Surgical technicians Lee Quick and Nicki Miller ready “Ursula,” the new daVinci surgical robot.
If someone had asked Mike Brown two years ago whether Presence United Samaritans Medical Center would use a robot in the surgery department, he would have said “no way!”
Now, he talks proudly about “Ursula,” the newest addition to the surgical department.
“We’re pretty excited about it,” said Brown, regional president and chief executive officer at Presence United Samaritans in Danville and Presence Covenant in Champaign.
The da Vinci Surgical System is one example of how Presence continues to invest in its surgical program and other areas.
Presence isn’t a small-town hospital, he said; instead, it’s a real hospital in a small town that stays abreast of the latest improvements.
“We’re a community hospital — and we’re pretty good at what we do,” he said.
The medical center has completed or is about to complete several improvements — including relocation of the rehabilitation center, a soon-to-open clinical decision unit, addition of a cardiologist, changes at the cancer center, a concept for a family retreat area, and new programs to help patients stay well.
Meet Ursula
Presence has invested $2 million in the da Vinci Surgical System, and will have an open house later so people can meet the robot named Ursula.
The system isn’t in use yet, as the medical center waits on the last piece of equipment. Some doctors have already completed training on it.
The biggest advantage to using this system for complex procedures is that it’s minimally invasive, which means less pain, less loss of blood and a shorter recovery period for the patient.
A patient facing surgery usually had two options — traditional surgery with a large open incision or laparoscopy, which uses small incisions but is typically limited to very simple procedures.
The robotic system allows major surgery with just two or three tiny incisions.
The surgeon sits at a console a few feet away from the patient, and views a high definition, 3D image from a camera inside the patient’s body. He can see an image 10 times stronger than he could with traditional surgery. The surgeon uses the controls to move the surgical instruments, which are part of the robot.
The robot has four arms that carry out the surgeon’s commands, and tools that can operate with precision and delicacy. It has tiny wristed instruments that bend and rotate far greater than the human wrist, according to the da Vinci surgery website.
“The robot is doing the work as the doctor manipulates it,” Brown said. The equipment can be used on children, as well as adults of all sizes.
The robot cannot be programmed, nor can it make decisions on its own.
Also, the surgeon can do practice exercises at the console to keep his skills sharp.
The product is called da Vinci in part because Leonardo da Vinci invented the first robot. He also used anatomical accuracy and three-dimensional details to bring his masterpieces to life.
On the move
Patients who receive rehabilitation therapy at Presence now have a more convenient location, not far from the front lobby doors. The lab also is located nearby.
In the past, patients using the Rehabilitation Department had to make their way to the ground level, check in at the office and go across the hall to start their sessions. The new location is just off the main lobby, right behind registration; patients can register, check in, and start therapy all in the same place.
“That’s a really cool thing for the patient,” Brown said.
Another bonus is that users have a nice view of the outdoors, facing south (but passersby can’t see inside the large windows). Stained glass windows bring beauty to the room.
The department delivers nearly 6,400 therapy sessions annually.
Rehabilitation Services provides physical therapy, occupational therapy, industrial rehabilitation, and speech therapy.
ER changes
Rehabilitation Services had been located in an area that now will become a Clinical Decision Unit (CDU), an eight-bed unit that is part of the Emergency Department.
The construction has been completed, staff hired and training done; it’s expected to open soon, pending completion of the approval process.
The CDU will provide an alternative to discharge or hospital admission for patients who may need extended observation or additional diagnostic evaluation. For example, if a person comes in with chest pains, but there is no obvious problem or immediate danger, he will be held in the new unit until further tests are completed. That’s an alternative to admitting him, perhaps unnecessarily, or discharging him.
The average stay is expected to be six hours, Brown said. The private rooms have cardiac monitoring systems.
The ER staff also is working to reduce the time that patients are there; the average is 2½ hours, which is lower than the national average. The ER sees 40,000 patients a year, Brown said, and has room for 27 patients at a time.
