 locker for medications

1 locker for IVs

2 lockers for supplies

1 C frame storage unit per bed

504 square feet



Ambulatory Surgery


Scrub Area, Operating Room

Scrub Area

Scrub areas are placed strategically

outside operating rooms. Surgical scrub

sinks are generally ceramic or stainless

steel with foot or knee controls. It ishelpful to place shelves above the sink to

hold scrub brushes and masks.

Operating Room

An operating room is the area where

surgical procedures are performed under

strict sterile techniques.

For sanitization purposes, operating

rooms should contain little or no built-in

casework. Supplies and equipment are

moved in and out as needed. Rather than

using wall strips, horizontally mounted

rail with rail-hung components are

appropriate for hanging work surfaces

for documenting/charting. Rail-hung

shelves or CST units are suitable for

overhead storage.


An operating room can be planned using movable modular casework and may include


Depending on the design of the scrub area,

scrub brushes and masks can be housed in

modular shelving hung on rail, on wallstrips above the sinks, or in rail-hung

C frame storage units with drawers beside

the sinks.

L carts or procedure/supply carts used for

· Anesthesia supplies and equipment.

· Suction and cautery equipment.

· Monitoring equipment.

· Prep and dressing.

Stainless steel case carts which can also be

used as a back table.

Lockers used for

· General supply storage.

· Backup supplies.

· Specialty procedure carts.

Process tables used as

· Administrative/computer workstation

· Back table for instruments.

Plan View of an Operating Room

An operating room will range in size from

300 to 450 square feet.


4 linear feet overhead storage3 lockers for supplies

1 L cart

1 anesthesia cart

case carts as required

336 square feet

Plan View of a Scrub Area

8 linear feet overhead storage (2 feet per sink)

50 square feet



Ambulatory Surgery



(PACU/Recovery Room)

This area is adjacent to the operating

room. Patients are brought to this area

after surgery to recover from anesthesia

and regain stable vital signs. After the

patients are stable, they are moved to

secondary recovery before being

discharged.

The space is usually in an open area with

patients separated with cubicle curtains.

Those patients who need to be isolated

are kept in a separate isolation recovery

room. The isolation room also can be

used for pediatric patients.

The layout of this space usually includes

a nurses control station with a medication

preparation area, a physicians’ dictation

area, an area for supplies and equipment,

hand-washing sinks, and a patient toilet.


Movable modular casework components appropriate for use in the post-anesthesia

care unit include

Plan View of a Post-Anesthesia Care Unit

A post-anesthesia care unit will range in




80 filing inches


1 locker for medications

1 L cart for supplies1 L cart for isolation cart

1 emergency cart

1 C frame storage unit per bed

dictation area

2126 square feet


· Nurses control station.

· L carts or rail-hung C frame storage

units with drawers for supplies for

each patient.

· Lockers for linen and medical

supplies.

· Cantilevered sink units.

· Dictation area.



Ambulatory Surgery


Equipment Storage

Equipment Storage

There is a large amount of equipment

that needs to be stored for use in the

operating rooms. A single large room for

general equipment storage and/orspecific smaller rooms for specialty

equipment storage, such as orthopedic,

can be planned.

In addition to needing floor space for

housing large equipment, overhead

shelving can be used so equipment can

be placed underneath for maximum use

of space.

Much of this equipment must be

accessible to electrical outlets to

maintain battery charges.


An equipment storage room can be

planned using movable modular

casework and may include

· Extra-deep modular shelving units

and/or lockers with shelves to keep

smaller items off the floor.


Plan View of an Equipment Storage Room

An equipment storage room will range in


32 linear feet storage


225 square feet



Ambulatory Surgery


Sterile Storage

Plan View of a Sterile

Storage Room

A sterile storage room

will range in size from


Sterile Storage

Supplies may be reprocessed within this

facility or sent from an affiliated hospital

and stored in a sterile storage room.


A sterile storage room can be planned

using movable modular casework and

may require

· Lockers or supply carts to store

clean/sterile supplies or to stage

supplies for packing case carts

(if assembled here).


· Space for bulk supply or wire carts to

hold sterile linen, bulky supplies, and

instrument trays.

· Wire racks for suture storage.

· Case carts.


