The 2015 Carter Report, Operational productivity and performance in English NHS acute hospitals: unwarranted variations, makes a number of recommendations that are as much about changing practices as looking at cost-savings – spend the money wisely and the savings will take care of themselves.
The subtitle of the Carter Report, unwarranted variations, hints at the main problems facing healthcare – does it make sense for a hospital to have thousands of suppliers when hundreds would do? The emphasis is on enabling standardisation and optimising supply and service, as well as delivering volume discounts. The first chapters of the executive summary of the report are entitled ‘Optimising resources and quality, efficiency and productivity’. In light of this, KARL STORZ asks whether it makes sense for the tools of the trade of an operating theatre, i.e. surgical instruments, to be poorly maintained, or take weeks to be returned – simply because the unit cost of a repair (prima facie) is lower? Is it the best use of time to expect a surgeon or theatre nurse to be trained in front-line maintenance of surgical equipment? Is it efficient to have surgical trays consisting of equipment from three or four manufacturers? What is the true cost of faulty or missing equipment?
These recommended changes in practices and the necessary investment in functional equipment is all well and good, but how are NHS hospitals going to afford it when, as we know, they are challenged by the increasing lack of capital funds? Rather than lobbying for increases in NHS budgets, KARL STORZ tackled the problem head on by challenging whether the business model of cyclical capital investment was, in fact, sensible, which in turn led to the development of SMART Solutions.
SMART Solutions (Strategic Management of Assets and Resources in Theatres) is a bespoke partnership programme from KARL STORZ that aims to transform the operational productivity and efficiency of operating theatres. The SMART Solutions programme is specifically designed to enable the NHS to instantly improve upon the quality and quantity of first-class patient outcomes in a sustainable, affordable and reliable way.
KARL STORZ recognises that the NHS needs industry and industry needs the NHS – after all, the NHS accounts for 85% of UK medical device business. More importantly, it recognises that patients need both: the amazing advances in endoscopic surgery are largely due to the brilliant pioneers working in the NHS and the innovation yielded from it, and the company’s support for surgical skills training centres, educational programmes, research projects and fellowships helps to ensure these advances continue. The company’s commitment to the NHS with SMART Solutions is substantial: KARL STORZ takes the financial risk, makes the initial investment, trains staff and maintains the equipment so that the NHS hospitals can pay from optimised revenue.
SMART Solutions – providing the building blocks for a complete solution
SMART Solutions is a modular tailored solution: hospitals can choose exactly the elements they need, which can then be quickly and easily modified or extended if required further down the line, offering the ultimate in flexibility and affordability
This article reviews some of the key modular components of SMART Solutions: the role of the On-Site Technician (OST); working within the OR1TM integrated operating theatre; and the easily accessible Surgical Instruments as a Managed Service (SIMS) programme, which ensures clinical teams always have the very best in surgical equipment for minimal access surgery (MAS).
OR1 integrated operating theatres
KARL STORZ’s technological solutions have been installed in some of the world’s leading hospitals, with over 600 OR1 operating theatres in use in Europe alone. The OR1 system integrates the many complex requirements of an operating theatre, bringing together endoscopy, the latest image-enhancement HD camera technology, visualisation, documentation and communication, giving surgeons complete control over every aspect of their surgery, with all necessary information at their fingertips.
The ability to pre-set the OR1 theatre to an individual surgeon’s needs creates a bespoke experience that reduces both operating times and the length of time a patient is under anaesthetic. This, combined with the lower impact nature of keyhole surgery, reduces the amount of time patients need to spend in hospital and helps to speed up recovery
On-Site Technician (OST)
KARL STORZ can provide a dedicated and fully trained OST, based at the hospital, taking full responsibility for all technical and equipment support surrounding the OR1 theatre system and instruments for MAS. This helps to ensure theatre downtime is kept to an absolute minimum, and frees up clinical staff to focus on their responsibilities, safe in the knowledge that all the endoscopic technology is working perfectly – in an environment where there is no room for mistakes, knowing that all equipment is right first time is of paramount importance.
The OST ensures that all equipment provided by KARL STORZ operates at ‘as new’ capacity every time it is used, eliminating unnecessary downtime. This shifts responsibility for equipment from the clinical staff to the OST, and allows clinical time to be better focused on patient care. A significant proportion of OST time is spent within theatres being present at surgical procedures – building the interpersonal relationships required to operate effectively within any team and providing a safety blanket for clinical staff with respect to theatre technology.
The OST is also responsible for daily coaching and training of hospital staff in theatres and CSSDs, and can also support clinical training courses relating to equipment that is used in MAS. Ongoing training reduces the need for troubleshooting and repair management, and ensures the optimum life and performance of equipment.
Surgical Instruments as a Managed Service (SIMS)
With no upfront capital investment, no long tie-in period, no burden of depreciating assets, a hospital choosing SIMS can quickly have a brand new portfolio of MAS instruments, regularly checked and maintained, and replaced without question in the event of any damage.
For a flat quarterly fee, clinical teams are guaranteed a complete range of marketleading new equipment, regularly audited and maintained to ensure it is always in peak condition. Hospitals are even offered the option of trading in existing items, so they can start afresh with an entirely new set of equipment.
SIMS takes all financial risk away from the hospital and offers an ‘easy in, easy out’ contract. Passing the risk, responsibility and cost of maintaining endoscopic technology onto the manufacturer, liberates clinical staff to concentrate on clinical responsibilities and has a positive effect on patient outcomes – since Wythenshawe Hospital introduced SIMS, of the 2,647 cystoscopies carried out between April 2013 and March 2016, every one was right first time, every time, with no equipment downtime.
For more information contact: KARL STORZ Endoscopy (UK) Ltd 415 Perth Avenue Slough, Berkshire SL1 4TQ Tel: +44 (0)1753 503500 Email: info-uk@karlstorz.com Web: www.karlstorz.com
