The University of Arkansas Medical Science’s Orthopaedic and Spine Hospital (TOSH) has “arrived,” proving that, “Measure twice, cut once” fosters excellence not only in the OR, but also in creating a world-class facility in which to perform those procedures.
The official ribbon cutting ceremony for the $85 million surgical facility came to fruition two years after the initial groundbreaking.
Located in Little Rock, Arkansas, TOSH brings to life a state-of-the-art and unique concept of how orthopedic and spine care services can be organized and delivered.
Orthopedics This Week was invited to tour the facility in May 2023, where we witnessed the trailblazing vision of C. Lowry Barnes, M.D. in action.
Regarding the facility’s design, it is abundantly clear that Dr. Barnes, former President of the American Association of Hip and Knee Surgeons and Chair of the Department of Orthopaedics and Musculoskeletal Services at the University of Arkansas Medical Science (UAMS), had assembled a team of experienced caregivers who fully understand the shifts in musculoskeletal medicine.
Indeed, many digital, communication, and other caregiver wish lists are fulfilled in this facility.
For the legions of patients who can be helped via conservative care, Dr. Barnes and his team elevated Interventional Spine and Pain both literally (located on the hospital’s top floor) and figuratively. TOSH incorporates many of the innovations found in leading ambulatory surgery and pain centers.
But these and other innovations would have to contend with the rising tide of a global pandemic.
Just after the ceremonial shovel made its initial dig in March 2020, musculoskeletal surgeries ground to a halt all over the United States because of the COVID pandemic.
Undeterred—and laser-focused on crafting a facility to offer the highest level of patient care—Dr. Barnes, his team, and the entire UAMS leadership corps, held to their concept of a new type of modern orthopedics and spine hospital. The Request for Proposals went out to architects and contractors in March 2020, the first meetings were held in July 2020, and ground was broken in April 2021.
The first patient was scheduled for June 1, 2023.
Building the Vision
Serving as lead architect was Cromwell Architects of Little Rock, who partnered with Davis Stokes Collaborative from Nashville, Tennessee, ultimately working with Arkansas construction company, Nabholz.
Guided by Lowry Barnes’ idea of what was possible, their work has resulted in a facility that is rare in its attention to the needs of patients. The four-story hospital includes more than 158,000 square feet dedicated to orthopedic surgery, spine care, and pain management.
On the first floor of the clinic there are 12 exam rooms, 2 X-ray machines, and 2 Wide-awake Local Anesthesia No Tourniquet procedure rooms (primarily for carpal tunnel). There are advanced imaging options, including MRI, CT, and extremity CT—with the capacity to add X-ray with fluoroscopy and a second MRI. Sterile processing is also located on the first floor, as well as a café for employees and visitors.
Moving to the second floor you find 12 operating rooms, 4 of which are 800 square ft (for spine) and 8 are 600 square ft. Of those 8, 2 have the observation room between in non-restricted space, and the other 6 have observation/workspaces between them in restricted spaces.
Where the magic happens?
Upon reaching the third floor you find 24 inpatient rooms, along with outpatient and inpatient therapy. Soon, inpatients will have sedum grass on the rooftops outside their rooms. Step outside and there is a Therapy Walking Garden with gravel, wood, and concrete walking spaces to help patients with mobility. Additional preparation for postoperative life includes a car simulator and a bathroom for patient Activities of Daily Living assessment and training. Coming soon is an outdoor Patient and Family Healing Garden.
On the fourth floor you find the Interventional Spine & Pain Clinic featuring eight exam rooms, four procedure rooms, a 70-seat conference room and a 40-seat conference room. Orthopedic faculty offices are on this floor, as is a resident lounge with computers, a kitchenette, lounge space, and lockers. On the educational front, there is a cadaver skills lab with two autopsy tables and OR equipment.
“I am proud that our team took such care to think through the details of the daily needs of patients, as well as staff,” said Dr. Barnes to OTW. “TOSH adds 250 new employees to the UAMS system and will help ensure that our patients have their needs met in a timely fashion.”
Dr. Barnes, who became Chair of the Department of Orthopaedics and Musculoskeletal Service Line Director in August 2014, was the 11th faculty member hired. By September 2023, UAMS will have 49 orthopaedic and musculoskeletal faculty members, a 350% increase in nine years.
As faculty have joined, patient volume has increased as well. When Dr. Barnes took the reins of UAMS’s Department of Orthopaedics and Musculoskeletal service, the patient volume amounted to 21,414 completed clinic appointments and 3,557 surgical cases. For the last 12 months, patient volume has reached 66,591 clinic appointments and 5,787 surgical cases, a remarkable track record of growth—during, it’s worth noting—the three-year COVID period.
“No shortage of talented individuals brought their insights and approval to the table,” stated Dr. Barnes to OTW. “These patient-focused individuals include UAMS Chancellor Cam Patterson, Campus COO Christina Clark, Campus CFO Amanda George, Vice Chancellor Stephanie Gardner, UAMS Health CEO Steppe Mette, COM Dean Chris Westfall. UA System President Don Bobbitt, and the UA Board of Trustees.
Thanks to a remarkable level of teamwork, TOSH surgeons are expected to perform 6,000 surgeries during the hospital’s first year in operation.”
TOSH…Transcending the Ordinary in Spine Hospitals©
