The Hospital of Saint Raphael opened its newly renovated short-term surgery unit Monday after eight months of planning and construction.
The 4,500-square foot suite of pre- and post-operative beds is designed to accommodate the growing number of patients undergoing elective surgery and going home the same day.
You’ll be seeing more of these short-term centers across the country as new medical techniques make lengthy hospital stays unnecessary, the chief of surgery at St. Raphael’s said.
Procedures such as arthoscopy, setting broken ankles, installing tubes to drain chronically infected ears, and carpal tunnel surgery will be among the increasing spectra of short-term, or out-patient procedure, said Dr. Scott Helton, chairman of surgery at St. Rapahel’s.
The unit is officially called the Cronin Short Term Surgery unit, in honor of benefactors Lorraine Cronin and the late Dr. Robert Cronin.
Patients undergoing ear, nose and throat surgeries, including tonsil removal, are also usually hospitalized in the morning and read to go home that afternoon.
The $1.5 million project expanded the hospital’s short term beds from seven, in 1986, to 19 beds.
About 13,000 patients travel through the short-term system annually, and before the remodeled unit was built patients awaiting surgery mingled with patients coming out of surgery, Helton said.
The old configuration also required incoming, already anxious patients, to be wheeled past patients still recuperating who might be bandaged, semi-anesthesized, and in discomfort, he said.
Now patients will progress through the process in one direction to avoid this problem, said Bob Boebert, director of perioperative services.
The new rooms are also spacious and “family friendly,” with room for family members and gurneys.“Now the bed spaces are user friendly,” Boebert said.
“Patients used to be isolated and claustraphobic,” he said, which is not a good state to be in before surgery.
“The original short-term unit was incredibly non-functional,” Boebert said.
Incoming patients would stack up in the morning, and then tax recovery rooms in the afternoon, Helton said.
“Patients had to walk in through the emergency room,” to reach the outpatient center, and then walk down the hall to the opeating rooms.
Nonetheless, the old short-term unit performed about 52 to 55 percent of the hospital’s surgeries. Now the short-term unit has twice the capacity at peak hours in the morning, so surgeons, nurses, and other specialists are not standing around idle in an operating room.
“Operating room time is expensive. Times must be maximized. There should be no ‘hourglass’ coming in and no traffic jam going out,” he said. To achieve this smooth operation, there will be certain times when the unit appears to be under-used, he said. “We need that excess capacity,” Helton said.
Meanwhile, advances in anesthesia and surgical instruments are reducing the need for overnight hospital stays, he said.
New Haven has an elderly demographic, or the percentage of in-and-out surgery would probably be higher, he said.
Some major surgeries that required hospitalization a decade ago are now routinely performed as outpatient procedures, he said. The use of wand-like laparoscopic surgical instruments, which require only a few tiny incisions, leave the patient with less pain and no incisions to heal.
Surgeons at St. Raphael may be able to fuse neck vertebrae, and insert artificial disks, as possible future out-patient procedures. Helton said an abdominal aortic aneurysm, or bulging of the main blood vessel to the lower half of the body, was repaired laporoscopically and the patient discharged that evening.
Insurance companies and health plans are delighted to pay for fewer days in the hospital, but don’t patients feel more comfortable knowing that help is only a few seconds away?
No, a nurse said. Patients feel more comfortable at home, and organizations like the Visiting Nurses are available to check the patient, if that’s what the patient and doctors desire. Medicare alone requires patients to stay overnight.
The new unit also features an LCD tracking board, so that relatives can tell what’s happening to their loved ones, and surgeons can see if an operating room will be free soon.
Nurses will be able to communicate wirelessly with operating room nurses to update the board as necessary. Patients will be identified by number to ensure privacy.
“It’s just like being at an airport. The boards are everywhere,” Helton said.
Helton said that minimally invasive surgery will increase short-term hospital stays in the future.
Modern hospitals are building separate units for short-term care so that the elective patients need not witness the travails of the seriously ill, he said.