Pwarble

I certainly respect your concerns. I have been in the OR for 20 years and I agree that vascular certainly in theory should comprise a "basic" surgical skill. However, what I see happening is that the majority of our staff whether due to inexperience or rapid turnover are not even competent in many of the basic surgical techniques. Now maybe this is unique to our facility, I'm not sure. Also as technology advances with endograft procedures (we do all our aortic endograft cases in the OR), vascular is becoming more specialized. In my experience, for those vascular emergencies in non-vascular cases, a good scrub with good basic skills usually will do fine. We are more concerned with the daily operations, the emergent AAA that could be repaired endografically but because your offshift personnel are unfamiliar with the wires and equipment you must subject the patient to an open repair that increases their mortality, etc. I understand your argument that specializing in the OR may not provide a well rounded department, however our experience has been that training programs are not adequately training staff in even the basics which is even more stressful for the surgeons and dangerous for our patients. We have also found that in the rare instance when a vascular emergency occurs during a non-vascular case the surgeons are much more tolerant of the staff. We are not trying to run our service as an outpatient center, just trying to make it safer, more efficient for everyone. The debate will continue whether to specialize or not.

Hello, I am looking for anyone who may have experience with developing a vascular or other specialty team staffing model. We are looking to develop our own team model similar to trauma, transplant, cardiac surgery. Our goal is to design a team with expertise in vascular surgery who would be responsible only for our service. Ideally, the team members would work on a system that would allow for more efficient time management and increase OR efficiency and patient outcomes. The idea would be that if cases are finished early, then staff may eligible to leave however the team would be responsible for afterhours coverage of their own specialty cases. If anyone has any experience with such a model, how to make it work, how to make it lucrative for both staff & hospital administration, etc. I would appreciate any input, information and resources. You can contact me via private message. Thanks, Patricia