3 bulk supply carts

4 case carts

wire rack for suture storage

287 square feet



Ambulatory Surgery


Preparation and Packaging

Plan View of a Preparation and

Packaging Area

A preparation and packaging area will

range in size from 150 to 300 square feet.

12 linear feet work surface8 linear feet overhead storage

2 lockers

wire wrapper rack

wire staging carts

177 square feet

Preparation and Packaging

Also known as “prep and pack,” this is a

clean area where items from decontami-

nation are delivered and reassembled into

appropriate sets, packaged in sterilecontainers or wraps, and sterilized for

use.

Sterilization equipment may be part of

this area, and storage also is required for

supplies used in assembling instrument

sets and other sterilized items. Employ-

ees wear scrub attire. Other stringent

management controls and work processes

are observed in this area to ensure quality

control.

· Wire wrapper rack for storage of

wraps.

· Wire carts for staging prior to and

after sterilization.

· Extra-deep modular shelving units,

lockers with drawers and shelves, and

dispensing rail with subcontainers for

storage of supplies and instruments.

· Large process tables for wrapping

packs to be sterilized.· Modular administrative workstation

for quality control documentation and

policy and procedure manuals.


Movable modular casework components can be used to plan the prep and pack area

and may require

· Process tables, lockers with shelves

on wall strips, and/or TR3 carts used

in a staging area to place items

received from decontamination.

· Process tables with casters and

C frame storage units for associated

supplies where instrument sets are

reassembled.



Ambulatory Surgery


Decontamination

Decontamination

Soiled items such as carts (including case

carts), instruments, procedure trays,

equipment, and used linen are brought

here from the operating rooms to becleaned or held until they are repro-

cessed.

Decontamination is considered a

restricted area with increased potential

for contamination from blood or body

fluid pathogens on the soiled utensils and

materials.

If the ambulatory surgery unit processes

its own instrument sets, this room may

function as the decontamination area and

should be large enough to accommodate

washing and decontaminating equipment.

Ambulatory surgery units processing

their own instruments may also require

stainless steel sinks (double and triple

bowls) and a counter for washing

instruments and utensils. This area

generally is a very wet area.


Movable modular casework components appropriate for use in a decontamination

area may include

Plan View of a Decontamination Area

A decontamination area will range in size

from 150 to 250 square feet.



stainless steel case carts

cart washer

154 square feet

· Shelves on wall strips for storage of

cleaning supplies.

· Lockers to hold sterile containers.

· Process table to hold small items

waiting to be processed.

· Stainless steel case carts.



Ambulatory Surgery


Anesthesia Workroom

Anesthesia Workroom

Anesthesia will have a workroom with an

area for washing equipment and

maintaining/testing anesthesia machines.

Anesthesia supply carts are generally

replenished from this room, and at the

end of the day, these carts may be parked

and secured here.


The anesthesia workroom can be planned using movable modular casework and may

require

Plan View of an Anesthesia Workroom

An anesthesia workroom will range in





139 square feet

· Work surfaces or process tables to

receive and clean equipment.

· Small administrative area with work

surface, file storage, tackboards,

space for computer, overhead storage

for manuals and binders.

· Cantilevered sink unit.

· Shelves and lockers for supply

storage.


· Medication storage using locked

drawers and cassettes.

· Bulk supply carts.


· Anesthesia carts storage.



Ambulatory Surgery


Satellite Lab

Plan View of a Satellite Lab

A satellite lab will range in size from




1 locker (optional)

332 square feet


A satellite lab can be planned using

movable modular casework and may

require

· Heavy-duty work surfaces or process

tables to hold centrifuges, blood gas

analyzers, blood glucose monitors,

microscopes, and urine testing

equipment.

· Wall strips, modules, or support

panels to hold work surfaces and

overhead storage.

· Tackboards.· File storage.

· Flipper units, lockers, C frame

storage units, and L carts for storage.

Satellite Lab

Ambulatory surgery may have a satellite

lab for STAT testing of blood, urine, and

tissues and for creating and reading

frozen section slides.



Ambulatory Surgery


Plan View of a Satellite Pharmacy

A satellite pharmacy will range in size

from 120 to 250 square feet.

18 linear feet work surface28 linear feet overhead storage

80 drug bins average

1 locker

1 medication cart

140 square feet

Satellite Pharmacy

A satellite pharmacy may exist in the

ambulatory surgery unit. This decentrali-

zation of the pharmacy function allows

for more rapid response to the needs of the patient.

