Minimally invasive robotic surgery has evolved from ad-hoc acquisitions of robots by surgical departments to being part of an intentional programmatic approach designed to provide cutting-edge care.
During a workshop sponsored by Intuitive at Becker's Hospital Review's 12th Annual Meeting in Chicago, two leaders from Fort Myers, Fla.-based Lee Health — Scott Nygaard, MD, COO, and Jonathan Velez, MD, vice president of operations and chief physician executive — discussed insights and best practices for building a financially viable da Vinci service line.
Four insights:
1.) Perceptions of da Vinci-assisted surgery have evolved from transactional to programmatic. When hospitals first began acquiring surgical robots, those robots were mostly viewed as pieces of equipment that existed within the operating room, sometimes purchased for an individual surgeon and were available only at a specific location but were not attached to a particular program or broader initiative.
"When the [robotics] conversation became focused on what we wanted to accomplish in service to our mission, our values and our organizational priorities, that got to be a much more interesting program," Dr. Velez said. The consensus was around wanting to be trusted partners to patients, which meant paying attention to quality and consistency of care across all venues that had a da Vinci robotics program, as well as wanting to become an attractive place for physicians to practice.
2.) Establishing a da Vinci robotics service line can be a competitive advantage. The value of a da Vinci robotics service line is not in the equipment per se, but in how well that equipment fits into an organizational strategy for delivering on broader goals. "Everybody could have a robot, everybody could have certain aspects of equipment, but that's not the differentiator — the differentiator is the program or the experience or the outcomes," Dr. Nygaard said.
3.) To optimize care delivered at a da Vinci level, aligning executive, clinical and operational stakeholders is key. Crafting a vision statement for Lee Health's da Vinci program involved bringing together surgeons and operating room directors first to define the boundaries of what the program could look like. Then additional stakeholders from the finance, business development and quality teams were added to the conversation. Finally, the concept was presented to senior leadership for feedback, further input and decision about assigning of resources.
4.) Incorporating actionable data is essential to advancing program and volume growth. There are several categories of data that can help healthcare organizations calibrate their da Vinci surgery strategies as they advance them from concept to execution, including:
- Brand studies to understand what the community expects from its local or regional healthcare provider
- Google Analytics to glean insight into what people are searching for online when they search for surgery, and da Vinci surgery in particular
- Physician surveys to understand how physicians would use da Vinci surgery if access to it was no barrier
- An organization’s quality iniatives, such as decreasing hospital-acquired conditions, reducing readmissions, shortening length of stay and improving patient experience
- Metrics that can signal a need for additional training or access, such as moving through a learning curve to shorter OR times and greater efficiencies
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