How to Start a Sustainable RAS Revolution in Your Hospital

Building and managing a robotic-assisted surgery program in 3 steps

Medtronic Robotics System Utilization Manager, Berta Ortiga, a former hospital operations manager and deputy hospital CEO, joins us to share her experience and perspective on the best way for hospitals to approach investing in robot-assisted surgery technology and building a successful robotics program.

To start, we’ll first let Berta answer the big question: Why should a hospital entertain the idea of a robotic-assisted surgery program? “Adding or expanding robotics in a hospital’s portfolio aligns with goals to deliver better care by broadening the adoption of MIS procedures. Not only can that attract patients, but also talent – the surgeons of the future will be using robotics more and more.”

But, as Berta points out, there really is a lot more to it than just being a forward-thinking healthcare provider. 

#1: Prepare for a successful RAS program

Preparation is everything leading up to the first surgery, it's the kickoff of the robotic-assisted surgery program in the hospital. “The hospital needs to go deep into analyzing their needs and goals,” Berta explains. “There are strategic decisions to be made. It’s important to establish proper governance, and the right program management. Someone needs to be responsible for the use of this technology and represent the surgeons and nurses who will be using it. Even the installation process requires some assurance that in the facility everything and everyone is going to be ready to receive the robot” she adds.

She suggests beginning with some high-level questions to help define program objectives, such as:

The analysis process involves a combination of clinicians, nurses, and administration. It requires alignment to ensure a smooth implementation of the technology on a short and long-term basis.

The second part is preparing for the first surgery. The hospital needs to train the right surgeons, as well as nurses and OR staff to cover all the procedures. This technology cannot be left to untrained professionals. It's like an orchestra in the OR and everything needs to be aligned and coordinated to ensure a safe and smooth surgery. Additionally, all items needed for an agile RAS will be checked to ensure a safe and successful first procedure such as preference cards, and sterilization. It’s also important before the first surgery to perform a dry run with the entire clinical team.

#2: Initiate the first cases

After the first clinical team has been trained and the hospital has done all the rehearsals or ‘dry runs,’ it’s time for the first surgery with a patient. The first 15-20 surgeries are probably the hardest part of the learning curve and should be performed during the first 7-9 weeks after the first surgery. In this phase, the utilization team needs to be very present to guide the clinical staff, surgeons, and nurses to ensure a good experience with our technology, and the focus is patient safety and quality. Everyone wants to be sure early procedures and the overall adoption process go smoothly, so that clinicians are committed to the benefits robotic technology can bring to their professional lives, and that the results are what everyone expects.

#3: Expand for optimized utilization

The next phase is the roll out for using a RAS system, among different surgical specialties and to perform diverse procedures. This phase should align with the hospital’s progress towards its robotic program objectives. The expansion phase is crucial to ensure high utilization of the investment. In this phase it's critical to focus on efficiency to maximize access to the technology. Hospitals need to establish and track metrics on OR turnover times, instrument and supply standardization, and operative times in order to advance towards an optimized surgical robotic program.

“This is a fundamental part of our perioperative process on how to improve the use of the technology, minimize waste of resources - whether these resources are material or human: time, consumables, and more.”

By following the "3 Rules of Engagement", hospitals can establish and expand their surgical robotics programs, and ensure that their investment in capital equipment is optimized to meet both short and long-term goals.