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Robotics and the Physician Assistant

adding a PA to your robotics program leads to growth and improvement. Suzannah is available for Consulting Services and Speaking. http://leouno2.wix.com/roboticsurgery
by

Suzannah Sorin

on 4 January 2016

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Transcript of Robotics and the Physician Assistant

Robotics and the Physician Assistant:
PA within the robotics program leads to growth and improvement
Consistency:
"let's do it the same way every time"
Liaison for the whole team
RNs
Scrub techs
Surgeons
Residents/Fellows
Anesthesia

PA is a consistent member
Where have we made improvements?
Using the same operative suites for all robot cases
Having back-up supplies stored within the robot room
Streamline instrument trays
Disposable packaging sets
Resource maps and Room Layouts
On-going communication as a member of the operational oversight committee
Training:
Surgeons
Residents
PAs
Nurses and scrubs: frequent in-services
Positioning:
Room Layouts:
Prep and drape
Parallel Processing
First Assisting &
Console Training
Efficiency
"Conservation of motion"
"Lets do it faster"
"Cost Effective"
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PA Impact:
Comparison of PA versus non-PA centered room
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OR Cost per minute $115
Suzannah Sorin hired
Chronology of Robotic Growth
Q3 Run Rate
255 cases
3rd System added: Si
2nd System added: Si
Standard traded for Si
Robotics Director Appointed
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How to be more efficient
Room Layout maps for staff
Consistent operative suites. Park the robot
Consensus of Layouts to reduce equipment movements
Reduce packaging of disposables by creating case standard sets
Instrument consensus and create pared down caskets. Reduce time spent counting
Briefing and Debriefing
Familiarity with auxiliary equipment
Backup supplies for robotic cases in the room
Limit frequent flyer staffing
Growth
The Role of the PA in Robotics
$3,795 saved per case
At 3 cases per day, potential savings of $11,385 per day
Weekly savings of $56,925
Yearly savings of $2.96 mill which more than pays a PA salary
Cost Savings of having a PA
Cost to run an OR $115/min
"Let's do it better"

"Let's do it best"
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Utilization Comparison
40%
89 mins
60%
133 mins
Console Time
43%
115 mins
Current Average
(3 hrs 42 mins)
Non–Console Time
57%
153 mins
Target Average
(3 hrs 42 mins)
Previous Average
(4 hrs 26 mins)
52%
115 mins
48%
107 mins
MIUU Efficiency – Improvement Results
My role at NYU: Robotics Coordinator
First Assistant
Communication
Teaching
Efficiency strategies
Consistency
Data supporting use of PAs
Cost savings having a PA

Suzannah Sorin, PA-C
Thank You!







Questions/Comments

The right PA provides:
Consistency
Training
Efficiency
Growth

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Responsibilities:
Clinical
Administrative
Technical
Other

What is a Robotics Coordinator?
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Clinical
First Assistant, Obtain informed consents, orders, sign out, etc.
Clinical troubleshooting of the daVinci System during robotic procedures
Setup of the daVinci system for robotic procedures
Supervise the preparation and positioning of patients for robotics surgeries
In-service and teaching of residents, fellows, and PAs
Develop and maintain records of resource maps for robotic surgical procedures
Develop and maintain patient safety protocols
Pre-clamp checklists
Positioning standardization
Develop on-going efficiency strategies
Develop strategies for improving efficiency in OR
Develop and collect database capture sheets for efficiency
Review and analysis of efficiency data
Implementation of improvements for efficiency based on data patterns
Robotics Coordinator Job Description
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Robotics Coordinator Job Description
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Technical:
Manage routine and preventative maintenance on daVinci Surgical System
Report and communicate with daVinci Field Engineer on technical issues
Knowledge of setup and troubleshooting for auxiliary equipment for daVinci procedures (Gyrus ACMI, BK ultrasound, Gynecare and Storz morcellators, Enseal, cystoscopic and laparoscopic equipment, etc)
Conduct daVinci System training via Interactive Training Tool
In-service OR Nursing and CST staff on pre-, intra- and post-operative management of the daVinci System

Other:
In-service central Supply/Processing regarding cleaning and sterilization of Endowrist instruments and accessories
Serve as a point person for any daVinci related questions (system or clinical)
Liaison between robotic surgeons and nursing/CST staff
Demonstrate daVinci system to visiting surgeons or groups
Robotics Coordinator Job Description
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Administrative:

Attend Robotic Surgery Operational Oversight Committee meetings
Attend Robotic User group meetings
Manage Robotic Attending time-off calendar
Manage Robotics PA schedule
Supervise and train Robotics PAs
Read-back communication
2013 Q2 Run Rate 308
There are no other NYC hospitals with 4 systems (NYU Q2 RR 308):
Hospital 1: 3 systems 293 cases
Hospital 2: 3 systems 183 cases
Hospital 3: 5 systems 458
Full transcript