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Operating rooms, once home to a surgeon and his scalpel, have changed dramatically over the past 30 years. They now also have robots with fingers, lasers and sophisticated video and computer technology.

At Billings Clinic, the number of surgeons and procedures also has changed dramatically. More than 45 surgical specialists in 14 specialties operate 24 hours a day, seven days a week, straining the existing suite of 10 operating rooms.

The current shortage of rooms forces routine cases to be started late in the day, a less than ideal situation for patients anxiously awaiting surgery. The shortage also fragments patient care between two hospital floors.

The one thing that has not changed is that the OR remains home to lifesaving procedures.

To that end, the 1980s-era operating rooms at Billings Clinic no longer function at an optimal level.

Although the recently completed Outpatient Surgery Center is serving the growth in outpatient procedures, five-year projections show an increase in the hospital setting as well.

“We’re just jam-packed,” said Dr. Richard Melzer, who has practiced as a urologist for nearly 30 years. “We can’t get everything done.”

To alleviate the squeeze and raise the level of safety and efficiency, Billings Clinic has embarked on a $13.5 million expansion and renovation of the surgical services facilities. The 43,000-square-foot project will be completed in six phases with the first phase scheduled for completion in mid-July. The entire project, in the planning stages for 14 months, is scheduled for completion in late 2014.

The number of operating rooms will increase from 10 to 13. The average size of an existing operating room is 425 square feet; the average size of a new operating room will be 650 square feet. Larger rooms will better accommodate technology and equipment and improve work flow. The end result is greater patient safety.

The project, which includes $8 million for construction and $5.5 million for equipment and technology, will be paid for in part with proceeds from the 2013 Billings Clinic Classic. Money also will come from both Billings Clinic and the Billings Clinic Foundation’s capital expansion and renovation budgets.

“This is one of the most important pieces of real estate in a multistate area when it comes to health care and saving lives,” said Jim Duncan, president of the Billings Clinic Foundation. “The OR is at the core of what we are. Life and death happens in that environment. We want it to be the best.”

Expanding and renovating the current surgical services will pave the way for all phases of the surgical experience — from pre-op check-in and care to recovery — to happen on the same floor.

This goal is to enhance the patient experience, prevent disruption in care and decrease pre-surgical waiting times, said Mitch Goplen, vice president of Facility Services. The waiting area for family and friends will also be on the surgery floor. Putting everybody on the same floor was crucial, he said.

“This can be a scary time,” said Jackie Hines, director of Perioperative Services. “Patients are vulnerable. The wait times, the efficiencies and the safety factors are key to making sure you have the best possible outcomes. Seconds matter.”

Another feature will be expanded family waiting rooms to allow for dedicated private space for surgeons to visit with family after surgical procedures.

“This is going to be great for patients,” Melzer said. “It offers a healing environment that offers a sense of comfort and confidence when they come into a room.”

Dr. Paul Grmoljez, a retired Billings Clinic general, thoracic and vascular surgeon, is chair of the 2013 Billings Clinic Classic. When he joined the Clinic in 1977, only four operating room existed. A few years later, another six operating rooms were added with a few upgrades along the way.

“Surgical services are at the heart and soul of every advanced medical center,” he said. “The time has come to create another state-of-the-art facility that will serve our patients for the next 30 years.”

Grmoljez said he considers it a “distinct honor” to help raise money for this project.

Before beginning the project, a group of surgeons, nurses, facility planners, architects and others travelled to Oregon, Texas, California, Colorado and South Carolina and visited more than 12 hospitals and operating rooms to learn what works — and what does not.

The primary architect will be CTA Architects Engineers. Bauer Construction will serve as the general contractor. Both are from Billings.