The ER is working on “lean performance” — reducing the patient’s time from door to doctor. That means removing anything that gets in the caregiver’s way of giving excellent care to patients in optimal time, Brown said.
Cancer center
The community supports the Cancer Center, and Presence continues to invest in it, Brown said.
The program is accredited, with commendation, by the American College of Surgeons’ Commission on Canter — a recognition given to only 25 percent of hospital-based cancer programs in the nation.
The center recently acquired new equipment and software, an investment of more than $81,000. With funding from Presence United Samaritans Medical Center’s Foundation, the center purchased three new power examination tables, MapCheck for IMRT Verification, and a radiographic film processor/scanner for dosimetry verification.
The exam tables have power height and back adjustments, a 650-pound weight capacity, and allow for efficient patient positioning.
MapCheck is a two-dimensional therapy beam measurement system intended for quick and precise verification of the dose distribution resulting from an Intensity-Modulated Radiation Therapy plan. This device and software, in addition to a new film process/scanner will both be used for the latest quality assurance for precise radiation therapy dosage.
In addition, the center is able to offer more accurate treatments and fewer side effects with new technologies, such as PET/CT fusion treatment plans.
Positron Emission Tomography (PET) and Computed Tomography (CT) are both standard imaging tools that doctors have used to diagnose and monitor cancer. In the past, doctors had to review both PET scans and CT scans separately and mentally synthesize the data. Now, with image fusion technology, it is possible to design highly accurate treatment plans.
A CT scan can depict the size and shape of body organs and tissue; however, it cannot assess its function. A PET scan can determine function. Using PET/CT scans, doctors can specifically pick out which part of the tumor needs treatment while minimizing risk to the normal tissue and reducing the amount of side effects that patients experience.
Other projects
— Presence also is partnering with the Ronald McDonald House Charities to create a Family Retreat Area on the third floor. It will be a multi-generational oasis — something different from the chapel or the waiting room. The idea is to give visitors and family members a different environment for a while.
That area will be near the obstetrics waiting room; the nurseries will be moved to make room for the retreat area. The project is still in the design stage, Brown said, and fundraising is under way.
— Quality scores and patient satisfaction scores are high, with a Value Based Purchasing rating of 99.68, Brown said. However, that’s not good enough and teams are engaged to make the patient experience better, he added.
“I’m pleased with what our teams have done to enhance the patient experience,” he said.
— Helping a community stay healthy is important.
In March, CRIS Healthy-Aging Center partnered with Presence to offer seniors discounted meals. Presence provides the well-balanced meals at-cost as part of its giving back to the community.
Presence works with CRIS in several ways. A nurse visits CRIS weekly, offering education and blood pressure checks, and speakers go to CRIS a couple of times a month.
Presence also is trying to reduce hospital readmissions through Medicare’s new Community-Based Care Transition, which is being administered by CRIS. The program, created under the Affordable Care Act, is intended to improve transitions for Medicare patients as they move from the hospital to other health-care settings, to avoid complications that might require a repeat hospitalization.
In the pilot program that was conducted, the re-admission rate dropped from 29 to 6 percent, Brown said.
Another program, Project Boost, gives people educational materials when they’re leaving the medical center.
— Physician recruitment continues, with the following added: primary care, Drs. Rahat Sheikh and Kamatchi Ondiveerappan; surgery, Venkata Kakarla; and cardiology, Vijay Roy. In the past, Presence diagnosed cardiology issues, but the addition of Roy means that procedures can be done now.
Looking back on the year, Brown said, “I think we’ve had tremendous growth and success. We’ve accomplished everything we set out to do as a ministry and a health-care system.”
He added, “The credit goes to the doctors, nurses, management team and everyone who works in our ministry to ensure patients have an excellent experience.”
The bottom line is to help a community get healthy and stay healthy, he said.
FYI
For information, visit http://www.presencehealth.org/unitedsamaritans.
Source: Commercial News
Robotics 