The patient is prepped. The surgeon is scrubbed. Cameras are recording. Then, just as the endoscopic procedure gets under way to repair a knee injury, monitor lights begin to blink. The nurse filling in for the day looks at the unfamiliar equipment, perplexed. When the patient on the table had an emergency, he came to the ER. When the instruments to help him need emergency care, who do you call? At Trinity Medical Center, surgical endoscopy teams don’t have to pick up the phone to call anyone to check out equipment, or to prep and manage surgical instruments and recording equipment. They simply turn to the technician from Integrated Medical Systems, who is right there in the room, making sure everything is ready to go and taking care of hardware glitches that might arise. “The demand for endoscopic procedures is skyrocketing, and the technology is becoming more involved,” said Mike May, director of Surgical Services at Trinity Medical Center. “The IMS technician is trained to troubleshoot and take care of equipment if anything comes up. Our repair costs are down tremendously. Surgeons like having everything there and ready so they can concentrate. Having an IMS technician handling the equipment frees nurses to focus on the patient. It enhances patient care.” Integrated Medical Systems was co-founded in 1990 by Gene Robinson, who, as a distributor of surgical instruments, often helped surgical teams repair equipment because there were few third-party resources at the time. As the Birmingham-based company grew, it expanded into central sterile process management and is now providing on-site technical services and instrument management for endoscopic surgeries. Based in Birmingham, IMS currently has 95 employees throughout the country working in this capacity. With faster recovery times and smaller incisions, minimally invasive endoscopic surgeries are popular with patients and are being used in a growing range of procedures. IMS provides both flexible and rigid endoscopic equipment for everything from routine diagnostic procedures to removing gallbladders, repairing damaged knees, positioning lap bands in bariatric surgery, and performing gynecological and neurological surgeries. Electronics isn’t a typical course of study at most nursing schools, and equipment for different types of procedures can be highly specialized. Having a technician who is familiar with the equipment in the room prevents frustration and frees nurses to spend more time doing the work they trained for — caring for patients rather than caring for hardware, which is a particularly important advantage during a nursing shortage. “It’s difficult for nurses to become proficient with equipment when staff shortages require them to move to different rooms,” said Sharron Hadley, RN, CNOR, clinical OR director of IMS. “Our people are in place and can be a resource for nurses. They know the equipment and the video towers and how to care for them and troubleshoot problems if needed.” Another plus is being able to equip more surgical suites without tying up capital. Equipment costs are figured on a per-procedure basis. “We can be staffed and equipped to do more procedures. It’s easier to schedule surgeries,” said May. Fewer repairs and longer equipment life are added benefits of having a technician trained in the more intricate aspects of caring for delicate instruments maintaining them. Traditional sterilization procedures can sometimes damage the inner mechanisms of complex endoscopic equipment, which has its own specialized sterilization and maintenance protocol. Having sufficient equipment available for proper rotation also adds to its long-term reliability. In addition to its on-site technician program, IMS continues to offer surgical instrument repairs and proactive maintenance planning. The company has also been working with hospitals locally and across the country in central sterile process management. “An IMS manager and team of technicians are on site, working with hospitals on a day-to-day basis to improve processes and efficiency,” said Hadley. “We help hospitals evaluate how they are working now and identify goals to streamline their work flows. Together, we work to create a full base of support. Formal staff training is another important step. We educate the staff on regulatory standards and help them prepare for certification. Since we go into a central sterile consultation with an exit strategy, at the end of the process, the hospital knows what we know.” In endoscopic surgeries, IMS technicians are a resource that bridges the gap between technology and the human side of medicine. They use their expertise to take care of equipment so surgical teams can focus their expertise on taking care of patients. December 2007