Oct 16

The Robotics Program: Introduction (1 of 9)

Introduction October 16, 2017 367 0 By - Dr. Terry Loftus, MD, MBA, FACS

Several years ago, while working as a Medical Director of Surgical Services for a large healthcare system in the southwest, I had the opportunity to review a substantial amount of data and information regarding our robotics assisted surgery programs. Because of that review, combined with what I have learned since then, I’ve concluded that highly-structured programs perform much better compared to poorly-structured programs.
This is the first in a nine-part series describing exactly what a highly-structured program is and how to develop one. Before we go into the details, let’s look at the data supporting this statement regarding program structure.

There was significant variation in outcomes across our system and we wanted to understand what was driving this variation. One of the more obvious drivers was surgeon volume. When we compared the high-volume surgeons (top 20th percentile) to the low-volume surgeons we found marked differences in complications and costs. The risk of complications was 36% greater for low-volume surgeons compared to high-volume surgeons. Costs were 20% higher for low-volume surgeons compared to high-volume surgeons. This wasn’t the only driver of outcomes.

We could see variation in the facilities as well. Through a series of surveys and site visits, we determined that each facility’s robotics program was structured differently. Highly-structured programs performed better. The complication rate of a poorly-structured program was 46% greater than a program that was highly-structured. A similar observation was made with cost. The cost in a poorly-structured program was 37% higher compared to a highly-structured program. Since this analysis, I’ve spoken with hundreds of people involved in robotics programs across the country. This is not an isolated observation; more and more programs are realizing the benefits of organizing their program for superior performance.

This series will describe one way to organize your program. It is based on a simple model known by the mnemonic SPECIAL PI. This stands for Seven Pillars, Purpose, Engagement, Communication, Infrastructure, Accountability, Leadership and Performance Improvement. Each segment of this series will describe these pillars in more detail. To learn more, go to https://loftushealth.com/and download a free PDF copy of The Robotics Program: A How-to-Guide for Physician Leaders on Starting Up a Successful Program.

Dr. Terry Loftus, MD, MBA, FACS
Dr. Terry Loftus, MD, MBA, FACS
President at Loftus Health

Dr. Terry Loftus is the President of Loftus Health a healthcare consulting company committed to educating physician leaders on how to successfully implement programs that improve the delivery of healthcare. Prior to this, Dr. Loftus was the Medical Director of Surgical Services & Clinical Resources for Banner Health in Phoenix, Arizona. His undergrad work and MBA are from Arizona State University and his Medical Degree is from the University of Arizona. He completed a residency in General Surgery at the University of Utah and a Trauma Surgery and Surgical Critical Care Fellowship at the University of Maryland’s R Adams Cowley Shock Trauma Center in Baltimore, Maryland. Dr. Loftus is also a graduate of the Advanced Training Program for Executives and Quality Improvement Leaders sponsored by Intermountain Healthcare’s Institute for Healthcare Delivery Research. Dr. Loftus has served in various leadership roles including Chief Medical Officer as well as a Medical Director of a Surgical Intensive Care and a Level 1 Trauma Center. He is board certified in General Surgery and Surgical Critical Care, and is a Fellow in the American College of Surgery.


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