An annual review of procedures performed at Sunnyside Medical Center revealed that urologic surgery has decreased. You are the Vice President of Operations in charge of surgery and you decide to meet with the Chief of Surgery and the Chief of Urology to determine why urological cases have declined by 39%.

At the meeting, the two Chiefs inform you that most of the prostate surgeries are performed in centers where robotic surgical system is available. Patients are informed consumers and many are arriving at their physician's offices with the robotic surgical system printouts in hand and inquiring if Sunnyside Medical Center has one. The patients cite the statistics of less pain, shorter length of stay, and faster return to normal activities of daily living that are posted on the robotic surgical system website. When the urologists associated with Sunnyside Hospital tell them no, that is the last time they see the patient. Consumers vote with their feet and wallets, including prostate surgery patients.

It quickly becomes apparent that if Sunnyside Medical Center wants to compete, they must purchase and operate a robotic surgical system. The physicians also hasten to point out that despite its consumer appeal, the follow are important to address:

Only 25-30% of the cases are appropriate for the machine.

The price tag is well over $1 million dollars. The VP of Operations estimates an additional $1,000 will be added to the cost of each prostatic surgery case.

Physicians and staff will need extensive training on the system.

Operating time will increase as will its use of more expensive disposable instruments.

Research has shown that hospital that acquire robotic surgical systems increase prostatectomy volumes and some estimates that hospitals can lose over $4,000/radical prostatectomy.

The robotic system can also be used in other areas such as bariatric surgery, gynecological surgery and thoracic surgery. However, costs in these areas will also increase.

Bottom line, to compete for urological cases, the robot has to be in place although it has to be considered a loss leader (a product that brings in customers for other procedures by virtue of having the robotic system at the hospital).

You have to decide if you want to bring this capital budget item to your Board of Trustees for review and approval at tomorrow night's meeting. But before you can d o that, you know you need to d o your hom ework - it's going to be a long night. Respond to the following questions in a new parabgraph and please use at least one professional healthcare quality resource to support your work and cite in APA at the end of your response.

Discussion Questions

Discuss the facts of the case including 1 quality and IT issue the case illustrates.

How would this system fit into Sunnyside Medical Center's mission, vision and value statement?

Discuss whether or not the costs support positive outcomes and quality of care.

From an administrative perspective, would you support the financial costs to both the organization and the patients for this technology?