Here are five ways spine surgeons can save precious minutes in their clinic and operating room that could ultimately be used to spend extra time with patients or on other professional activities.
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1. Schedule staff members and procedures in an efficient manner. Closely monitoring when staff members and procedures are scheduled minimizes, if not entirely eliminates, down time between procedures and cuts out unnecessary staffing expenses.
"Each physician at our spine center has a template that's built into our practice management system, and those templates determine how many patients there will be in one hour and what procedures will be done so that we can efficiently move patients around," Kathie Stewart, administrator at Cascade Spine Center in Tualatin, Ore. "There's no down time between patients, but it also allows enough time for procedures and keeps everyone on time."
2. Stick with experienced operating room staff. Spine surgeons must have a high level of expertise among their operating room staff to appropriately utilize OR time. Staff members should be familiar with the minimally invasive technique and experienced with the surgeon, which means working with the same team for every surgery if possible.
"Everyone should know everyone else and be comfortable in the operating room, who the patient is and what is being done," says Brian R. Gantwerker, MD, of The Craniospinal Center of Los Angeles. "There should be specialized teams formed where people know spine very well and others are cross trained to speed up the process. There is a lot of teamwork in the OR and everyone has to be comfortable working together and having an open and efficient discussion when issues come up."
Just like surgeons, the operating room staff will have a learning curve when you first begin performing the minimally invasive procedures. However, with the right preparation work and repetition, the staff will become as efficient as the surgeon in the operating room.
3. Make sure proper equipment is available. Equipment efficiency is one of the most important elements for making sure a case runs smoothly. Have the proper equipment available and make sure there is a replacement if necessary. Your nurse should be in charge of coordinating these materials before the case begins.
"If, for example, a certain cervical retractor isn't available, the nurse should communicate that to the physician and have alternative options ready," says Dr. Gantwerker. "All it really takes is a couple of hours when setting up the spine service to go over preferences. Make sure all spine surgeons are present so there is unification of practice; it will make the service line more efficient because there will be less hunting for different equipment."
4. Standardize where possible. The time consuming nature of spine practice has required renewed efforts in efficiency. The standardization of procedures is one key to increasing efficiency. Marilyn Gates, MD, neurosurgeon with Spectrum Health Medical Group in Grand Rapids, Mich., offers the example of standardized operating trays. Tools for spine surgery normally spread across two or three trays can be condensed to a single tray, eliminating the need to switch from tray to tray.
Specialized instruments can be placed in storage labeled with surgeon names to be easily reached when needed. Standardized operating rooms can save on preparation, operation and turnover time, contributing to overall efficiency and time management.
5. Collect patient history before the appointment. Use electronic medical records or online, HIPAA-compliant patient portals to gather patient history and information before the visit. This way your staff has all the patient's information ready when they walk in the door and can prepare appropriately for the visit. Additionally, if the patient should have imaging studies or other test results, you can make sure they bring them to the appointment for your examination. This streamlines the process for patients who are unable to develop the treatment plan without their test results.
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