Executive Summary

As the urology coordinator, I will be overseeing and managing the entire process from start to finish. Implementations of new procedures are always large and expensive projects for hospitals as they open up new treatments to the world. The HIFU procedure stands for high intensity focused ultrasound. This procedure is used to treat prostate cancer in a way that reduces side effects dramatically. This FDA-approved procedure is minimally invasive and offers a more personalized form of treatment compared to some of its competitors. Throughout the paper, I will discuss and analyze the entire implementation process of the new HIFU procedure being offered.

Over the course of the past month, it has been very busy within my surgical operating unit as the nursing urology coordinator. For a few years now, my hospital institution has been working on the idea of bringing in the HIFU procedure. This surgical procedure is known as HIFU. HIFU stands for High-Intensity Focused Ultrasound. This procedure is used for the treatment of prostate cancer that offers more personalized treatment with dramatically reduced side effects (UCLA Health, 2020). This treatment offers an alternative to more invasive procedures with much higher levels of side effects and longer recovery times. The HIFU procedure works by destroying prostate cancer through the delivery of precise and focused sounds waves to a targeted spot of diseased prostate tissue. This technology uses ultrasound, and not radiation, to destroy targeted tissue. This leaves healthy tissue untouched and minimizes the sides effect (UCLA Health, 2020). When implementing a new procedure in a hospital it becomes the responsibility of the level nursing coordinator to become the project manager once the piece of equipment is bought. When the piece of equipment is finally obtained, the job of the project manager begins.

This month, the piece of equipment for the HIFU procedure reached my hospital facility with brief notice for preparation. Now that we have received the HIFU machine, it is my turn to take over the project as its manager and plan out every step along the way. These steps include the financial aspects to the procedure, vendor and hospital relations, training involved, time frames and restrictions, safety regulations, and finally, the conduction process of the entire procedure from start to finish. As the project manager, it is my responsibility to implement this procedure successfully into our hospital system. This project not only has many moving parts to implement it successfully, but it also must be done in a matter of approximately 6 weeks. For the beginning stages of the project, the most important step is to plan all the aspects of the entire project out. These aspects include communication with the vendors for the HIFU machine, communication with the HIFU tech that will be present for each HIFU procedure, arranging for inspection of the machinery by Biomed, coordinating with the stakeholders like the hospital, doctors, and nursing administrators. In addition, I will have to coordinate the implementation of a new plug socket for the machine, disposable supplies used throughout the procedure, expenses for the hospital, safety regulations, educational sessions for the staff, time frames for everything to get done, and finally the implementation and conduction of the procedure itself.

When planning for the procedure, the initial plan is to discuss the procedure with the stakeholders. The stakeholders involved include the administrators for urology, nursing managers, doctors doing the procedure, techs involved in the procedure, and finally the manufacturer of the company. This process should allow me to gauge what interests the stakeholder’s hold and how they want to proceed with the project. To successfully communicate between all parties, I will have to set up overlapping meetings that allow multiple stakeholders to attend. By getting multiple stakeholders to one meeting, this allows the exchange of more ideas and concerns.

After planning out meetings needed for the HIFU procedure, prices for the specific supplies and labor go into effect. According to the Western States HIFU cancer center, most insurance companies currently do not cover the cost of the HIFU procedure. The current cost of a HIFU procedure is approximately $25,000 at an all-inclusive cost (Western States HIFU, 2019). This procedure is currently very expensive, but insurance companies are working to bring down out-of-pocket costs drastically to a more affordable level. The hospital and insurance companies are working closely to implement this procedure because it improves the quality of life for people to undergo the surgery drastically.

Once preparation and the costs for the procedure are evaluated, educational sessions can go into effect. The first educational session will be demonstrated in person. The persons at this educational session will include stakeholders, and staff members like the manufacturing company, nursing managers, techs, doctors, and the director of outpatient surgery. This session will be the platform for the initial education session leading up to the implementation phase of the project. During the educational sessions, they will discuss the advantage to the HIFU procedure like its precise targeting to minimize damage to non-targeted healthy tissue, that a single therapy session is usually all that is required, that there is a low complication rate, especially regarding impotence and incontinence. In addition, it does not utilize ionizing radiation, complies with drug therapies like chemotherapy, has a low morbidity treatment, a short recovery time, and can even induce an anti-tumor immune response (FUF, 2020). Once the advantages and reasons we are implementing the procedure are discussed, we will provide an activity demonstration of the medical device. Following the in-service, we will then implement online learning modules for re-enforced learning. Once the educational session is completed, I will hold one more meeting with the stakeholders to discuss the final setup and date to preform our first High-Intensity Focused Ultrasound procedure.

Once our first patient is picked to undergo the first test procedure, my surgical unit will set a date for the case to be performed. During the day of the procedure, the manufacturing company, HIFU tech, nursing manager, and staff members will be present. The procedure itself must go smoothly, as many situations that arise in healthcare are not very forgiving. The risk of implementing a new procedure is much higher as everyone from the hospital is new to the procedure itself. During this time, it is critical that everyone communicates and does their part from a team perspective. The first procedure and future cases to come must maintain a high level of quality to provide the best care possible. By implementing this procedure and being a successful project manager, I will be able to help change the lives of countless people and offer a better quality of life to my patients.

Biography:

My name is Perry Charles Ritota Jr and I am currently the Urology Coordinator for outpatient Ambulatory Surgery at a well-known hospital in New Jersey. I graduated from Montclair State University with an undergraduate degree in psychology and public health. Following Montclair State University, I pursued nursing at New York University. Within Nursing school, I had realized that I had wanted to work within a peri-operative environment. Upon completion of nursing school, I had entered into a peri-operative training program that had trained me for intra-operative surgery. Within my first year of working, I had realized that I had strongly gravitated toward urologic procedures. This strong interest had quickly led me to take over the surgical specialty altogether for my unit.

References:

FUF. (2020, July 8). Prostate Cancer. Retrieved from https://www.fusfoundation.org/diseases- and-conditions/oncological/prostate-cancer

UCLA HEALTH. (2020). HIFU. Retrieved from https://www.uclahealth.org/urology/prostate-cancer/hifu

Western States HIFU. (2019, June 18). Is HIFU Covered by Insurance? Cost of HIFU Treatment. Retrieved from https://hifuprostatecancermd.com/our-center/financial-info/