Suite Success

Surgical Suites See Action Seven Days a Week

Jesse Dominguez, M.D.

What’s going to be surgically repaired today in any one of the five operating rooms (OR) at NorthBay Medical Center, or the two at NorthBay VacaValley Hospital?

You name it.

A typical day could start off with an Achilles tendon repair in one suite, and a double mastectomy and breast reconstruction surgery in another, all while unscheduled trauma surgeries for gunshot wounds or traffic accidents are being carried out in yet another surgical suite. “Just like a box of chocolates,” suggests Jesse Dominguez, medical director and chief anesthesiologist, “you never know what you’re going to get.”

And, unlike other medical facilities in Solano County, NorthBay’s surgery suites are busy seven days a week, handling not only elective surgeries and unexpected traumas, but urgent cases as they present.

Those urgent cases may involve tending to a patient who is already in the hospital but whose condition has changed, such as for appendicitis or gallbladder. “If we can repair them on the weekend, it means we can resolve urgent issues quickly, decrease the patient’s length of stay and improve their outcomes.”

NorthBay’s surgery suites are busy seven days a week, handling not only elective surgeries and unexpected traumas, but urgent cases as they present.

The strategy to have NorthBay’s surgery suites available 24/7 really began about four years ago, even before NorthBay became a Level II Trauma Center, Dr. Dominguez explains. “Since we had to have anesthesiologists available at all times to support the trauma surgeons, we developed a shift rotation system that keeps teams rested, even though they work hard.”

The teams need to be prepared to handle anywhere from 15 to 20 surgeries a day, for everything from that Achilles tendon repair—which takes about 30 minutes—to reconstructing a crushed pelvis—which can take 12 hours or more, Dr. Dominguez notes.

On a typical day, staff arrives before 7 a.m. and checks the surgical schedule, which has been prepared late the day before. It notes which surgeon has been assigned to which suite for what procedure. “Everyone knows it will be augmented with last-minute additions, whether the patient arrives from the ED or from Labor & Delivery, the hospital’s Intensive Care Unit, or from another facility,” Dr. Dominguez says.

The OR crew has been specially trained to prepare the suites for their respective surgeries, and when each procedure is complete, they spend from 15 to 20 minutes setting up for the next one including replacing or sterilizing equipment and restocking supplies.

In the meantime, “I go to meet the next patient,” Dr. Dominguez says. “The operating room nurse tells me their name, what concerns they may have, what their medical condition is and what drugs they may be taking. This is my chance to introduce myself and address their concerns. The hand-off is efficient and routine, much like a pre-flight experience. We may be a ‘little’ hospital, but we have amazing things going on here.”

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