Skip to main content

3 Tech Tips for the Surgical Suite

 |  By gshaw@healthleadersmedia.com  
   September 13, 2011

Technology is everywhere in the surgical suite—from the smallest medical gadget to the largest, most expensive piece of imaging equipment or robotic system, to the electronic medical record system that ties it all together.

The latest HealthLeaders Media Breakthroughs Report on high-performing surgical programs centers on four organizations that share how they used technology to create more efficient, quality-driven, patient centered, and successful surgical programs. 


1. Don't buy what you don't need

There was a time not so long ago when surgeons heard about a medical device, decided they wanted the shiny new toy, put in an order, and gleefully await for their shipment to arrive. "There were no questions asked, there was no discussion done, and it led to the proliferation of a lot of technology that was quite useless," Michael L. Marin, MD, chair of surgery at The Mount Sinai Medical Center in New York City, says in the multimedia report.

Those days, he says, are over.

"The paradigm has shifted. Certainly it has at Mount Sinai, where we have a much more financially responsible approach to the use of technology."

Before a new technology or device is adopted at the organization, a committee conducts a cost-benefit analysis of the device's value to the patient to determine its potential economic impact on the hospital, Marin says. "We now walk into the use of new technology with much greater knowledge and more careful forethought than we ever have in surgery in modern times."

 

2. Don't pave the cow path

Hospitals spend millions of dollars on new programs, platforms, and tools "with the expectation that the transformative power of technology will also transform surgical services into a high-performance, high-tech/high-touch driver of future profitability and quality rankings," says Lawrence Hanrahan, MD, a principal at PwC Health Industries Advisory.

"It's possible, but not guaranteed," he adds.

In order to get true performance you must also address fundamental people and process issues—workflow, roles, and responsibilities.

"The introduction of new technology in the surgical services area may result in 'paving the cow path.' It may look like a new road, one that is greatly improved and can handle far greater volumes of traffic at higher speeds, but it is still utilizing the same operational process or work flow," he says. "At the same time, your competition is utilizing the 'new superhighway,' which has bypassed your old way of doing things operationally.

Organizations must anticipate and manage the change and its impact.

 

3. Put your technologies in the right place

A multi-purpose outpatient center has the power to improve operational efficiency—allowing services to share large and expensive technologies, for example. One such center allowed The Methodist Hospital in Houston, TX, to share the MRI suite with 10 centers that use the same technology, says Roberta Schwartz, senior vice president of operations.

"What we did with the building is try—to the best of our ability—to co-locate services that made sense," she says. "For services such as cancer that have all-encompassing services, we gave them a home. This is the first building where they've really had a comprehensive home for all cancer services, and that was inclusive of their location for tumor boards, their physician clinics, their infusion space. Cancer isn't located on six floors; they've got a floor in the building. Could we have built a stand-alone cancer center? Sure. But we could co-locate that with all of the imaging services that they needed."

Similarly, Bassett Healthcare in Cooperstown, NY, was aiming for safety and consistency when it consolidated surgical services. "There is a cost for quality—the cost of a piece of equipment. Do you replicate it five times or do you ask patients to travel some distance?" says Lorraina Smith-Zuba, RN, Bassett's director of perioperative services.

St. Francis Hospital in Roslyn, NY has a new building with 17 operating rooms and is opening six new ORs, one of which is a hybrid cardiac endovascular suite that enables imaging and surgery in one sterile environment.

The hybrid ORs will help with a national percutaneous valve implants trial it's conducting. "We're currently using our cath labs, but the cardiac hybrid is the ideal location. Just the technology alone, the robotic nature of the c-arm, and being able to convert in seconds from an imaging facility to an operating facility is going to make work a more pleasurable experience," says Newell Robinson, MD, chair of cardiothoracic and vascular surgery.

The theme common to all three tips—and at all four organizations in the report—is careful planning.

Bob Nimon, managing director at Genesis Planning, a healthcare technology consultancy, and manager of medical technology planning at The Methodist Hospital, says technology can account for as much as a quarter of the building costs, but given construction lag times and other strategic decisions, that cost may be difficult to pin down. At the time the center was being conceptualized in 2005, the health system could not say exactly what surgical and other outpatient services would be in the building, Nimon says.

"In order to accommodate not knowing what physicians or services were going to be using these ORs, and not having an exact handle on what procedures were going to be done in the future, we came up with a layout of the ORs in terms of the utility booms, lights, integration, and all of the different elements that could accommodate multiple surgical interventions on a multidisciplinary basis," Nimon says. "We worked with the hospital, architects, and engineers to make sure that these adaptations were planned and that the staff understood what we were doing so they could get best utilization out of these spaces later on."

Hospitals must consider the impact of new technologies on clinical and nonclinical workflow and operations, Hanrahan says.

"It is less about the specific surgical instrumentation or clinical technologies or the electronic medical record, but more about the necessary training of current staff and change implications, even in terms of shaping the new job description and rethinking the type of person that you want to hire going forward. So we tend to be more focused on ensuring that the appropriate change management program is put in place across all the stakeholders and how you're going to communicate to all of them of the new requirements and expectations. Executing that change management over the specific time frame to help achieve those safety objectives and efficiency objectives—that sounds great theoretically, but there are always some additional pieces that need to be put in place beyond the specific piece of technology.

You can read more about how these organizations are improving their surgical programs in our most recent HealthLeaders Media Breakthroughs Report, The High-Performing Surgical Program

Tagged Under:


Get the latest on healthcare leadership in your inbox.