While da Vinci-assisted surgery has gained traction within many healthcare systems, others are reluctant to embrace da Vinci-assisted surgery due to concerns about costs, implementation and value.
Keys to maximizing benefits of a da Vinci-assisted service line lies in executive support, strong alignment, ongoing training and transparent communication.
During a workshop at Becker's Hospital Review 13th Annual Meeting, sponsored by Intuitive, Will Bertram, RN, chief operating officer at Sky Ridge Medical Center in Lone Tree, Colo., discussed his organization's da Vinci-assisted surgery service line evolution, shared results that Sky Ridge has achieved and offered lessons for others embarking on a da Vinci surgery journey.
Sky Ridge is part of HCA, one of the nation's leading healthcare providers with 186 hospitals and 124 surgery centers across the country. HCA has more than 400 surgical robots and has performed almost 100,000 da Vinci-assisted surgeries.
Three key takeaways from Sky Ridge's experience were:
1. Sky Ridge boasts a world-class da Vinci-assisted service line. When Sky Ridge began its da Vinci-assisted program in 2017, the organization lacked executive support and data and analysis capabilities, was in need of a different organizational structure, faced block time issues and had communications challenges. "Back then, we had a robot, but we didn't have a da Vinci program," Mr. Bertram said. "We needed to see da Vinci as a service line and begin treating it as such."
Over the next several years, Sky Ridge created a vision for its da Vinci program, defined its purpose, changed its culture, operationalized its program in pursuit of the quadruple aim and achieved greater program maturity. Sky Ridge's da Vinci surgery program revolved around three pillars of program excellence:
- Clinical excellence. This involves making data transparent and accessible, recruiting new surgeons, aligning with anesthesiology and working to more rapidly flip rooms.
- Operational excellence. This was based on achieving a lower OR cost per case, securing OR team support and creating greater alignment.
- Leadership excellence. This required corporate support, alignment from the top down, a commitment to growing revenue and closely tracking revenue.
Today Sky Ridge has a dedicated da Vinci surgery program with nine da Vinci specialties, 38 da Vinci surgeons, seven da Vinci Xi da Vinci and 24/7 access to da Vinci surgery. In 2022, Sky Ridge performed over 1,800 da Vinci surgeries and experienced 36 percent annual growth in the number of da Vinci cases.
2. Sky Ridge's da Vinci program has produced impressive outcomes and has helped drive Sky Ridge's growth. Through da Vinci surgery, Sky Ridge has reduced length of stay across all service lines. "For example, the difference in length of stay between an open colorectal procedure and a da Vinci procedure is 4.2 days," Mr. Bertram said. "That's huge; there's a lot of money to be saved by not having a patient in the hospital . . . It's also safer for the patient to recover at home."
da Vinci surgery does more than just provide good outcomes. "We've also seen tremendous growth," Mr. Bertram said. "Our da Vinci line outpaced our regular growth. We've completed more than 10,000 da Vinci-assisted cases."
In addition, this world-class da Vinci center has helped attract surgeons. "We're in a very competitive area surrounded by five other hospitals," Mr. Bertram said. "Many doctors are what we call splitters; they practice at multiple facilities. We have to provide the best place for them to work or they're going to go to one of the other facilities."
3. Creating a successful da Vinci program requires vision, alignment, culture change, communication, training and partnership. According to Mr. Bertram, health systems interested in building or accelerating their da Vinci program must start with a vision. "Share your passion through national outcomes data that focuses on incremental volume growth and how new service lines will make you more competitive and efficient," he said. "Illustrate what the cost and the revenue opportunities are going to be."
Communications and training must be consistent, transparent and ongoing. "Our VP of surgery makes sure that the staff is trained with da Vinci technology and she created a unique OR-only float pool," he added. "Folks have to be able to float to at least three areas and cross training is provided. This has been a great way to recruit and retain folks because it gives them opportunities to do different things."
Finally, Sky Ridge has valued its partnership with Intuitive, particularly its Genesis and MACA performance programs. "I can't speak highly enough about Genesis," Mr. Bertram said. "We've done four Genesis assessments since 2017 and we learned something new to improve or streamline every time. MACA is also a great service that Intuitive offers. Our partnership with Intuitive has been a game changer for us."
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