MD / MBA The Robotics Program

A How-to-Guide for Physician Leaders On Starting Up a Successful Program
1. Auflage 2016
ISBN: 978-1-4835-7395-3
Verlag: BookBaby
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 76 Seiten

The Robotics Program: A How-to-Guide for Physician Leaders on Starting Up a Successful Program builds on the concept that successful programs can be differentiated from unsuccessful programs by seven core elements. Dr. Loftus describes his personal journey as a physician executive in developing a surgical robotics program for a large healthcare system. He demonstrates how to incorporate the seven core elements in the development, implementation and sustainability of a robotics program.

Autoren/Hrsg.

MD,

MBA,

Leseproben

CHAPTER 1
SEVEN PILLARS Several years ago I began a new role as a physician executive for a large integrated delivery network. My previous role was as a Chief Medical Officer of a large community hospital and before that as an Acute Care Surgeon at a Level 1 Trauma Center. The new role was a corporate position, and my title was Medical Director of Surgical Services and Clinical Resources. One of the primary functions for the system’s surgical services was to oversee clinical quality and patient safety. This involved guiding the development and implementation of clinical practices across the system. The other primary function was to work alongside, and advise supply chain services, especially with regards to surgical services. On my first day of work at the corporate office, one of the members of our senior management group stopped me in the hall and asked, “Terry, what do you know about robots?” “Not much”, was my reply. “Do you have a strong belief, either way, regarding robotics? He pressed. “Not really”, I said. “I’m pretty much an agnostic.” “Perfect”, he said, “we would like you to learn as much as you can”. And so began my journey. His real concern was the system invested millions of dollars in robotic technology, and was still not sure if it was a good investment. They wanted someone who was a surgeon who could provide insight into this investment, and guidance for the system. They received plenty of opinions from surgeons who either supported or didn’t support the use of robotics. What they needed was someone who was relatively neutral to the technology, and was willing to do a deep dive into the vast amounts of data the system collected on robotics. The hope was that mining the data of twenty robotic systems in thirteen facilities would reveal new insights regarding the technology. I’m a bit of a data geek and I love a great mystery, so I was perfect for this adventure. What I hope to convey to you in this book is what I learned along the way. Before we delve any further, I want to say a word about who the audience for this book is. It is primarily for people who want to develop a Robotics Program for a hospital or system. It is also for those who already have a program in place and are looking for ways to improve it. While it doesn’t matter which type of robotics systems you are using, this program was primarily developed around the Intuitive Surgical system. By the end of 2015 there were almost 3,600 Intuitive Surgical da Vinci systems installed worldwidei. Two-thirds were in the United States and one out of every six systems was in Europe. There is a good chance you are working in one of these facilities. Regarding the evidence, this book will not go into an exhaustive review of the clinical literature regarding robotic assisted surgery. In addition, this book is not a replacement for other programs such as: Intuitive Surgical’s Genesis Training Program, the ECRI Institute’s Robotic Surgery Planning Program, The Center for Applied Value Analysis (CAVU) program for robotics or the program from the Texas Institute for Robotic Surgery. This book is meant to supplement these excellent programs. You are reading this book because you wish to expand your knowledge of how to build a successful Robotics Program. You are also reading this book because you may still have some doubt, and want to know what would transform someone from a robotics agnostic to a robotics believer. As you may have already determined, I am no longer agnostic to the technology. I believe it has a role in the discipline of surgery. I also believe its role is slowly evolving as the technology improves, and the clinical evidence for its best use is slowly being revealed in the literature and in the proving grounds of the operating room. As it turns out, it is not as simple as buying a robot and setting it up in an operating room. Yes, it is a tool, and like all tools it works best under specific conditions. This book is about what programmatic elements need to be in place to get the most out of this tool for optimal utilization, cost and clinical outcomes. This book is presenting a hypothesis. The hypothesis is: A structured Robotics Program with specific, defined elements produces better quality at a lower cost than a relatively unstructured program. The