The Business of Surgery 
By 2022, orthopedic procedures performed in ambulatory surgery centers (ASCs) were already outpacing expectations. For years, total hip and knee replacements were considered too complex for same-day surgery. Yet, total joints replacement volumes jumped nearly 200% between 2020 and 2022—outpatient total knee arthroplasty surged nearly 194%, while total hip arthroplasty…
For decades, ambulatory surgery centers (ASCs) have shown their ability to deliver high-quality surgical care at substantially lower cost than hospital outpatient departments (HOPDs). ASCs achieve these savings through leaner operations, streamlined staffing models, and specialty-focused efficiencies, not by compromising safety or outcomes. Studies consistently highlight procedures performed in ASCs…
Ambulatory surgery centers (ASCs) are taking on more high-acuity, same-day procedures than ever before. This growth is driven by evolving clinical protocols, cost-conscious reimbursement strategies, and expanded capabilities in outpatient care. Specialties like orthopedics, spine, ophthalmology, and cardiovascular care are moving more complex cases—and the implants that come with them—out…
As we celebrate National ASC Month, it is worth recognizing how central ambulatory surgery centers (ASCs) have become to modern healthcare. Today, there are more than 12,000 ASCs across the US, including over 6,500 Medicare-certified facilities operating some 18,800 surgical suites. With over 80% of all surgical procedures being performed…
Although hospital performance from January to April 2025 outpaced the first 4 months of 2024, according to Kaufman Hall’s June 2025 “National Hospital Flash Report,” many surgical departments remain under intense financial pressure. Labor and supply costs continue to rise, while surgical services are especially vulnerable to inefficiencies like labor…
Once limited to hospital inpatient settings, total joint surgery is increasingly common at ambulatory surgery centers (ASCs) across the US. What is not so common is performing these complex procedures without the benefit of an onsite sterile processing department (SPD). And yet, that is exactly what we have accomplished at…
Editor’s Note: This page is a companion piece to the main article, Centralized sterile processing cuts costs, complexity for four ASCs. Implementing offsite sterilization is a major project. At Total Joint Specialists, our journey began gradually, growing in scope over time as the team became comfortable with the process…
Perioperative leaders often have to make critical decisions, not just in the middle of an operational crisis but also somewhere in the edges—the routine but still high-stakes moments where leaders need to adjust resources or absorb costs under tight constraints. The economic margin for error continues to narrow, and many…
Editor’s Note: This page is a companion piece to the main article, Emergency preparedness: Identifying essential supplies for unplanned surgical events. While the main article outlines the principles of emergency readiness and supply preparation in the OR, the posts below offer a closer look at two key implementation areas: Supply…
While most emergency surgical procedures are carried out uneventfully and safely, the OR is also a place where potentially life-threatening and least-expected instances can arise. Emergencies such as malignant hyperthermia, intraoperative cardiac arrest, and anaphylaxis can catch OR leaders and staff off guard. Perioperative teams need proper and adequate preparation…
