Conversion of a Stand-Alone Academic Ambulatory Surgical Center into an Intensive Care Unit During the COVID-19 Pandemic in New York City: Challenges and Lessons Learned

The COVID-19 pandemic overwhelmed New York City's healthcare infrastructure, prompting rapid adaptations to expand critical care capacity. Montefiore Medical Center's Hutchinson Metro Center (the Hutch), a standalone ambulatory surgical center (ASC), was converted into an ICU within 5 days to address the surge in COVID-19 cases. This was done by repurposing 16 operating rooms and 60 post-anesthesia care unit beds into 14 ICU and 60 floor beds. A 5-step framework guided the conversion process, including: (1) feasibility of conversion, (2) critical structural logistics, (3) essential supplies and technology, (4) Clinical criteria, and (5) staffing. Key challenges were oxygen supply limitations, staffing shortages, and logistical hurdles such as medication and equipment procurement. This report highlights the potential of ASCs as adaptable overflow facilities during public health crises and provides a blueprint for future pandemic preparedness.