After five months, the collaboration between Stamford Health and New York City-based Hospital for Special Surgery is going about as smoothly as possible as HSS Orthopedics at Stamford Health prepares to move to the fifth floor of the new Stamford Hospital.
“We’re up and running and off the ground,” said Charles “Chip” Cornell, an orthopedic surgeon who in March was named chair of the newly created Department of Orthopedic Surgery at Stamford Health.
“We’re melding quite nicely with Stamford Health, “ Cornell said, referring to policies, procedures and practices.
“They’re very enthusiastic about learning how we do things, including our approach to patient care,” he said.
Other departments within Stamford Health surgery have also expressed interest in talking with HSS, he said.
In announcing the partnership in February, Stamford Health President and CEO Brian G. Grissler said it would “elevate our institution to the forefront of musculoskeletal services and further differentiate us from others in the region. Through this collaboration, we will create a new Department of Orthopedic Surgery that integrates best practices and expands our capabilities.”
HSS Orthopedics at Stamford Health has been operating at the hospital’s Tully Health Center since April. Ambulatory procedures have grown in volume each month, Cornell said, with 10 in April, 20 in May and an anticipated 40 in July.
A number of collaborative initiatives have been introduced, he said, including “pre-op optimization.” The process of medical clearance while preparing for elective surgery, which usually takes place five to six weeks beforehand, can now be done as little as seven days in advance by identifying a patient’s issues and concerns during the initial visit, Cornell said.
The approach “makes the hospital more efficient, can cut down on complications and avoid unanticipated cancellation of surgery on the day of,” Cornell said. “And the discharge procedures are also worked out in advance. HSS has been doing this for decades, and they’re interested in adopting the policy throughout Stamford Hospital.”
While not relevant to urgent or emergency surgeries, Cornell said the optimization procedure has cut the cancellation rate down significantly. “We’re still at about a 6 percent cancellation rate,” he said. “It’s terribly inefficient to have an OR scheduled for a procedure and then that time goes empty. Our goal is to get it down to zero.”
The reason for day-of-surgery cancellation can include finding a patient is not fit for operation as well as the patient failing to show up. Researchers at Tulane University Medical Center in New Orleans found that in 2009, 327 of 4,876 (6.7 percent) scheduled elective outpatient surgeries were canceled, costing the hospital nearly $1 million that year alone – a number that has presumably risen significantly in the years since. On average, surgeries account for about 60 percent of a hospital’s total revenue.
The fifth floor of Stamford Hospital – which completed a $450 million construction project last year, opening on Sept. 26 – “was built with us in mind,” Cornell said. “It’s pretty incredible to have a brand new building in modern health care in America. Everything is brand new, there’s been no chance of contamination. It’s the perfect situation for us.”
Designed by EYP Health, which also served as the architects for Tully Health Center, construction of the fifth floor by Skanska is ahead of schedule, Cornell said. “They were supposed to be finished in October, but are on pace to finish in August,” he said. “We should be ready to open by November first.”
The time is being used to hire and train staff, he said. “There will be 15 surgeons working with me, with some more dedicated to outpatient procedures like sports-related injuries, and eight adult reconstruction surgeons.”
The HSS-Stamford Health center will start with two operating rooms, and Cornell anticipates expanding to six in a short time, for an expected total volume of 1,500 cases a year.
“We’re hoping that we can establish a foothold in the marketplace and rapidly grow,” Cornell said. “We fully expect to be the busiest center in the state for orthopedics.”