my PAs can handle the rest of the case," he
says.
When he makes that call, he knows he
has enough time to scrub out, complete
the op note, talk to the patient's family and
go to the pre-op area and sign the next
patient. He never wants to make the call
early for the next case, but he wants it
timed so that he can get into the next room
in time to help position the patient.
"If I send for the patient earlier, then I
may find myself rushing to make sure I get
there on time," says Dr. Topolski. "I really
try to not put myself in a position where I
feel like I'm rushing."
Dr. Topolski prefers to make his incisions
on the half hour. He'll make his first one in
OR 1 at 7:30 a.m., his second one in OR 2
at 8:30 a.m. and so on. He typically makes
his last incision of the day around 12:30
p.m. Of course, there can be delays.
"Let's say there was a couple of tough spinals and it took them an
extra 10 minutes to get it, I just kind of twiddle my thumbs in the cor-
ner," says Dr. Topolski. "I know that it's better for the patient to end
up getting a spinal than to just randomly put them to sleep. I'd rather
everybody spend that extra time to do what's going to turn out to be
better for the patient."
Several years ago, OrthoCarolina in Charlotte, N.C. — which has
been running dual ortho rooms for 20 years — looked at ways to best
maximize the surgeon's time. What they didn't want was the surgeon
N O V E M B E R 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 4 1
"It's difficult until
you get the pieces in
place. I think it's easy
to do it poorly and it's
hard to do it well."
— Daniel Branham, MD,
Tennessee Orthopaedic Clinics
Tennessee
Orthopaedic
Clinics