The satellite pharmacy usually is staffed,

stocked, and serviced by the primary

pharmacist.

Modular carts are appropriate for the

transfer of medications to the satellite

pharmacy.


The same movable modular casework components used in the main pharmacy are

appropriate for the satellite pharmacy, allowing for continual flexibility and change in

the space and may include

Satellite Pharmacy

· Medication locker or cart.

· Double-locking drawers for storing

controlled substances.

· Cantilevered sink unit.



· Dispensing rail.



Ambulatory Surgery


Staff Conference/Locker Room

Plan View of a Staff Conference/Locker

Room

A staff conference/locker room will




40 filing inches

275 square feet

· Tackboards for displaying

information.

· Lockers or wire carts for surgical

attire – dresses, suits, caps, shoe

covers.

· Base cabinets for storage.


· Overhead storage units.


This environment should be easily cleaned, offer a warm, enjoyable atmosphere, and

may require


Staff locker rooms are provided for male

and female staff to change from street

clothing into surgery attire. Clothing

lockers, toilet facilities, and showers areprovided.

A staff lounge or in-service conference

room is often found adjacent to the

locker rooms. This space is used

primarily for in-service training,

conferences, lunches or meals, and coffee

breaks.

Space should be provided for a

refrigerator, microwave oven, and large

coffee maker.

· Wall strips with work surface and

overhead storage or heavy-duty work

surface with C frame storage unit and

drawers for a coffee maker and

supplies.

· L cart for microwave.

· Tables and seating.



Ambulatory Surgery


Supervisor or Physician Office

Private office spaces are required for

medical and business management staff.


These offices may be furnished with modular furniture systems and seating and may

include

Plan View of a Supervisor or Physician

Office

A supervisor or physician office will




136 filing inches

109 square feet

· Overhead storage, flipper units,

display shelves, and marker boards

for displaying information.

· Task lights and personal lights.

· Freestanding, under-work-surface, or

wall-attached drawers and files.


· Tool bar with accessories for paper

handling.

· Work surface with keyboard drawer

or tray to accommodate computers

and printers.




Ambulatory Surgery


Functional Program

Number Department Area Square Feet

Movable Modular Casework

Pre-Operative Holding Area

Scrub Areas @________ sq. ft.

Operating Rooms @________ sq. ft.

Post-Anesthesia Care Unit (PACU/Recovery Room)

Primary Recovery

Secondary Recovery

Isolation Recovery

Equipment Storage Room

Sterile Storage Room

Preparation and Packaging Area

Decontamination Area

Anesthesia Workroom

Satellite Lab

Satellite Pharmacy

Staff Toilets @________ sq. ft.

Janitor’s Closet

Subtotal

Modular Furniture Systems

Waiting Area

Reception Area

Admitting Area

Business Office



Subtotal

TOTAL NET SQUARE FEET

Net-to-Gross Conversion Factor X

TOTAL GROSS SQUARE FEET

Functional Program



Ambulatory Surgery


Bubble Diagram

Bubble Diagram

The bubble diagram of the

ambulatory surgery unit demon-

strates typical departmental

relationships and interaction betweenareas. Necessary adjacencies within

the department become clear.

PRE-OP

HOLDING

BULK

STORAGE

OPERATING ROOM

ANESTH.

WORKRM

DRESSING

SCRUB

WAITING

RECEPTIONIST

ADMITTING

BUSINESS

OFFICE

CONFERENCE/

LOCKER

ROOM

PREP AND

PACK

CLEAN CORESTERILE

STORAGE

DECONTAM.

PATIENT CORE DICTATION

EQUIPMENT

STORAGE

PRIMARY

RECOVERY

SECONDARY

RECOVERY



Ambulatory Surgery


Block Diagram

Block Diagram

The block diagram demonstrates the adjacencies and relative sizes for the areas within

a typical ambulatory surgery unit. Evaluation of the work flow and materials flow

from the bubble diagram has determined this initial general layout.

The size of each area is determined by combining the typical movable modular

casework plans for each identified function. Traffic patterns are developed, and an

overview of the general work process can be evaluated.



