Team Development at Downstate
Downstate University had not done robotic heart surgery in the past. In order to train the surgical team, we performed a series of “dry runs”. This involved setting up the OR as close as possible to a live case and then rehearsing the normal course of events as well as emergency scenarios.
St Francis Medical Center Gala
At the annual fundraising Gala for St. Francis Medical Center on June 4, 2016, Dr. Poston and the Department of Cardiac Surgery were honored with the “Healing Hands Award”. The recipients of this award were selected by the hospital board to represent the spirit and drive of St. Francis. Dr. Poston’s acceptance speech at the Gala is included.
Weekly Cardiac Debriefings
Our regular debriefing sessions at St. Francis include everyone in the OR – anesthesia, surgeons, nurses, techs, PA’s, perfusionists and hospital administration. This effort illustrates that we acknowledge communication has been dysfunctional in the cardiac surgical OR in the past. Sadly, this problem is known to be responsible for a considerable portion of preventable adverse events at other institutions analyzing this issue.
The main goal of our weekly meetings is to get past the traditional one-sided communication (i.e. surgeon tells staff what to do) into a new two-way approach that taps into the insights and wisdom of others in the room. To accomplish this, the lead surgeon is responsible for creating an environment where everyone feels comfortable speaking out. It has been helpful to follow the model of military debriefings where military ranks are temporarily ignored to allow each member to become an equal witness for the duration of the debriefing.
Obviously, this activity is attractive to OR staff because it empowers them to help problem solve and avoid surgical complications. In addition, our hospital’s commitment to the speedy resolution of problems identified in the debriefing process has been an important part of why this activity has been popular even among the surgeons asked to cede control.
Monthly Support Group Meetings
The support group for the department of cardiothoracic surgery meets monthly. There are a variety of goals for this meeting. Most importantly, it provides a forum for past and future patients to meet with each other and with their cardiac surgeons.
This type of social interaction has proven valuable for reducing the anxiety of recovering from heart surgery. The continued chance to interact socially also helps demonstrate our surgical program’s commitment to their long term outcomes.
We want to show that we are not just interested in them 30 days after surgery. Some agendas include updates on the program at St Francis. The attached picture demonstrates a support group gathering that was given a live demonstration of how the da vinci robot works. Several patients that underwent a robotic procedure gave us feedback that they were often asked about their surgery and had a hard time explaining what the robot did. They wanted to see the robot up close and understand how it works better. So we used one of the support group sessions to bring the robot in front of our patients and provide this information. After the demo, it was particularly interesting to see patients get a chance to “test drive” the same robot that operated on themselves.
This is a prime example of how we use the support group to grow our relationships with patients.