What does it take to move 150 patients — the youngest a mere two hours old — to a new facility three miles away in under four hours? Twenty-four ambulances, over 175 nurses, 100+ volunteers and 18 months of planning, practice and passion.
Virtua’s Voorhees Hospital in south New Jersey was maxed out on space. Besides no land to expand on, retrofitting the building built in 1973 for tomorrow’s technology while concurrently improving workflow was not only challenging, but costly.
So Virtua decided to build a new $463 million, 680,000-square-foot campus that would enable them to transform their entire care system and create an environment to meet needs of patients and providers for decades to come.
In the midst of the venture was Tejas Gandhi, MS ’03, assistant vice president of management engineering and lean leader at Virtua, who led the process-driven hospital design. “Before pen went to paper, we looked at over 200 processes,” he says. “Ninety-nine percent of people come to work to do a good job. When there is an error, it’s because the system fails.”
Gandhi, who studied industrial and systems engineering at Binghamton, used patterns and hospital data to make educated, cost-saving decisions. “When the planners came back with 395 beds, we said we only needed 368. It’s less than 20 beds, but each bed costs us $2 million.”
Together, the engineers and architects infused art with science as the planning moved forward.
They removed barriers that were non-value add — spend a year in the shoes of a nurse at Virtua and you’ll have walked from Philadelphia to Atlanta. “It’s not about the walking, it’s about time spent away from patient care,” Gandhi explains.
They also removed opportunities for mistakes.
By identifying and isolating critical pathways, patients travel shorter distances for testing and procedures. And staffing models ironed out issues with flow for modification at the new location. For example, bathrooms are now located off the end of the patient bed instead of the head.
Also on Gandhi’s team were industrial and systems engineering alumni, Joshua Bosire, MS ’07, and Balagopal Gopakumar, MS ’08. As graduate research associates with the Watson Institute for Systems Excellence (WISE) working at Virtua, the duo built computer models and simulations critical to ensuring that hospital staff and volunteers understood move concepts before the full-scale drills. Virtua has since hired both full-time, and Gopakumar is also a part-time PhD student in the ISE program.
At the end of the big move day, Gandhi and his fellow Virtua colleagues were thrilled with how smoothly things went, and with their organization’s new home. “Working out scenarios ahead of time allowed staff to be on top of the process, and, most importantly, for our patients to feel at ease.”
By Natalie Blando-George
Imagine having surgery without a surgeon present in the operating room. What if your surgeon were in another state or even another country? With robot-assisted remote surgery, that’s exactly what can happen.
Remote surgery combines elements of robotics and state-of-the-art communication technology. With remote robotic surgery, physical distance between surgeons and patients is irrelevant, allowing patients to access the expertise of specialized surgeons around the globe from any hospital equipped with a surgical robot.
But remote robotic surgery has some challenges, says Mechanical Engineering Professor Frank Cardullo, MS ’72, a researcher in the field of man-machine systems. Before joining the Watson School, Cardullo spent years designing simulators for flight and aerospace.
Today, he is applying his expertise regarding perception and stimulation of visual and motion cues, and computational methods for real-time systems, to improve remote robotic surgeries and develop a simulator that will provide valuable true-to-life experience for surgeons.
“The tactile feedback surgeons get during traditional, ‘open’ surgery is missing with these remote robotic procedures, and that information is very useful,” explains Cardullo.
Through the use of sophisticated signal-processing techniques, Cardullo is also working to mitigate the time delays introduced when you physically separate the surgeon and the surgical robot. The time it takes for the signal to travel to and from a communications satellite results in a time lag between the surgeon’s “command” and the robot’s response that can affect the surgeon’s performance and the outcome of the surgical procedure.
“During remote robotic surgery, you’re operating over long distances and through computers, so there is a communication delay that can be as much as two seconds.” And as he explains, in robotic surgery or any high-performance man-machine system, any delay greater than 50–75 milliseconds is problematic.