8 - Optimizing Robotic Surgery Efficiency Through Intraoperative Team Dynamics

Description: The robotic operating room team at Lehigh Valley Health Network in Dickson City, Pennsylvania was established in 2022 following the opening of the new hospital. Upon the initial establishment of the robotic program on this site, it was evident that there was room for improvements to be made, especially in the areas of process efficiency and turnover times. As the team worked through initial growing pains of the program, a precedent was established which has made the robotic team an efficient, well-oiled machine. The team has consistently been the most efficient robotic team in the system for turnovers on a monthly basis. The team consists of a robotic coordinator/RNFA, Registered Nurses, a surgical technologist, CRNA, and a physician champion. The establishment of a team who was fully invested into the success of the robotic program on this campus was of high importance to drive the program forward. This team has found success in the key areas of culture, training and coordination, process and efficiency, and block utilization access. To further invest in the success of the robotics program at the hospital, a robotics committee was established in early 2025. The idea committee was proposed to the director of the department and a formal proposal was submitted for approval. The development of this committee functions as a catalyst to making process improvements and troubleshooting barriers to success within the program. Using these key areas of success to drive the daily flow of the team, the efficiency and effectiveness of the robotic team has been unsurpassed. Measurable metrics of success are turnover times. Turnover times, on monthly average hover around 25 minutes, meeting the system-wide goal of 30 minutes. For the year so far, the average turnover time is 24.9 minutes. Recently, the lowest turnover time of 10 minutes has reinforced the work of the core robotic team. The culture of the team, while not a numerical metric is a key indicator of success as well. The team takes great pride in its functioning. Everyone on the team is committed to delivering excellent care and doing it in a climate that is respectful, accountable, collaborative, and supportive. The team started performing briefings and debriefings for each case being done throughout the day. This ensures everyone is on the same page and to address needs or issues that need to be resolved before moving forward. Thus far, the outcomes have been highly satisfactory for turnover times and team satisfaction. The implications for perioperative nursing include safety, situational monitoring, education and support, prevention of complications, and infection control.