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This January, OAH is thrilled to open one of the most innovative surgical centers in Connecticut, if not the nation. Dr. Pietro Memmo and Dr. Andrew Caputo have been overseeing all aspects of the facility's development from inception through completion.

In the below question and answer which was recently featured in a national orthopedic publication, Dr. Memmo addresses why this Center is so unique and how every detail was managed to enhance the patient experience.

How has physician involvement helped shape and enhance the final product?

One of the keys to success is we received input from fellow partners, our nursing staff and administrators, and our patients. The success of our original surgical center for over 15 years provided a wealth of knowledge to help create a state-of-the-art surgical center where patients will choose to come, physicians will want to operate, and our staff will want to work. They then coordinated directly, often on a daily basis, with the architect, construction manager, our surgical center administrators, and onsite project manager, the successful completion of the center. Whether it was the selection of the masonry stone, the design choices of the outdoor courtyard, soothing fabric schemes for the furniture, or the OR technologies, Drs. Memmo and Caputo were there to make decisions that were representative of their fellow partners.

Our facility was designed with strong emphasis on employees. Our employees, nurses, and dedicated staff are the heart of what we do. We want them to be in a beautiful setting that is designed to make their jobs easier and is also designed to optimize patient workflow and surgical outcomes. We want our staff to be happy and to work in a setting that is second to none.

The new facility is described as one of the most innovative outpatient surgical facilities in the state, if not the nation. What makes it so distinctive? 

This center exemplifies a modern approach to construction of patient care centers with emphasis on sustainability and being lean and efficient. From the exterior of the building to the landscaping, electrical units, lighting, and finishes, every detail was designed to be environmentally responsible and resource efficient. Even the skin of the building is environmentally efficient and uses Centria panels that have built-in insulation and water drainage systems.

Every possible enhancement was implemented to create a safe and sterile environment that meets the highest standards reserved for brand new hospitals. For example, Epoxy floors and Whiterock walls in the operating rooms create the most innovative surfaces for maintaining a sterile environment. Our Autoclavs and sterilization equipment are the most advanced means for keeping patient infections at near zero percent.

Technology in our 650 square foot operating rooms was critical. The ORs are fitted with ConMed surgical camera systems with two floating 32-inch monitors and one 75-inch Sony 4K monitor; video integration will allow surgeons to view live video while simultaneously viewing MRIs and X-rays from multiple sources; wireless connectivity will allow for a seamless interface of data, images, and video with electronic medical records; the ORs are equipped for live HD video and audio streaming for viewing and recording for educational and training purposes. Robotic surgery will allow for more precise and safer surgeries.

What are some features that were incorporated in the building to enhance the patient experience?

Designed with the patient in mind, down to every last detail: covered walkway to keep patients dry; built on a sloped hill, so no stairs or elevators; physical therapy right on the premises, overlooking a beautiful garden with silhouetted renderings of people in motion; and a snack bar for patients, families, and employees.

We want our patient experience to be second to none. The surgical center is on one floor, so there are no stairs or elevators. The drop-off and pick-up areas have covered entrances to protect against snow and rain. The elegant lobby is more of a family lounge, equipped with large screen televisions, a snack bar, and a patient monitoring system so family members can track the status and progress of the patient’s surgery. A physical therapy area is placed right in the post-operative care unit so therapy can begin immediately after surgery, directly in the recovery area. We have a courtyard with outdoor seating for family members to enjoy as they wait for their loved ones. Lastly, there is natural lighting, high ceilings, and clean finishes throughout the interior of the center to create a soothing and meditative environment.

Patients are shopping around for care, and you're clearly adapting to that trend with this patient-centric facility. What else is Orthopedic Associates of Hartford doing to adapt to overall industry trends?

Orthopedic Associates of Hartford has perhaps the most comprehensive orthopedic urgent care in Connecticut. We are open 7 days a week in Farmington and Glastonbury (and soon in Rocky Hill), and provide an avenue for both new and current patients to have immediate access, specifically for orthopedic emergencies. This will allow patients to avoid going to costly and time-consuming Emergency Rooms. We are confident that we can provide superior orthopedic care above and beyond the services which are provided in other stand-alone facilities that are more equipped to deal with non-orthopedic medical conditions.

