At the 10th Annual Orthopedic, Spine and Pain-Management-Driven ASC Conference in Chicago on June 15, John Peloza, MD, an orthopedic spine surgeon specializing in spine care at the Center for Spine Care in Frisco, Texas, presented six key concepts for successfully introducing spine surgery to an ambulatory surgery center.
1. Minimally invasive spine surgeons. Although it may seem intuitive, in order to introduce spine surgery to an ASC, it is imperative to have surgeons who conduct minimally invasive procedures. "You have to have the right surgeons doing the right operations," said Dr. Peloza.
2. Equipment. The right equipment is also very important. The equipment an ASC should have to conduct spine surgery includes: retractor systems, instrument sets, microscopes, endoscopes, headlamps, drills and operating room tables.
3. Anesthesia. An ASC will need the right anesthesiologists who can handle complex patients, said Dr. Peloza. "[Center for Spine Care] prefer the [anesthesiologists] who can handle anesthesia for complex patients and who are very experienced in spine and neurosurgery, " said Dr. Peloza.
4. Staffing. Staffing is the fourth key concept. "If you have the wrong people at your ASC, you are going to have troubles," said Dr. Peloza. What Dr. Peloza means by the "right people" versus the "wrong people" is that an ASC needs employees with spine and pain experience. Having both is even better, said Dr. Peloza. In addition, employees in the operating room really need to have spine experience. The employees that are critical to an ASC include the scrub tech, circulator, radiology techs and pre/post-op nursing. For the clinical director, Dr. Peloza recommends that they are familiar with ASC rules and regulations, have experience and training in spine, are organized and exert effective leadership.
5. Radiology. It is important to have radiology at the ASC. "At our center, we have an x-ray area and MRI and CT capabilities. We also have a post-op MRI available, " said Dr. Peloza.
6. Convalescent center. The sixth key is a convalescent center because it allows the ASC to expand its caseloads or to offer the "whole shebang," as Dr. Peloza put it. With a convalescence center, the ASC can also use private nursing, decrease the incidence of transfers and offer a "medical hotel" to patients.
To conclude Dr. Peloza added one final thought. "Those six key things are working great at [Center for Spine Care]. However, one final key is a good business partner. You do not want to go bankrupt and that could happen without the right guys helping you out," said Dr. Peloza.