Spine surgery has gone through a tidal wave of change in the thirty years, and Chris Lycette, MD, a spine surgeon and co-chief of the Division of Spine Surgery at Bethlehem, Pa.-based Lehigh Valley Health Network for nearly a decade, discusses ways his spine center is riding that wave. He shares several tips for any spine or medical center looking to become excellent.
1. Stay abreast of your specialty's changing landscape. For Dr. Lycette, that means understanding the transformation within spine surgery from an almost entirely inpatient process to one with a growing amount of outpatient services."When you go back a few decades, spine surgery was quite different," he says. "Patients expected to stay a long time in a hospital."
No longer the case, spine surgery — with the introduction of minimally invasive techniques — can start and finish before dinnertime. Patients are under anesthesia less and expect to spend as little time as possible in a hospital bed.
"A lot of surgeries that would take a few days before are done as outpatient surgeries now," Dr. Lycette says.
The challenge is for hospitals and health networks to adapt to a surgical environment introducing more outpatient care. But, when keeping the patient at the center of care, emphasizing outpatient and minimally invasive surgery makes a world of sense. By offering more outpatient surgeries, Dr. Lycette's health network achieves its goal of providing the kind of care patients seek: minimally invasive and efficient.
2. Meet high quality standards 'from the top to the bottom. "You can't have a center of excellence and have one part be a C minus," Dr. Lycette says. "When you run a highly specialized center, in order to have a good result — a happy patient — you need to have high standards and accountability."
He lists four components of a spine center of excellence:
- A strong surgical team
- Pain management specialists
- Established physical therapists
- Experienced physiatrists
Additionally, everyone on the team has to share a vision of excellence in order for the specialized center to attain it. It's about "having a team that's assembled where all are looking for the same outcome: to develop a center of excellence, something that everyone can be proud of," Dr. Lycette says.
Lehigh Valley Health Network's spine center utilizes SpineMark, a hospital and physician service company that helps specialty centers define goals and tracks the process of attaining those goals through evidence-based measurements.
3. Get to know primary care physicians in your community. To get the Lehigh spine center publicity and gain working relationships with primary care physicians in the area, Dr. Lycette says he scheduled breakfasts, lunches and dinner meetings speaking with primary care providers. "I wanted to tell them our goals but also get feedback from them and hear their frustrations."
Dr. Lycette's "tour-de-force" connected him with primary care physicians and taught him how the community works. "That was very helpful in learning the lay of the land," he says.
One of the issues that kept coming up in conversation with primary care physicians was the admittance of an ad-hoc, disconnected referral system. Primary care providers had separate go-to specialists they would send their patients to, and Dr. Lycette said there seemed to be a need for smoother coordination across the Lehigh Valley Health Network and some physicians would send patients to larger cities for specialty spine care. Dr. Lycette's meet and greets were a way for him to associate with primary care physicians who may refer patients to his spine center. It exposed primary care physicians to the spine center through interaction with its co-director. Extending an ear to community physicians also opens an ongoing invitation to build a collaborative care model with community physicians.
4. Always keep the patient at the center of what you do. Dr. Lycette understands that patients are perhaps leery of the physician traditionally thought of as the one who holds the scalpel.
"Most patients don't want to come and see a surgeon in the first place," he says. "But if they are in severe pain and it's affecting their quality of life, I can do something to improve that."
The spine center at Lehigh also promotes non-surgical care such as physical therapy, physiatry and other pain management techniques. It's about trying to heal the patient and do what's in his or her best interest. Dr. Lycette said he takes the time to explain to the patient the pathology of what he does as a surgeon.
"You put it into context with what they're going through," he says. "Someone has broken parts, and you're looking to fix the broken part."
That could include medical or surgical care — whatever best fits an individual patient. It's ultimately about addressing the patient's needs.
Dr. Lycette will be a keynote speaker at a SpineMark Corporation and Active Communications International Interactive Conference of Key Influencers in Spine in Allentown, Pa., on how a hospital can develop Spine Center of Excellence Model. He will discuss Lehigh Valley Health Network as a case study for how to create an optimized spine center.
More Tips from Spine Surgeons:
6 Steps to Prepare for the Future of Outpatient Spine Surgery
7 Ways for Spine Surgeons to Stay Ahead in Competitive Markets
5 Thoughts for Spine Surgeons on Migrating Cases to ASCs