Northwell Health's journey to standardized surgical outcomes — 5 takeaways

Health systems have seen a remarkable shift to less invasive surgical techniques that offer faster recovery times, smaller scars and equal or better patient outcomes than open procedures.

Robotics are now taking minimally invasive procedures to the next level in terms of improved patient outcomes.

During a virtual featured session sponsored by Intuitive as part of Becker's Hospital Review 11th Annual Meeting, two experts shared New York City-based Northwell Health's strategic approach to robotic surgery and the benefits of standardizing patient care:

  • David Battinelli, MD, Senior Vice President and CMO at Northwell Health
  • Francesco Cascio, Robotics System Lead at Northwell Health

Five key takeaways:

1. Northwell Health has built its robotics program around four pillars of excellence, in combination with standardization. The executive leadership team charged the organization with creating a robotics program rooted in superior quality outcomes and a positive patient experience. From there, the robotics steering committee focused on four pillars: quality, credentialing, operations and education. "Those four pillars were the foundation of our work that led to the first Network of Excellence for Robotic Surgery designation in the United States," Mr. Cascio said. "A lot of our efforts in those four areas focused on standardization."

2. Delineation of privileges and site of care strategies have strengthened Northwell Health's robotics program. Historically, Northwell had a single line item that delineated robotic surgery privileges. Now privileges have been broken down into four tiers of complexity, depending on the specialty. The organization has also created tertiary and community site of care strategies. Community-focused facilities typically perform lower-complexity robotic procedures. This frees resources at tertiary facilities to handle more complex cases.

3. A commitment to physician training contributes to standardization and quality procedures. With the help of its partnership with Intuitive, Northwell Health quickly identifies surgeons who want to be trained on robotic-assisted surgery. The organization aligns each physician's training date with the date on which their privileging goes into effect. This reduces the time between a surgeon's training and access to the technology. Northwell Health has also created a state-of-the-art bioskills training facility that gives physicians 24-hour access to robotic simulation technology. The training center offers opportunities for additional practice and refining of techniques.

4. Data are critically important for measuring quality. To evaluate patient outcomes, Northwell Health first needed information about the volume of robotic procedures. The team analyzed how each facility was documenting robotic procedures and found that some were using Current Procedural Terminology codes, while others were using ICD-10 procedural codes. Once Northwell Health implemented a consistent coding approach for robotic procedures, it was able to overlay quality information on the procedures. Today, the organization can extract whatever data are needed for payers to understand that robot-assisted surgery is a process that delivers positive patient outcomes.

5. Continuous quality improvement is a reality with robotic surgery. Robotic surgery creates a digital fingerprint in the operating room that wasn't possible before. "We videotape all our robotic procedures, analyze them and provide feedback to practitioners," Dr. Battinelli said. "That data also helps us understand efficiencies. It's a huge advance beyond traditional open procedures that had minimal monitoring."

To view this session on-demand, click here. For more content, visit our Robotics Content Hub.

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