Video Integration on Display

Today's modern surgeons are directors and executive producers of the motion picture institutes that are today's sleek ORs, routing video from and to any flat-panel, high-def display at the touch of a button. Let's look at what it takes to navigate the cabling, complex configurations, trials and vendor negotiations to successfully roll out integrated ORs at your facility.

Like most high-tech purchases, a trial is key. At a former facility, Jason Smith, MSN, director of perioperative services at Baylor Surgical Hospital in Fort Worth, Texas, worked with multiple vendors to set up on-site OR integration simulations in a conference room. He invited his top 15 high-volume surgeons and any others with a particular interest in integration to try out the various types of monitors, routing options, audio recording and videoconferencing technology. The goal was to determine exactly what would be beneficial for their needs and what would likely be a waste, he says.

He went with the lowest bid. That led to a 2-week delay in both of the ORs they were integrating. That was 4 weeks without any cases, a delay that wiped out any of the "savings" the vendor promised and wound up costing more.

"You get what you pay for," says Mr. Smith. "You can't get a gold nugget out of a penny."

If he had it to do over again, he would have found a creative way to stay within budget and still get the best results for his surgeons and staff. He offers this example.

Let's say your facility budgets $750,000 for 6 integrated ORs, and you wind up with a $1 million quote. Maybe you reach out to surgeons individually and ask, "OK, in which 2 primary ORs do you need videoconferencing capability?" Then, you outfit those rooms, pare back on the other 4 and save $6,000 to $7,000 per OR, he says. Another option: "Sit down with leadership and say, 'Look, outfitting 4 rooms is going to cost us a minimum of $650,000 with the vendor we want. So should we do 4 ORs now and do the other 2 in the next revenue cycle?'" says Mr. Smith.

Making sure the integration project stays on budget and your vendor(s) stick to the agreed-upon timelines is a project in and of itself. So you may want to appoint somebody to handle all the minutiae that comes with a typical integration.

"I recommend every facility assigns itself a dedicated project manager and financial lead to report the financial progress of the integration at every stage, document the progress, hold vendors accountable and provide any relevant feedback to staff along the way," says Robin Gallant, BSN, RN, director of surgical services at Lawrence (Mass.) General Hospital.

Too often the OR integration process is viewed only through the lens of business and administration. And that's a big mistake.

"You need both the clinical and the non-clinical perspective in order for it to work," says Ms. Kendall. "It's been a long time since I've worked in the operating room, so I need folks with real clinical expertise to let me know the features that are likely to cause issues or the components our ORs absolutely must have."

To ensure her facility got the dual perspective it needed, Ms. Kendall relied on clinical champions. "We had 2 surgeon champions as well as a nurse and a surgical tech," says Ms. Kendall. The benefit of surgeon champions is as much about efficiency as it is buy-in. After all, when you get physicians to buy-in to any major initiative, it's much easier to get other staff to follow suit. But often facilities fail to get other clinical staff involved and miss out on a golden opportunity.

"Our nurses and techs provide critical details from the circulator's point of view," says Ms. Kendall. They can speak to ease of use from the staff perspective and how intuitive a system is at communicating the surgeon's needs at the field to the circulating nurse, she says.

You need to get key questions answered early on:

• How easy is it for your staff to use the system and maneuver around the room?
• How easy is it for anybody in the OR to switch between screens?

"If your whole staff isn't able to easily use your system, it's useless," says Mr. Smith.

Involve a good cross-section of your staff in the vetting and trialing process as early as possible — everyone from service- line leaders to end-users like physicians and nurses, to installation team leads from IT, to entire departments such as finance, biomed and facilities, says Ms. Gallant.

Critical component

While price and technological features tend to dominate the discussion, it's often a post-install feature that dictates the overall success of a facility's OR integration. "Without a doubt, customer service is the single most important quality of an OR integration vendor," says Mr. Smith.

So how do you ensure your facility gets the superior service it needs from a vendor? Go out to other organizations in your area that have recently gone live with an integration, says Ms. Kendall. Ask them point blank, "How's the service? How quickly do they [the vendor] respond and resolve issues?" A lot times there are slight variations in the product, but huge differences in the customer service. Your peers can let you know about an unreliable vendor before you find out the hard way, she says. OSM