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Hospitals’ Response to
Robotic CABG
Robert Poston, MD
Chief, Division of Cardiothoracic Surgery
SUNY-Downstate, Brooklyn, ...
NOVICE PROFICIENT EXPERT
Credentialed in Robotic Cardiac Surgery Expert Robotic CABG Programs (>100 cases/yr )
National Ma...
Robotic MIDCAB Programs Initiated by RP
Time
Performance
Low
High
Rapid ImprovementsNew program
introduced
Trial and error
Status quo
Organizational Learning
Novi...
Morale
Low
High
Status quo
Organizational Expectations
Time
Novice Proficient Expert
Morale Performance
Low
High
Low
High
Rapid Improvements
Trial and error
Status quo
Novice Proficient Expert
Reality –
Expe...
Expectations
Time
Performance
Low
High
Low
High
Rapid Improvements
1st case …Nth case
Robotic program
introduced
Trial and...
Expectations
Time
Performance
Low
High
Low
High
Rapid Improvements
1st case …Nth case
Expectations-
reality gap
Robotic pr...
Expectations
Time
Performance
Low
High
Low
High
Rapid Improvements
1st case …Nth case
Expectations-
reality gap
Robotic pr...
MY ADVICE
• UNDERSTAND THE PATTERNS
• GET TEAM TO SPEAK UP
• LEARN FROM NEAR MISSES
• REGULAR MEETINGS WITH ADMINISTRATION...
Invited Presentation at the Eastern Cardiothoracic Surgical Society 2018
Invited Presentation at the Eastern Cardiothoracic Surgical Society 2018
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Invited Presentation at the Eastern Cardiothoracic Surgical Society 2018

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The classic focus of cardiac surgeons attempting to implement robotics programs is on the technical tasks. This presentation focuses on the managerial and political challenges that can strongly influence the chances of success with these high profile programs.

Published in: Healthcare
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Invited Presentation at the Eastern Cardiothoracic Surgical Society 2018

  1. 1. Hospitals’ Response to Robotic CABG Robert Poston, MD Chief, Division of Cardiothoracic Surgery SUNY-Downstate, Brooklyn, NY
  2. 2. NOVICE PROFICIENT EXPERT Credentialed in Robotic Cardiac Surgery Expert Robotic CABG Programs (>100 cases/yr ) National Marketing Database, Intuitive Surgical Corp, queried 2013 Robotic Cardiac Surgery
  3. 3. Robotic MIDCAB Programs Initiated by RP
  4. 4. Time Performance Low High Rapid ImprovementsNew program introduced Trial and error Status quo Organizational Learning Novice Proficient Expert
  5. 5. Morale Low High Status quo Organizational Expectations Time Novice Proficient Expert
  6. 6. Morale Performance Low High Low High Rapid Improvements Trial and error Status quo Novice Proficient Expert Reality – Expectations gap Time Novice Proficient Expert
  7. 7. Expectations Time Performance Low High Low High Rapid Improvements 1st case …Nth case Robotic program introduced Trial and error Status quo Organizational Learning of Robotic CABG Novice Proficient Expert STAGE 1: HYPE EFFECT AND DENIAL Reality – Expectations gap
  8. 8. Expectations Time Performance Low High Low High Rapid Improvements 1st case …Nth case Expectations- reality gap Robotic program introduced Trial and error Status quo Organizational Learning of Robotic CABG Novice Proficient Expert STAGE 2: INFORMATION ASYMMETRY AND CRISIS
  9. 9. Expectations Time Performance Low High Low High Rapid Improvements 1st case …Nth case Expectations- reality gap Robotic program introduced Trial and error Status quo Organizational Learning of Robotic CABG Novice Proficient Expert STAGE 3: ACCEPTANCE BUT NOT A NEW STANDARD
  10. 10. MY ADVICE • UNDERSTAND THE PATTERNS • GET TEAM TO SPEAK UP • LEARN FROM NEAR MISSES • REGULAR MEETINGS WITH ADMINISTRATION • RUN THE NUMBERS

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