How will shifting most procedures to the outpatient setting set OAH up for success?

Industry trends are clearly seeing a shift in most orthopedic surgery moving from costlier inpatient settings to more efficient and less expensive outpatient, same-day venues. This includes spine surgery and joint replacement surgery. These changes are being driven by cost, technology, and advances in anesthesia. Orthopedic Associates of Hartford welcomes this trend and is prepared to meet this demand.

Most orthopedic surgical procedures done in an ambulatory surgical center cost 25% of what hospitals get reimbursed for the same surgical procedure. Ambulatory surgical centers will reduce costs for individuals who often have high deductibles, self-insured employers who find the current cost curve unsustainable, and the federal government itself. Research, our own data, and patient feedback from our existing surgical center in Rocky Hill show that our patient outcomes are superior, our infection rate is near zero, and patient satisfaction is over 98%. We expect to further improve these outcomes in our new state-of-the-art surgical center which will have even better efficiencies, robotics, and more advanced sterilization equipment.

For these reasons, Orthopedic Associates of Hartford is well positioned to satisfy the demands in this ever-evolving healthcare landscape.

Why should other practices/organizations follow your lead?

They will have no choice. The trend towards outpatient surgery is only accelerating and orthopedic practices must have the infrastructure to adapt to this change, or they will fail or be bought out by another healthcare system. Some studies have shown that, in the very near future, over 70% of joint replacements will be done in an ambulatory surgical center.

The federal government and insurers are already reducing the reimbursement for the number of post-operative days that are allowed for surgery. However, with the advancements in anesthesia, robotics, and pre- and post-operative coordination of care, there is no reason why these mandates cannot be met while still maintaining optimal patient outcomes and satisfaction rates. At Orthopedic Associates of Hartford, we have invested in our future to meet these industry changes and hopefully other independent practices will do the same.

Pictured below are some pictures of the new Surgery Center:

   

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We were pleased to be a featured case study in December's New England Journal of Medicine. Thanks to Dr. Schutzer, Dr. Grady-Benson and Mike Cremins, PhD. for their outstanding work and research in this study and article. Learn about how the Connecticut Joint Replacement Institute (CJRI) has been committed to quality and safety improvement initiatives. A rigorous focus on metrics and analytics has allowed them to continuously monitor the delivery of the highest quality care leading to better outcomes, cost-efficient care, lower infection rates, and higher patient satisfaction.

Building a “Hospital-within-Hospital” Model for Joint Replacements New England Journal of Medicine Case Study · December 5, 2018

OAH Team Receives Accolades and Published Article in Prestigious New England Journal of Medicine


Steven F. Schutzer, MD


John C. Grady-Benson, MD


Michael Cremins, PhD, PA-C

The oldest continuously published and prestigious peer reviewed New England Journal of Medicine has selected three OAH team members for their recent publication. Learn how this innovative team has taken an integrated approach to joint replacement that provides superior patient care, reduces costs and improves outcomes.

Read the Study December 5, 2018 New England Journal of Medicine


Hand and wrist specialist, Dr. Nicholas Bontempo, shares some of the latest advancements and treatments for hand and wrist pain.

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Entrance to outpatient surgery center

We are thrilled to announce our plans to open the most cutting edge outpatient surgical facility in the state, if not the nation.

Leading the way in innovation and patient safety

Every detail of this stunning new facility is designed to create an extraordinary patient experience. The 45,000 square foot facility is slated to open on January 7, 2019. It is located at 150 Enterprise Drive in Rocky Hill.

“The future of orthopedics is moving surgeries to outpatient venues,” explains Dr. Pietro A. Memmo, Assistant Director of the Orthopedic Associates Surgical Center. Dr. Memmo, along with Dr. Andrew Caputo, are partners and co-project managers of the new surgical center and have been overseeing all aspects of the center from design through completion. Dr. Memmo points out that “Research, patient satisfaction, and our experience shows that outpatient surgeries are more cost effective for patients, with much lower infection rates and superior outcomes. That is why we have made the significant investment of approximately $30 million to build a center that is truly unparalleled in the Northeast.”

