Maximizing Efficiency and Reducing Robotic Surgery Costs Using the NASA Task Load Index

Abstract

Perioperative leaders at our facility were struggling to meet efficiency targets for robotic surgery procedures while also maintaining the satisfaction of the surgical team. We developed a human resources time and motion study tool and used it in conjunction with the NASA Task Load Index to observe and analyze the required workload of personnel assigned to 25 robotic surgery procedures. The time and motion study identified opportunities to enlist the help of nonlicensed support personnel to ensure safe patient care and improve OR efficiency. Using the NASA Task Load Index demonstrated that high temporal, effort, and physical demands existed for personnel assisting with and performing robotic surgery. We believe that this process could be used to develop cost-effective staffing models, resulting in safe and efficient care for all surgical patients.

Roles, experience and views of nurses working in robotic surgery settings: A mixed-methods study

“…In addition to positive views, the nurses in this study reported that RAS was a very costly procedure for patients, their relatives, and healthcare institutions and organisations. The disposable nature of robotic surgical instruments and their production by only one company, setting high prices in the lack of commercial competition, led to increased annual maintenance costs (Moloney 2020, Walters & Webb 2017).…”

Clinical Issues — March 2023

“…During the preoperative briefing, the team members also should discuss patient factors that may increase the likelihood of conversion to an open procedure (eg, history of previous surgeries, known presence of adhesions) 2,3 and determine the appropriate level of preparedness (ie, having the identified resources in the procedural room and ready for immediate use versus verifying the availability of resources but not having them in the procedural room). Resources often used during conversion include additional surgical instruments (eg, retractors, laparotomy tray, vascular tray), 1,4,5 drapes, 1 soft goods (eg, radiopaque sponges), 1 supplies (eg, scalpel blades, suture, clips, basin, suction tip, tubing), 1,4 surgical energy devices (eg, electrosurgical pencil and unit), 1 irrigation fluids, 1 equipment (eg, irrigation warmer, suction device, headlight), 1 medications or blood products, 1 additional personnel, 1,4 and other items based on the anticipated procedure and surgeon's preferences 1,4,6 …”

Robotic Systems in Operating Theaters: New Forms of Team–Machine Interaction in Health Care

“…This raises many open questions such as: who will be the owner of what parts of the data, what will be done with them, and will they be used with beneficial or detrimental intentions, and for whom? 22 The discussion of these questions cannot only consider economic evaluations 41 which, in the worst case, could lead to limitations in the quality of patient care and security.…”