M A R C H 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 4 3
He suggests you put as much effort and thought into how the
facility looks as how it functions. "All too often aesthetics gets
glossed over by surgical facility leaders," he says. "But that's a
mistake. After all, the look of a facility often plays a huge role in a
patient's overall satisfaction." — Jared Bilski
Good says that benefit of surgical navigation can reduce radiation
exposure to patients and surgical staff by more than 75%, another
benefit to consider in a cost-benefit analysis.
He's bullish on what the future holds for same-day spine and robot-
ics, which he's used to perform a wide range of procedures, from scol-
iosis reconstruction to lumbar fusions. Dr. Good is also one of the few
surgeons in the world to have performed robotic endoscopic spine
surgery. "We're trying to move an entire group of patients over to the
outpatient arena," he says.
Up for the challenge?
Outpatient spine has a lot of growth potential, but it's not for every-
one. In order to safely and effectively tackle the specialty, you need to
run a high-volume facility that hosts spine cases 5 days a week with
highly skilled spine surgeons who perform at least 25 to 100 proce-
dures per year, says Matt McGirt, MD, FAANS, a spine surgeon at
Carolina Neurosurgery & Spine Associates in Charlotte, N.C.
Dr. McGirt says you also need to establish perioperative protocols to
catch potential problems before patients are discharged. One such pro-
tocol at Dr. McGirt's facility involves making all ACDF patients stay in
the PACU for at least 4 hours before discharge. That directive is based
on research that says hematomas or neck bleeds nearly always occur
in the first 4 hours of recovery. Of the 2,000 ACDFs Carolina Neuro-
surgery & Spine has done, fewer than 5 patients had to be hospitalized