OAH surgeons will perform a wide range of surgeries at the center including:

  • Shoulder, knee, and hip replacements
  • Spine surgery
  • Shoulder and knee arthroscopy
  • Hand, wrist, elbow, foot and ankle surgery
  • Interventional pain procedures to relieve pain and restore function.

The majority of procedures that were previously done in an inpatient facility will now be performed in an outpatient setting. “The center has everything and more that a hospital offers, without the overnight stay and with improved convenience and lower costs,” says Dr. Memmo.

Entrance to medical office building where patients can see doctors and receive physical therapy

The new facility includes seven operating rooms and one procedure room. The operating rooms are over 600 square feet to accommodate the latest technology and robotic systems while providing surgeons with more room to comfortably operate. Patient safety is at the forefront and the newest advancements in care are in place, including the most advanced sterilization systems on the market.

On the lower level, there are 25+ rooms for doctors to see patients and a full service physical therapy center. In fact, physical therapists will immediately start physical therapy in the post-operative surgical area so that patients can go home the same day. Patients will be able to stay up to 23 hours. Every single detail, from the layout of the building to the onsite services and accessibility, was considered to enhance the patient experience.

This new center will replace the existing Orthopedic Associates of Hartford surgical center in Rocky Hill located on Cromwell Avenue. “When our Rocky Hill surgical center opened 15 years ago, it was ahead of its time,” said Dr. Memmo. “Patients reported a 98% satisfaction rate and preferred it to a hospital setting. This new building is 40% larger, is at the forefront of patient care, and allows our surgeons to handle over 100 cases a day and, at capacity, up to 15,000 cases per year.”

Size was only one consideration behind building the new center. Dr. Caputo shares that patient comfort, safety, and convenience were all primary drivers behind the new center. He explains, “As a physician-owned and led project, the new building was planned with the patients, doctors, and employees in mind. Our nurses and dedicated staff members are the heart of what we do. We want them to be happy in a setting that is second to none. It is designed to make their jobs easier, as well as to optimize patient workflow.”

Part of what contributes to the positive experience is the natural beauty of the center. One of the most prominent architectural features is the floor-to-ceiling windows which bring an abundance of natural light flooding the interior patient care environment. Beautiful natural stone walls, soothing colors, and custom art work embody a sense of calmness and serenity, unlike a hospital.

The state-of-the-art facility is also designed with sustainability in mind. Principal of MBH ARCHITECTURE, Nicholas Michnevitz shares, “This center exemplifies a modern approach to construction of patient care centers with emphasis on sustainability and being lean and efficient. From the exterior of the building to the landscaping, electrical units, lighting, and finishes, every detail was designed to be environmentally responsible and resource efficient.” Even the skin of the building is environmentally efficient and uses Centria Panels that have built-in insulation and water drainage systems.

Mark Caccio, Senior Project Manager with A/Z Corporation who is overseeing construction, points out that “Every possible enhancement was implemented to create a safe and sterile environment that meets the highest standards reserved for brand new hospitals. Walls, surfaces, ceilings, and flooring were designed using the most cutting edge materials on the market to create a sanitary sealed environment where patient safety is at the forefront.”

An official ribbon-cutting Grand Opening ceremony is planned for February of 2019, in conjunction with the Rocky Hill Chamber of Commerce, local legislators, and members of the healthcare community.

Tim Taylor, CEO of Orthopedic Associates looks forward to kicking off 2019 with this major advancement in patient care. “This center raises the bar on orthopedic and musculoskeletal care and takes it to a whole new level. We look forward to opening our newest facility, where our exceptional team can continue to offer patients the best orthopedic care in a setting that maximizes their comfort and convenience.”


Dr. Pietro Memmo

Dr. Andrew Caputo

Partners at Orthopedic Associates of Hartford and Co-Project Managers of the New Surgery Center

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