Interdisciplinary collaboration is the hallmark of the robotic surgery program at Inova, a leading five-hospital health system based in Falls Church, Va. John Moynihan, MD, President of Inova Surgery Service Line — which includes robotic surgery — attributed the success of Inova's robust robotic surgery program to "working together in a disciplined fashion, with all members of the team at the table."
He said Inova brings together nursing, surgery and administration to make decisions.
It is this spirit of collaboration that led Inova to have 27 individuals attend the most recent Intuitive 360 event. Becker's Hospital Review recently spoke with Dr. Moynihan and two other leaders from Inova about the health system's robotic surgery program and about lessons learned from Intuitive 360: Paula Graling, DNP, RN, Vice President, Nursing, Inova Surgery Service Line, and Art Sivaslian, Senior Vice President and Administrator, Inova Surgery Service Line.
Investing in robotic surgery
A trailblazer and national leader in surgical excellence, Inova has been performing robotic-assisted surgeries for decades, Dr. Moynihan said. The first robotic procedure was performed in 2001. Since then, the program has expanded to serve many disciplines, including cardiac, thoracic, urology, gynecology, head and neck, transplant, general surgery, and more. According to Dr. Moynihan, the outcomes justify the organization’s investment in the robotic surgery program. “Inova is committed to our patients, our team members and our mission to provide world-class healthcare,” said Dr. Moynihan. “Robotic surgery has become the standard of care. The technology further helps us to unify the delivery of surgical care and consistently achieve the best outcomes for our patients.”
Currently, Inova is in the process of transforming its operating model from hospital-based operations to service-line-based operations. As part of this transition, Inova is focused on standardizing care across the enterprise and reducing variation.
Expanding robotic surgery at Inova
Expanding Inova’s extensive robotic surgery program is an ongoing journey, supported by the organization’s leaders. Ms. Graling explained that two of Inova's five hospitals currently offer robotic surgery 24/7 and all five offer robotic surgery in the evening. Getting to this point has been a gradual process of increasing staffing and training.
Learning from Intuitive 360 and applying what was learned
At last year's Intuitive 360 conference, 27 leaders from across Inova attended. This included executive, clinical and operational leaders from each Inova campus. Mr. Sivaslian said Intuitive 360 "gave us the opportunity to learn from other systems that have also put together [robotic surgery] programs quite successfully."
In Dr. Moynihan's view, a big lesson was the need to establish a framework for robotic surgery governance. "One of the first big steps we took [after Intuitive 360] was getting all of the physicians, senior directors and nursing to come together to look at a model for communication and governance for the delivery of robotic technology." The model spanned establishing high-quality standards for performance and efficiency, credentialing, measuring outcomes and peer review. Mr. Sivaslian saw value in learning about building subgroups to tackle different parts of the governance structure and identifying initiatives to advance governance.
"I find the clinical education pieces to be most valuable," Ms. Graling said, who also liked the nursing peer-to-peer breakout sessions. Intuitive 360 had something for everyone on the robotic surgery team. "We recognize that the entire team is needed," she said. "Whether it's the surgeon, the surgical assistant or the robotic coordinator, we're trying to look at the roles of the team and how we prepare them to do the multitude of procedures that we do."
Advice for health systems on Intuitive 360
The leading recommendation was to have representation from the entire care team attend Intuitive 360. "Having a very diverse group of team members attend is important,” Mr. Sivaslian said. “They will each bring back significant learnings, education and perspectives.”
Ms. Graling added an important piece of advice. "Make sure you have the commitment afterwards to reassemble the team at your care site and share what each person learned from their individual sessions. You would lose the impact of the event if you don't debrief with your team and share all the learnings."
Dr. Moynihan agreed. "None of us is as smart as all of us. 360 highlights experts in the field who have also been on this journey to share lessons learned. Organizations that participate in 360 can take those lessons home and customize them to their own organization."
To learn more about Intuitive 360, please visit our Robotics Content Hub.