Seamless Integration of Your New OR

Standardized equipment control from one central location boosts your staff’s workflow and optimizes efficiency.

With the rapid advances in computing power, artificial intelligence (AI) and remote operation capabilities, today’s integrated ORs can do wonders for facilities.

As impressive and exciting as the latest technology is, the cost may make it financially prohibitive to incorporate the newest models. But you still have plenty of options.

Building it up

Having an operating room to boast about in 2023 means having one with the latest and greatest tech — be it touchscreen controls for innovative devices or wireless connectivity to electronic medical records and intraoperative images that lead to more precise and efficient surgery. But it’s not just the cutting-edge equipment that’s important for success; it’s upgrading with scalable platforms that can be outfitted for the present but designed for seamless upgrades in the future.

That’s why the thought process behind any changes in the OR must include both a present-day and future viewpoint to ensure a seamless integration for years to come.

In August 2022, Cohen Children’s Medical Center (CCMC) in Queens, N.Y., opened eight state-of-the-art operating rooms and a 27-bed PACU. During the years of planning and preparing for opening, technology was at the forefront of its leadership’s vision.

“The standardization of the video system allows us to have seamless integration with compatible surgical equipment to streamline workflows and optimize efficiency,” says Theresa Nolan, RN, BSN, MSN, associate executive director of perioperative services at CCMC. “There were several key stakeholders, including the surgeons, in the vendor selection process.”

Seamless integration, streamlined workflows

Just prior to the inception of the OR, the perioperative team — surgeons, anesthesiologists, nurses and surgical technicians — participated in multiple simulations to understand all the capabilities that the new integrated system offered.

“Technology, just like health care, is always evolving,” says Ms. Nolan. “In this ever-changing climate, it’s necessary to ensure any platform that you seek comes with the ability to upgrade and adapt to the constant technological advances. Keep in mind that there will always be upgrades and maintenance, but the benefits of technology bring efficiency, standardization and safety to our children’s procedures.”

Surgical technology is being enhanced every year, so modernizing and integrating an old system or building a new one will allow organizations to use the newest technology on the market. “Without a digitally integrated foundation, many revenue opportunities, top surgical recruits and even marketing campaigns will be out of reach,” Ms. Nolan says.

More precise and efficient surgery

In CCMC’s ORs, technology has enhanced the surgeon’s capabilities. First, 3D visualization on multiple screens assists in teaching, provides opportunities for teleconferencing and provides images from other departments. Second, it has assisted practitioners in more precise incisions, due to the mapping ability from customized software. Third, the technology has helped decrease the amount of anesthesia, allowing staff to return children to their families more quickly.

“Our system allows the circulating nurse to set up the room based on the individual surgeons’ preferences for equipment settings and lights,” says Ms. Nolan. “It also allows us to have the child’s favorite movie or song playing in the OR before they come into the room for their procedure. The technology even ensures we stay connected to our patient families and they are well aware of where their child is along the timeline of the surgical process. This all helps support communication and sponsors an enhanced patient-family experience.”

Don’t jump too fast

HIGHER GROUND Robotics have taken minimally invasive surgery to a higher level — providing more precise operative maneuvers.

As newer technological innovations become available, certain features or add-ons can be enticing. But make sure adding new features does not distract or remove the fundamental value of the solution you’re investing in to begin with. Sometimes the bells and whistles are useless and potentially harmful to the primary goals of the facility. That’s why it’s important to thoroughly research any new offerings and avoid investing without doing your due diligence.

“Look before you leap to ensure you analyze the system. Make sure the new product is comprehensive and provides services that you need now and in the future,” Ms. Nolan says. “Always ask, ‘Is it scalable?’ Collaboration and communication across the perioperative service is needed.”

The search for new integrated OR systems opens up opportunities to visit other organizations to learn about successes and failures of specific products as well as their working relationship with specific vendors and the support they have received in the long term.

Consider what happened with those who invested in laparoscopy technology over the past five years. Ronald Grifka, MD, chief medical officer with University of Michigan Health-West in Wyoming, says several years ago minimally invasive laparoscopic surgery replaced open surgical methods for many procedures. Laparoscopy resulted in smaller and less invasive incisions, more rapid recovery, less pain and reduced need for narcotic medications, all of which were positives for the patient. However, there was a noticeable cost to obtain the laparoscopic instrumentation.

“Competition to produce the equipment increased over time and the cost of laparoscopic surgery decreased,” he says. “Over the last five years, robotic surgery has taken minimally invasive surgery to a yet higher level, providing more precise operative maneuvers. For many procedures, robotic surgery has become the standard of care — making some of the recently purchased laparoscopic equipment obsolete.”

Due to challenging healthcare finances, the funds to purchase this new technology are becoming more difficult to obtain.

With several equipment options available to perform the same procedure, choosing the technology that will provide the best results and offer the longest lifespan is crucial to any competitive HOPD’s or ASC’s success.

“Purchasing requires a strong and trusting relationship between the surgeons and administration, and significant input and attention to detail by both parties to avoid ‘jumping on the new technology bandwagon’ too early or waiting too long,” Dr. Grifka says. “This process may include overlooking a previous relationship with a vendor to investigate new technology from a new one. That said, an established vendor who provides excellent post-purchase support and a reliable upgrade path can be a valuable ally.”

Money matters

The added benefits of new, integrated systems and equipment ultimately enhance the care you provide your patients. As such, determining an ROI is not always the top concern.

“We have specific niches of procedures that require additional equipment, supplies and instrumentation,” Ms. Nolan says. “While cost is considered, our focus is on quality of care, efficiency, and patient and surgeon satisfaction. The added ability to create new programs and perform new procedures elevates our skills, capabilities and reputation.”

Technology, like healthcare, is always evolving. In this ever-changing climate, it is necessary to ensure that any platform that you seek comes with the ability to upgrade and adapt to the constant technological advances.
Theresa Nolan, RN, BSN, MSN

Two interesting areas of technology advancement, Dr. Grifka notes, are lasers and hybrid procedure rooms — both of which can be cost-prohibitive.

“There are many different lasers, and indications for their use are increasing on a regular basis,” he says. “On occasion, a certain type of laser can be used by several specialties, increasing the number of patients benefiting from this technology and improving the return on investment. A laser can provide a more focused and discrete incision than a scalpel, and can be advanced into a more distal location than a scalpel.”

Meanwhile, hybrid procedure rooms combine an operating room environment with the technology of advanced imaging (X-ray, CT or MRI). During surgery, an imaging study can be performed in real-time to guide the procedure, eliminating the need to obtain an imaging study in radiology after surgery, then bringing the patient back to the operating room for another operation.

“When devised in focused discussions between the surgeons and administration, patient care is optimized and the equipment cost can be tolerable,” Dr. Grifka says. “To offset the high cost of acquiring new equipment, philanthropy is always the best plan — offering the opportunity to name an operating room or procedural suite can engage benevolent community members.”

Another option is to negotiate with a vendor a “per-use” charge. By determining the number of procedures a device will perform over several years, the cost of the device can be distributed over each procedure, eliminating the initial large purchase cost. OSM