The Varying Capabilities of Surgical Support – Selecting a Trusted Surgical Efficiency Partner

June 24, 2015  |  Posted in: Articles
The Varying Capabilities of Surgical Support – Selecting a Trusted Surgical Efficiency Partner

Ken Boccaccio, MMSc, PA-C

– Professional excellence and satisfaction is at its peak when a Surgical First Assistant (SFA) is assisting in a well-known procedure that has been performed with the same surgeon hundreds of times. In this scenario, an effortless and fluid communication is established, allowing the operation to flow safely and efficiently. The doctor appreciates that they can put their full concentration on the procedure and not on instructing the assistant regarding the next move. The SFA ensures that the specific instruments and supplies needed are present, and unneeded supplies are not opened, saving the hospital money. The day progresses smoothly because the SFA is closing for the surgeon and then positioning and preparing the next patient for surgery. Free from these duties, the surgeon is able to see a consult between cases, rather than after hours. The unique partnership that a SFA and surgeon can foster reduces OR time by about 30% per case, allowing the surgeon to book future cases sooner and increase throughput. This increased case volume equates to greater profitability for both the surgeon and hospital.

Many surgeons reading this would think, “That sounds like a nice scenario, but I can’t identify with that surgeon. I’m fortunate to get a consistent OR team.” This is because there are numerous challenges in health care delivery, including economic pressures that limit Full-time Equivalents (FTEs) to the absolute minimum. Dedicated service line OR teams are ideal for establishing efficiency, but often times are difficult to implement due to such staffing limitations. More FTEs are needed to make this approach work, not less. The result is that circulating RNs and Surgical Technologists (scrub techs) are frequently working outside their areas of expertise; this is especially the case after the first shift staff go home. The solution is a partnership with Intralign for expert Surgical First Assistants, allowing RNs and scrub techs to remain in their important roles.

Circulating nurses and scrub techs perform very important duties, however neither are allowed to first assist unless they have extensive additional training. This can include a specialized program, taking a year or more to complete. Intralign SFAs have, as part of their basic educational background, comprehensive coursework in medicine and surgery, giving them depth in the pathophysiology of disease, as well as the surgical remedy for that disease.

Then they have multiple rotations in surgery, giving SFAs hands-on skills and experience. Once employed at Intralign, they have additional clinical and operational training via the Intralign Academy, an educational curriculum designed to enhance an SFA’s impact on OR quality and efficiency.

The fact is, the amount of time and experience dedicated to improving one’s professional skill set is directly proportional to the level of mastery achieved. If I need a joint replacement, or another complicated procedure, I will select a surgeon who performs that procedure all the time. In the same way, an SFA who assists surgeons daily has a deeper knowledge of how to do that well, rather than someone who does it less frequently as a smaller part of their job. Using a scrub tech or nurse to first assist, when that skill set is not part of their original training, is inefficient and does not maximize OR productivity, or provide excellent patient care.

Intralign provides SFAs that first assist in surgery full-time. We are not burdened with other practice considerations and are able to focus on the OR. Working with a variety of surgeons gives us a depth of knowledge that other professionals working in single specialties do not have. We do hundreds (some of us, thousands) of cases across multiple specialties. Additionally, we provide a solution to the increasing demands experienced by private PAs and surgeons who are stretched too thin. With an Intralign SFA in the OR, specialty PAs can concentrate on floor and office duties while we provide excellent support operatively. They can increase income for their practice and work to generate additional cases, while supporting a model that improves efficiency in the OR.

I have admiration for the vital role hospital RNs and scrub techs serve to make the OR run efficiently. They are essential members of the OR team. Partnering with Intralign allows every professional to remain in their area of expertise, resulting in a seamless operative process and maximizing throughput.


Ken Boccaccio

Ken studied at Eastern Connecticut State University earning his Bachelor of Science in Biology, while maintaining the Dean’s List and High Achievement awards. He graduated with his Masters of Medical Science from Emory University School of Medicine in 1991. Since then Ken, has worked as Physician Assistant in various roles. From OB/GYN, Orthopedic, Urgent Care, General Surgery and Oncology, Ken has expanded his skill set which lead him to his current role as an Intralign Regional Clinical Team Lead in North Carolina. Here Ken is able to utilize his vast knowledge and skill set as a multi-specialty Surgical First Assistant.