Ambulatory Surgery


Preliminary Plan

Preliminary Plan

The preliminary plan clarifies the ambulatory surgery unit space requirements by

showing the location of all the fixed walls and open areas and identifies entrances,

exits, and exact traffic patterns.



Ambulatory Surgery


Schematic Plan

Schematic Plan

The schematic plan shows all of the specific movable modular casework, modular

furniture systems, and materials handling components appropriate for a typical

ambulatory surgery unit.



Ambulatory Surgery


Future Trends

Future Trends

Procedures

Ambulatory surgery, as a method of

patient care, has gone through intensive

growth in recent years. This growth hasbeen fostered by related shifts in the

entire healthcare field because of

improved technology, emphasis on cost

containment, and increased competition

for patients and staff.

Approximately 60 percent of all surgical

procedures are presently performed on

an outpatient basis, and that percentage

is continuing to increase.

The compounded effect of managed-

care pressures, advancements in

minimally invasive procedure

capabilities, and the increasing

miniaturization of technology has given

rise to the prediction that, in the next

few years, 80 percent of all healthcare

services (including surgery) will be

delivered in an outpatient setting.

Facilities

Freestanding facilities for ambulatory

surgery began in the 1960s, primarily

developed by surgical specialists as amethod of freeing hospital beds and

providing conveniences for both patients

and physicians. With increased competition

from freestanding ambulatory surgery

centers, hospitals began expanding

ambulatory services. This expansion

allowed outpatient surgery to utilize

existing support services, such as

anesthesia, admitting, nursing staff, etc.

Most hospitals, however, were planned andorganized for inpatient care, and

ambulatory surgical care was superimposed

on facilities not designed for this function.

Accordingly, hospitals are now either

enlarging to incorporate an ambulatory

surgery unit or building an ambulatory

surgery center on the hospital campus. This

satellite unit, owned by the hospital,

provides the decentralized cost-effective

service with the centralized backup facility

as support.

Some centers also are moving more toward

the hospitality concept in meeting patients’

needs, providing “recovery centers,”

staffed by registered nurses, and offering

private rooms comparable to hotel rooms.

These settings cost less to build and

accommodate patients’ desires for

convenience.

Hospitals, physicians, and architects willbe challenged to provide patients with yet

more extensive outpatient services and

advanced medical care in a non-

institutional, aesthetically pleasing facility

and to do so in a cost-effective manner.

Freestanding, “unbundled” facilities will

continue to be economical.

Patients

The average patient of today is better

informed, well educated, and more

demanding of a wider range of services.Emphasis is placed on early diagnosis

and new minimally invasive surgical

techniques, with outpatient surgery

being high on the patient’s criteria.

The increased volume of outpatient

surgery for general, ophthalmic,

gynecological, orthopedic, and

oncologic procedures will continue to

be enhanced by the improvement of

laser and endoscopic technology,minimizing tissue damage and reducing

the incidence of complications.

Early post-operative ambulation,

advances in anesthetic technology, a

decrease in required narcotic

medication, and less psychological

stress with hospitalization are

documented benefits to the patient.



lc

For the location of the sales facility or dealer near you, visit www.hermanmiller.com/healthcare

or call (800) 628 0058.

© 1999 Herman Miller, Inc., Zeeland, Michigan

® Z, Y, Action Office, Aeron, Ambi, Arrio, Beirise Collection, Co/Struc, Custom Choices,

Eames, Equa 2, Ergon 3, Ethospace, E-Wall, Frottage, Ground Cloth, Harmonics, Hollington, Intersite,

Kinemat, Liaison, Meridian, Milcare, Mosaic, Newhouse Group, Pellicle, Perspectives, Proper, Pulsar,

Rapid Response, Relay, Response Plus, Scooter, Super Room, Systems Bridge, Timepiece, V-Wall,

and Wild Card are among the registered trademarks of Herman Miller, Inc.

™ Y, Aeron Chair Configuration, Ambassador, Burdick Group, Chadwick, CLT, CoActive, DIAMOND,

Flex-Edge, Florence, ID, Iota, Milafin, Myriad, Passage, Potomac, Puzzle, Q, Raleigh, Rapunzel, and

Traverse are among the trademarks of Herman Miller, Inc.

SM OASIS is a service mark of Herman Miller, Inc.

ambulatory surgery by

Documents

Transcript of ambulatory surgery by