C
an you run dual ortho rooms without running into trou-
ble? The surgeons we spoke with say overlapping sur-
geries, in which surgeons delegate another doctor or a
physician assistant to close one surgery while he
works on a second patient in another OR, are safe if
you establish a precise protocol — and never deviate from it.
"It's easy to do it poorly and it's hard to do it well," says Daniel
Branham, MD, of Tennessee Orthopaedic Clinics in Knoxville, Tenn.
Running dual ortho ORs is known by many names — double-
booked, simultaneous, overlapping or concurrent surgery — but the
practice got a bad rap a few years ago. In October 2015, the Boston
Globe investigated concurrent surgery at Harvard's Massachusetts
General Hospital. Reports described patients waiting under anesthesia
for prolonged periods and absentee surgeons who forced residents or
fellows to operate on their own.
"I never want to be the one who gets told, 'I had my patient under
anesthesia for 10 minutes before you even got here,'" says Mark
Topolski, MD, of Gundersen Health System in La Crosse, Wis.
It starts with scheduling
One scheduling snafu caused by one patient not showing up can upset
a day of dual ortho ORs.
At Tennessee Orthopaedic Clinics, safety begins at the first point of
contact when the patient is booked, says Dr. Branham. He tries to put
as much information on the booking slip as he can, including vendor,
length of case, X-ray or fluoroscopic imaging, graft and implants. The
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 • 3 7
Double-booked surgeons must
choreograph their every move.
Mike Morsch | Associate Editor
