the process.
I also strongly recommend having a mobile surgical table. The alter-
native is to have to repeatedly move the C-arm. That not only wastes
time and radiation, it's so heavy, you'll likely need several people to do
it. That can be exhausting by the end of the day. A mobile table pro-
vides flexibility, and makes it easy to quickly and precisely focus the C-
arm where you want. It also frees up personnel to perform other tasks
while just one person moves the table.
We also use an intravascular ultrasound imaging system (IVUS),
which greatly augments our images, especially for complex proce-
dures. It's almost like having a camera inside the vessel. The IVUS
also helps us with patients who have poor renal function, since they
can't be given conventional dye. For those patients, we use CO2
angiography. But the CO2 image is not as precise, especially below the
knee, so the IVUS helps improve visualization.
3
The right anesthesia providers. We use conscious sedation,
and we contract with an anesthesia group that handles its own
billing separately. That way we can concentrate on the complex-
ity of the procedure without having to worry about the patient's vital
signs and level of comfort. We know those are being taken care of by
a provider who's more qualified than we are in that regard, and we
know patient satisfaction, which is immensely important, will be high-
er as a result.
4
The right staff. An advantage to having worked for years in the
hospital is that we were able to get to know who the best people
were. Those were the people we brought with us. We wanted the
folks who had the best work ethics, the most passion, the best social
skills and the best bedside manner. It's a win-win. We all get to do the
J A N U A R Y 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 5 3
