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Chief of Neurosurgery – Reflections

In my first  year as Chief of Neurosurgery at the University Medical Center of Princeton, my main focus has been treating patients. But the administrative aspects of the job have reminded me how important logistics are in the outcome of a patient’s treatment.

The amount of detail involved in orchestrating patients, families and caregivers who are spread across many buildings and connected with a variety of medical specialties is mind-boggling. But when a hospital delivers care using standardized processes in an efficient environment, consistent positive outcomes can be achieved.

An important patient benefit—shorter hospital stays—can be determined by the  physical layout of a hospital. A well-designed facility can accommodate state-of-the-art technologies and promotes a smooth flow of patients from one department to another. Patients receive quality care promptly, with less wasted time and effort, which reduces length of stay.

Patients also benefit from the use of electronic medical records throughout a health system. Accurate, current patient data that is instantly available for  caregivers at every location greatly increases efficiency. There is no searching for or sending paper records from one building to another, which saves time and reduces the chance of administrative or medical errors.

University Medical Center of Princeton at Plainsboro

Another vital aspect of logistics is ensuring patient safety. Clear communication among staff members, standardized procedures for nurses and physicians, the use of surgical checklists, collecting accurate data on surgical procedures and educating staff on patient safety protocols are essential for maintaining the culture of safety.

Part of providing a safe environment is complying with regulatory standards. Stringent regulations are in place to ensure that our management systems follow best practices and operate at a very high level of efficiency. To comply with these rules, a hospital must have an effective quality-improvement program, peer review, performance targets and accreditation by The Joint Commission. It’s my ongoing responsibility and privilege to ensure that the Neurosurgery Department adheres to these standards.

New Facility

Before our new facility opened in 2012, the previous hospital on Witherspoon Street in Princeton served our needs. But that facility consisted of a group of disparate buildings that were cobbled together to function as a single hospital. It reminded me of a 100-year-old house—it had a lot of quirks—and parts of it were built in ways that just didn’t make sense for a modern hospital.

Despite the cumbersome structure of the facility, we were able to provide very advanced care there. When patients looked at the surroundings, however, they didn’t feel they were in a place where sophisticated things were being done.

Our new hospital, on the other hand, can be compared to a modern house with all the latest amenities. Our administrators used their extensive knowledge of hospital design to create a facility that works extremely well.

Patients stay in private rooms that are beautiful and comfortable. This gives them and their families a positive experience and the appropriate feeling that they’re in the right place to receive state-of-the-art care.

One aspect of this efficiency is technology. The sophisticated equipment that we use gives our patients a wide assortment of surgical options including minimally invasive and robotically assisted procedures. Having more choices can minimize risk, discomfort and recovery time while providing outstanding results and giving patients peace of mind.

I’ll give you an example of how technology is a great asset in the operating room. If our team is performing surgery to diagnose a brain tumor, we take a sample of the tumor and send it through a pneumatic tube system to our Pathology Department. In just moments, our pathologists transmit a picture of the tumor sample to a huge screen in the operating room and we’re talking with them via videoconference about the next steps of treatment. The entire surgical team gets a clear understanding of the patient’s situation, which helps each of us do our jobs better.

As technology changes in the future, healthcare facilities that aren’t adaptable will  become obsolete. Our hospital has a large capacity for growth, in terms of adding new technologies and expanding our space. As a matter of fact, the facility is so adaptable that it can be reconfigured if necessary. We’ll provide excellent care here for a very long time.

Patient-Centered Care

An essential part of that care is regarding the patient as a person dealing with a difficult situation, not just as a medical problem we’re trying to solve. We must truly listen to our patients and try to understand not only their symptoms but also how other aspects of their life are affecting their emotional as well as their physical health.

To provide this type of patient-centered care, it’s helpful to consider patients’  cultural traditions, personal preferences and values, family situations, social circumstances and lifestyles. When caregivers understand those things, we’re better able to recognize a patient’s dignity and collaborate with them to help them choose the treatment that will give the best possible outcome and greater personal satisfaction.

Research has shown that patient-centered care reassures patients that they are on common ground with their doctor regarding their treatment. This peace of mind can lead to faster recovery, better emotional health after treatment and fewer diagnostic tests and referrals. This information comes from The Journal of Family Practice, September 2000.

The patient-centered approach can also reduce medical costs. Studies have found that when physicians have more personalized discussions with patients and encourage them to take an active role in their care, lower medical costs and a reduced need for health care services can result. This information comes from the Journal of the American Board of Family Medicine, May/June 2011.

At the University Medical Center of Princeton and Princeton Brain, Spine & Sports Medicine, our teams provide high-quality medical care by employing the latest medical procedures, but we strongly feel that techniques and technology are only part of the picture. It’s essential that, while we care for our patients’ physical health, we care for their personal and emotional health as well.  At Princeton Brain, Spine and Sports Medicine we have always known that High-Tech doesn’t work without High-Touch. We are proud to partner with the  University Medical Center of Princeton at Plainsboro and its new state-of-the-art facility.  I am privileged and honored to be the Chief of Neurosurgery at UMCPP.

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