This article on infrastructure is the fifth in a nine-part series to support institutions planning to start a robotic surgery program. This nine-step programme is based on my book, “The Robotics Program: A How-to-Guide for Physician Leaders on Starting up a Successful Program”. The book is available on Amazon in paperback and kindle format. It can also be freely downloaded as a pdf. In part four of this series we examined the vital contribution that communication plays in the development of a successful program. Today we turn our attention to 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.
Overview of the infrastructure elements
Infrastructure refers to all the people, process, technology and cultural elements that are required for the successful implementation, management and sustainability of a program.
“People“ are the personnel who are essential for the smooth operations of a Robotics Program. They are characterized by the roles and responsibilities they have as members of the Robotics Program. They include: Physician Lead, Nursing Lead, Administrative Lead, Anesthesia Lead, Administrative Assistant, Data Analyst and the Multidisciplinary Representatives of the specialties utilizing the robot in the hospital. “People” is the element which answers the question, “who does the work of the Robotics Program?”
“Process” focuses on how the work gets done. Key process categories include things like: establishing regular meetings of the Robotics Program Committee, maintaining an agenda and minutes for the meetings, establishing a reporting structure, developing a communication plan for your stakeholders, having a structured approach to reviewing data, goal setting for the program, taking ownership of credentialing and privileges for robotics and establishing the programs credibility as the subject matter experts for the hospital.
“Technology” refers to things like: robot/case mix alignment (best robot for case type), electronic medical record (data collection), risk-adjustment and bench marking capability (performance improvement), centralized storage of documents (ease of access to information) and tele-conferencing capability (increasing engagement with easily accessible meetings).
Last, and certainly not least is demonstrating a strong robotics “Culture”. This is manifested with: a highly functioning performance improvement program, interest in becoming a center of excellence, history of quality awards or active pursuit of them, and a robotics supportive environment.
The four structural elements of people, process, technology and culture are a must for a highly-structured Robotics Program. They pave the pathway to success. Join us for part six of this series where we will focus on the role of accountability in a successful robotic surgery program.