The symphony of surgery- it starts with the surgeon-scrub assistant relationship

• Published in: The American journal of surgery Vol. 222; no. 4; pp. 692 - 693
• Main Author: Zenilman, Michael E.
• Format: Journal Article
• Language: English
• Published: New York Elsevier Inc 01.10.2021; Elsevier Limited
• Subjects: Anesthesia; Efficiency; Fuels; Hospitals; Leadership; Medical personnel; Orthopedics; Patient satisfaction; Personnel; Physicians; Scrub; Surgeons; Surgery; Surgical instruments; Teamwork; Trays
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2021.08.010

[...]this is how free-standing ambulatory surgical centers manage their profit margin- they keep it uncomplicated. While the authors observed that the surgeon-scrub interactions fuel efficiency, the circulators, facilities personnel, and the surgical Instrument processing/preparation fuel the overall efficiencies and cost to a greater extent.2 Optimized surgical trays will increase efficiency and decrease cost,3 especially in surgeries, such as orthopedics where over 20 trays can be opened. Furthermore, in arthroplasties, the turnover of circulators, scrub personnel, and anesthesia influences productivity, while the ‘noise’ of students, fellows, physician assistants and even the surgeons ‘preferred team” do not.4 Of course, six-sigma methodology helps immensely with identifying and correcting problems, improve overall efficiencies, and hence waste.4 Most importantly, focused interventions, which include hospital and administrative leadership yield streamlined processes, and improve hospital revenue.5 It is remarkable to me how we as physicians view hospital finances differently than administrators.