Exec Summary – Leadership

Since 1890 Scripps has been an innovative healthcare system that has provided San Diego quality healthcare and has been recognized by Thompson Reuters as one of the “top 10 health systems” (Scripps Health, 2013, para. 3) based on the core mission values of quality, efficiency and respect (Scripps Health, 2013). In the past two years, San Diego hospitals have been investing in a new type of technology known as the hybrid operating room starting with UCSD Silpizo Center (UCSD, 2011). Foreseeable Problem: No Hybrid Suite.

Currently Scripps does not have a hybrid suite and to stay competitive with the competition and offer the best care for the community Scripps may want to take the necessary steps to consider hybrid technology. With the addition of a hybrid suite Scripps can secure a foothold in a shifting medical model of providing excellent multi-modal care in one visit. With a shift to minimally invasive surgery it is paramount to consider a hybrid in the early stages so that the competence level of the surgeon and staff are equal to or better than that of the community.

If Scripps does not embrace this new type of surgical suite it may lose a valuable referral base that will be actively seeking for this type of modality. The addition of a hybrid suite is also in alignment with the new shift in medically treating patients from a “sickness model to a wellness care model” (Fitzhugh, 2012, p. 2) that is more holistic and encompassing. Solution and Timing The hybrid OR gives surgeons the ability to perform traditional, open surgery and minimally invasive, endovascular procedures on the same patient, at the same time, in the same place.

Having the ability to perform imaging studies in the same room eliminates the need to move patients during a procedure and reduces the risk of infection under the O. R. ‘safety net’. The implementation of a hybrid suite will benefit the patient by decreasing the amount of overall radiation to the patient. Patients also benefit by: • Shorter procedure times • Less radiation used during imaging • Reduced need for ICU care • Shorter hospital stays • Faster recovery Short to Midterm consequences: • Lack of expertise in the community as the competitor continues to be more proficient, early adopter strategy is paramount.

• Loss of marketing advantage as a “center of excellence” • Loss of referrals Return on investment detailed (Nollert et al. , 2012, p. 100): • Vanderbilt Group – through their cardiac program 2004 volume was 464. After installing the hybrid suite in 2004 their caseload tripled by 2008. • Beijing’s Fu Wai hospital 2008 annual report showed a 60% increase of procedures after the hybrid was installed. • St. Vincent Heart Center of Indiana had a $0. 8 million ROI in 2010 with a projected $5. 4 in 2015. • Cleveland Clinic data showed a ROI on their investment in 2 years and 3 months (2010). Current and Future Utilization of the Hybrid Suite.

|Interventional Cardiology |Percutaneous Heart Valve Replacement | | |Coronary Angio s/p CABG | | |Ventricular Assist Device Insertion | |Vascular |Abdominal Aneurysms (AAA) | | |Iliac Aneurysms | | |Peripheral Vascular Disease | | |Thoracic Aortic Aneurysms | | |Types A and B Thoracic Aortic Aneurysms | | |Complete Total Occlusions (CTO’s) | | |Carotid Artery Stenting | | |Lower Extremity Peripheral Arterial Disease Peripheral Vascular Intervention (LEPAD PVI) | |Neurology |Aneurysm Coiling | | |Carotid Artery Stenting | | |Ischemic Stroke Care | | |A/V Malformations | | |Neuro Cyst Aspirations | | |Neuro Tumor Resections | |Transplant Program |Possibility of RF Ablations*.

| | |Tunneled Hemodialysis Catheter Placements* | |Electro Physiology |A-Fib Ablation | | |Bi-Ventricular Pacemaker Implantation | | |Heart Road mapping | |Ortho-Spine |Kyphoplasty* | | |Cervical & Lumbar Decompressions (Wilson Frame required)* | | |Percutaneous Posterior Fixation* | “*” – Indicates possible future utilization and not a current practice.

The Opportunity Scripps can have a head start in the hybrid suite and be the leader in the community if not the state region with the implementation of this program sooner rather than later. With this recognition within the community, Scripps stands to become a center of excellence for the discerning patient that looks for a facility that is progressive and innovative in their approach to caring for the patient.

With bundled care pricing that many insurance companies are considering a hospital will maximize the patients treatment impact all the while saving the facility considerable dollars by utilizing the hybrid suite; bottom line is maximizing profits for the hospital and quality of treatment for the patient. Having the hybrid suite can also lend itself to referrals from doctors outside of the system that want or require this type of care for their patient.

A consideration of note is the possibility of securing contracts with facilities that do not offer this type of service which can contribute to the balance sheet for Scripps Healthcare. References Fitzhugh, M. (2012). Scripps creates digital medicine program with Qualcomm. Retrieved from.

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