Avoiding Common ASC Development Pitfalls

In this episode of Beyond the Build, Bruce Johnstone sits down with Barbara Walker to discuss the most common pitfalls healthcare organizations face during ambulatory surgery center (ASC) development — and how to avoid them. Drawing from decades of experience in ASC operations, planning, and development, Barbara shares practical insights across every phase of the process, from business planning and financing to site selection, design, and construction. The conversation explores why unrealistic proformas, siloed design processes, and lack of operational expertise can lead to costly delays, change orders, and long-term inefficiencies. Barbara also highlights the importance of integrated project delivery, early stakeholder involvement, and building the right team from the beginning. Whether you're a physician group exploring your first ASC or an experienced healthcare developer, this episode offers valuable guidance for creating a successful, scalable, and financially sound project. 00:00 Introduction to 'Beyond the Build' 00:07 Pitfalls in ASC Development 00:30 Barbara Walker's Experience in Healthcare 02:05 Key Pillars of ASC Development 02:56 How does financing connect with a strong business model and ensure that an ASC center is investment worthy? 05:37 Financing and Investor Relations 07:00 What are some of the biggest pitfalls to avoid during the site selection phase for developing a healthcare facility? 11:44 Design and Construction Integration 15:33 Can you share a real life example where you faced challenges due to lack of communication or accountability between architects and contractors during a project? 19:56 Can you provide an example of a situation where a lack of communication led to significant issues in a project? 22:36 Final Advice and Episode Conclusion