On the Brink, Season 1, Episode 6
About This Episode
Drew Garst (Principal & National Healthcare Leader of ASCs, Boulder Associates) has designed 400+ surgery centers across the country. He’s seen what works — and what tanks a project before construction even starts.
Your architect choice matters more than you think. ASC design is its own animal, and getting it wrong costs you time, money, and headaches.
For instance, most surgeons overestimate their OR size. Drew shares how mockups saved one project 120 square feet per room — with zero loss of functionality. We also dig into the equipment trap: delay those decisions and you’ll pay the price in change orders and construction delays.
Smart developers build in “soft spaces” from day one — strategically positioned areas that can expand naturally as your practice grows. And if you’re thinking any healthcare architect will do, think again. Hospital design and ASC design are fundamentally different disciplines, and the nuances matter.
The bottom line: start with vision, not square footage. The right partner asks what outcomes you want before drawing a single line.
Key Themes and Takeaways
- ASC expertise isn’t optional. Ambulatory surgery center design is its own discipline — distinct from hospital design in ways that matter. Choosing an architect without specific ASC experience can cost you time, money, and functionality.
- Start with vision, not square footage. The right design partner asks what outcomes you want before drawing a single line. Leading with your clinical goals shapes every decision that follows.
- Surgeons often overestimate their space needs. Mockups and early collaboration can reveal significant efficiencies. In one project, this approach saved 120 square feet per OR — with no loss of functionality.
- Equipment decisions can’t wait. Delaying equipment selections leads to costly change orders and construction delays. Early planning on technology and equipment integration keeps projects on track and on budget.
- Build in room to grow. Smart developers design “soft spaces” from day one — strategically positioned areas that allow natural expansion as your practice evolves, without major renovations.
- Workflow drives design. Efficient layouts that support both patient flow and staff experience aren’t just nice to have — they directly impact operational performance and patient satisfaction, which ties to reimbursement.
Chapters
- 00:05 – Shifting Focus to Patient Vision
- 01:04 – Understanding the Role of Design in Healthcare Facilities
- 07:56 – Understanding Design Decisions in Surgery Centers
- 12:27 – Planning for Future Growth in Healthcare Facilities
- 17:40 – Designing Effective Surgery Centers
- 22:56 – Choosing the Right Architect for ASC Design
About the Host
Carolyn Wilson brings decades of operational expertise in ASC development and healthcare real estate.
She’s guided countless physician groups through the journey from initial conversation to successful operations—and she understands the challenges that keep surgeons up at night.
Connect with Carolyn Wilson on LinkedIn
About the Guest
Drew Garst is Principal and National Healthcare Leader of ASCs at Boulder Associates, where he leads the firm’s ambulatory surgery center design practice.
With more than 400 surgery centers designed across the country, Drew brings deep expertise in creating efficient, patient-centered surgical environments that support long-term growth and operational success.
You can connect with Drew Garst on LinkedIn.