Orthopedic Blog: Roadtrip to Boston

By,

Brett Greenky

Kim Murray

Back to Boston

As you drive up to the New England Baptist Hospital in Boston the origins of the facility as a turn of the 18^th Century Tuberculosis Asylum is evident.  The hospital is perched on a hill overlooking the then farmland of Brookline, now a bustling extension of the classic New England Metropolis.  The architecture is classic New England brick and stone with waves of more modern extensions.  One could easily mistake the campus for an internal quad of one of the Hospital’s affiliated nearby academic institutions of Harvard and Tufts Universities. A banner over the front entrance announces the institution’s recent designation of one of the nation’s best Orthopedic medicine providers.

Entering the building I immediately flashback to my interview for the prestigious Aufranc Fellowship in Joint Replacement Surgery in 1988.  We all entered at 8am, myself and the other 39 applicants who competed for the 2 positions. We were the survivors of the initial screening process of a much larger candidate pool.  The interview process consisted of a series of three interviews that mirrored the oral component of Orthopedic Surgery Board examination.  We all rotated through three conference rooms each with eight Attending Surgeons.  We were asked typical interview questions, but also grilled on treatment options for carefully selected case presentations accompanied by X rays.

Back in Syracuse some 5 days later I was both pleased and humbled by the call notifying me I had been selected for one of the two fellowship positions. Thus began my real education in both the art and the science of Joint Replacement.  In medicine you never stop being a student.  The process of education is life-long as the obligation to our profession and our patients requires continued learning.  Even as the tradition has passed to Seth and me to be the teachers and professors, we continue to be students. 

As such myself and the team (Betsey Caiello, Dave Grygiel, Lynn Leo, Kim Murray, Diane Waldon, and Tammi Walker) left the Baptist with a more complete understanding of the equipment available to bring our hospital to the cutting edge with respect to efficiency in instrument processing.

More on Baptist recollections in future blogs.

Nuts and Bolts of Our Visit

Seventeen Operating Rooms, 40,000+ square feet of clinical and support space, state of the art/cutting edge technology, advanced telecommunications, and enhanced care delivery systems describe the surgical suite design that has been created as the result of more than two years of work by a multidisciplinary team comprised of nurses, physicians, and other clinical representatives.  A daunting task to say the least, but as this design phase draws to a close, we continue to review and refine specific elements to ensure that no stone has been left unturned when it comes to meeting our goals of optimized safety, efficiency, and care processes.

The fixed and mobile equipment necessary to deliver patient care is both expansive and complicated.  Amongst other challenges, selecting equipment that has a proven track record, will remain functional for years to come, and is not cost prohibitive is critical to a successful project and to meet the desired outcomes.  Item by item we have researched, investigated, and validated each item that will be introduced into the new OR’s. 

A particular challenge is the equipment that is necessary to render surgical instrumentation sterile.  Instruments, drills, retractors, and other specialty surgical implements become grossly contaminated with blood, tissue, and bone during surgical procedures.  Effective decontamination, cleaning, and sterilization equipment which minimizes the need for hand cleaning/preparation is necessary and is a critical step in the prevention of surgical infections.

A recent site visit to New England Baptist Medical Center, an orthopedic hospital in Boston, Massachusetts, provided us the opportunity to witness firsthand the advances in cleaning and sterilization processes and equipment.  A tour through the central sterile/processing area introduced us to a high performing service with state of the art equipment.  Our research had suggested to us that the equipment in use at The Baptist, as well as the processes and procedures that they have developed, are considered best practice.  Although inconvenient and time-consuming, our team of seven that travelled to the hospital found that validation that we were seeking.  Taking the time and exerting the effort for critical decisions such as this is well worth the inconvenience and hassle.  We left confident that we had discovered the best equipment for our new surgical suite.  This is a process that has been done, and will be repeated, over again until all equipment decisions have been finalized.