Vice President for Perioperative Services at Beth Israel Deaconess Medical Center

Ruben J. Azocar currently serves as a Vice President for Perioperative services at Beth Israel Deaconess Medical Center. He is responsible for handling all the operations and facilitating cases that come into the scheduled time. In addition, he has been working to deliver a quality standard of care to the patients keeping safety and compliance on track. In his current role, he is also responsible for managing the operational set of financial officers and the value analysis team within the institution.

What are potential challenges or pain points prevailing in the market today?

From the operational perspective, the biggest challenge that we face is staffing. Although there are enough vacancies, the travelers that are not permanent staff come with an incredible price. Hence there's a sense of tension between our staff and the travelers because of the price difference. Secondly, the other thing with travelers is that every time you get a new traveler, our teams have to orient them. So it has a cost for our staff, they had to train somebody new to the system in a relatively short period. So there's a cost for that. The second challenge we face is the hospital capacity, which must be solved in case of an emergency, as we have seen during the pandemic. We still have small but lingering numbers of COVID patients and are still experiencing challenges placing patients into acute care facilities post-operation. However, we are trying hard not to cancel any cases due to a lack of bed capacity. Ironically during the pandemic, we focused on many areas, like putting teams together to execute quality and safety. We were doing a lot of drills as a team of surgeons and nurses, which helped us strengthen our culture, quality, safety and protocols. Some of those works have also percolated into the compliance matter. So to summarize, these two challenges of staffing and hospital capacity are immensely prevailing in the market in the current day.

Would you like to mention any project you are currently working on and the kinds of technology or any latest strategies you're leveraging?

Through our EMR, we are tracking cases to determine whether they are set around on time or not and for turnover time, we're planning to have a pilot with the spine surgery team for various reasons. One is a very motivated team, and two is the same type of surgery instrumentation. Number three is if we were able to do an additional case every day because with the more excellent turnover times, those cases bring a more considerable contribution margin, so it will make sense financially to be able to help that group. We have also invested in our robotic surgery and acquired a couple of new robots last year. With robotics, there are various services that we can provide, such as urology, GYN, colorectal ENT etc. and help us in the projects that we'll undergo.

I think many medical institutions are focusing on compensation, so make sure your team's salaries are added per the market rates. However, it's not compensation that is everything but strengthening the purpose, the sense of teamwork, and the sense of belonging across your teams. People stay because of the culture, the sense of being recognized, the sense of purpose, and loyalty toward the institution. That can never be lost or fade away.