good news is there is some support for this hypothesis, although much of it is built on limited data and anecdote. We must start somewhere and this is as good a place to start as any. In fact, much of what we practice in medicine has a similar beginning. So back to the start of the story, and how I went from agnostic to believer. I love data. In my role I had access to an unprecedented amount of data about robotics. It was everything the system collected. It included financial, utilization, supply cost, equipment cost, and clinical outcome data. We even had data provided by our vendors. I could slice and dice it any way I needed. I reviewed data for the system, region, facility, specialty, service line, case type and down to the individual surgeon. The data was from multiple years (2010 – 2015), so I could see trends in all of these various categories. The data could be risk-adjusted and bench-marked to peer facilities across the United States. From all of this data, and my experience developing Robotics Programs, I started to see certain patterns emerge. When I began describing these patterns in lectures across the United States, I encountered other people, in other healthcare systems, who were seeing similar patterns. This book is a compendium of what I learned in the process. We are going to begin at the sixty-thousand-foot “system level” and bring it down to the dry, sometimes very mundane, “operational level”. So to begin, what is a Robotics Program? A Robotics Program is a facility or system based program, which is a comprehensive, multidisciplinary approach to implementing, supporting and utilizing robotically assisted technology for surgical procedures. The purpose of the Robotics Program is to improve the quality outcomes for patients, optimize the utilization of the robots, work to decrease the total cost of care of surgery and enhance the work place experience of the staff involved in providing care to patients undergoing robotic assisted surgery. A Robotics Program is the overarching structure, whereas, a Robotics Committee is the formal Executive arm which provides oversight in determining how that structure is integrated into the system and how it performs. In the remainder of this book we will discuss the specific features of a successful Robotics Program and especially successful Robotics Committees. In the remainder of this chapter we will focus on what I refer to as the Seven Pillars of successful programs. These are higher level elements that all successful programs build into their structure. To remember the Seven Pillars, think of the mnemonic “SPECIAL PI”. This stands for, Seven pillars, Purpose, Engagement, Communication, Infrastructure, Accountability, Leadership and Performance Improvement. Chapters two through eight will provide a description of each element in detail. The appendix is a checklist for how to start-up a successful program and specifically a successful Robotics Committee. The following is a summary of the seven pillars. The Seven Pillars 1. PURPOSE: There are key elements to any successful Robotics Program. It begins with having a purpose. Everyone on your team must understand the “why”. In chapter 2, we discuss the why in detail. In summary, it is because a formal organized approach to delivering robotic assisted surgery produces better outcomes at a lower cost compared to not having a program. 2. ENGAGEMENT: Engagement has become a buzz word in the healthcare industry. More specifically hospital administrators and physician leaders want “physician engagement”. For many it has become a quest for the Holy Grail. The unstated belief is, “If we only had physician engagement, then we could solve all of our problems in healthcare.” There is no doubt that physician engagement is important for change management in healthcare. Before we get to this place though, we need to set up our program to become engaging. Chapter 3 will discuss this in greater detail. In summary, the first step in this process is to stop doing those behaviors that disengage people and move on to those behaviors that create an engaging program. 3. COMMUNICATION: Programs must communicate to their members, leadership, patients and other stakeholders. It is impossible to educate and inform people without a consistent process for communicating to them. Communication must be a two-way process. A program must not only communicate to its stakeholders but its stakeholders must have a mechanism to communicate to the program’s leadership. Chapter 4 covers more specific information on how to communicate effectively. In summary, effective communication increases stakeholder support. If you want to be successful, then you must communicate effectively. 4. INFRASTRUCTURE: All programs must have a well-developed infrastructure. A program’s infrastructure is the foundation on which the program will develop and sustain itself. This is often considered the boring work of building a program and therefore nonessential. Unfortunately, many organizations overlook this important element. In...