This article appeared in the November/December issue of Surgical Products.

Because of the cost and complexity associated with capital equipment purchases for the operating room, hospitals must carefully evaluate what their investments will bring in terms of improved productivity and efficiency. While it is nice to have state-of-the-art equipment complete with cutting-edge features and capabilities, it does more harm than good to make the investment if the equipment cannot be leveraged properly.

Careful evaluation means making a concerted effort to identify future applications of the room and select equipment (such as satellite mounts, customizable booms, tables with multiple accessory options and modular wall systems) that offers the ability to adapt to changing circumstances, address clinical needs, and acquiesce to patient focus.

Furthermore, the increased prevalence of hybrid and integrated operating rooms have led equipment vendors like Eizo to develop a product line that features large format displays and monitor management equipment.

“These are really used to enhance procedures being done in hybrid and integrated ORs,” says Larry Perlman, Large Display System (LDS) Manager, Eizo, Inc. “Now in order for the hospitals to keep pace with these types of advancements, the surgical suite and the equipment really needs to be versatile and be used on multiple and flexible platforms.”

According to Perlman, being in tune with the needs of the surgical staff is critical toward making the right capital equipment investments.

“From a surgeon’s perspective, in terms of improving their efficiency with this complex array of traditional surgical approaches and minimally-invasive approaches all going on in the same room, the surgeon's focus is so important,” he says. “So being able to gather all of this important information quickly in an ergonomic environment is also very important.”

Creating an environment where a surgeon and his or her staff can be efficient and effective obviously helps contribute to successful patient outcomes and staff satisfaction. Therefore, those involved with making capital equipment purchases should be willing and able to lean on vendors to offer their knowledge and experience with the equipment to help ease the implementation process.

One critical consideration is whether the capital equipment can be customized to allow for broader use. Naturally, this leads to a better return on investment. Being able to identify equipment that is usable in a variety of different procedures and surgical scenarios (such as orthopedic, neurological, vascular, and minimally-invasive) pays significant dividends for facilities.

According to Perlman, one of the biggest challenges for a vendor like Eizo has been developing capital equipment capable of dealing with the significant uptick in information coming into the OR, especially in the hybrid or integrated space.
“We have to develop hardware that takes in all of these different procedures, inputs, and video management,” says Perlman. “What we’ve done is focus on large format displays in the OR -- typically 56-inch or 60-inch displays. We’ve tied that in with the monitor manager, which will allow you to bring in input signals from as many as 24 different sources – analog, digital, etc.  Then at bedside, during the course of this procedure, it allows you to compare all of that information on one screen.”

With older solutions, users have an array of monitors in the OR that takes focus away from the nurses and doctors. With a large format and the monitor management, it allows users to bring in all of these sources and view them on one large display with easily changing sources, scaling images with the simple use of a touchscreen at bedside. Users also have efforts to try to improve the overall flexibility of the surgical area, because now nurses are able to control devices from a control room, their centralized work area, away from the sterile field, and it improves their overall workflow and patient care as well, notes Perlman.

Finally, maintenance and replacement components add to the lifecycle cost of equipment in the OR. Being able to identify, understand, and factor in cost considerations such as energy usage and heat output from lighting systems and the level of quality engineering in tables, booms, and other equipment can help limit costly breakdowns and avoid downtime in the OR.

Simply stated, properly outfitting the OR with capital equipment is a matter of avoiding an unwise purchase. The cost of today's technology makes it difficult to overcome such a critical mistake.

To do that, hospitals and medical facilities need to have an eye on the future and work with a vendor that understands just how the process of outfitting an OR with capital equipment will change with time.

“Having a company that understands future scalability; future technology like gesture, voice, recording and streaming; and how to interface with all these OEM technologies, both legacy and new equipment, you really need to work with companies that understand the full space,” says Perlman.