COMMENT& ANALYSIS Navigating the red tape: A case for hybrid ORs in the VA

By Courtney Morgan, MD

The United States military has access to the most cutting-edge equipment to perform its duties, so we should expect nothing less for its veterans. As vascular surgeons, we all appreciate the importance of high-functioning, cutting-edge equipment. Over the past decade, hybrid operating rooms (ORs) have become more commonplace and are becoming the norm rather than the exception to be able to provide comprehensive vascular care in an efficient manner.1

Any institution that has been involved in the acquisition of a hybrid OR system understands the complex process involved. Multiple stakeholders, including representatives from specialties expecting to utilize the equipment—OR leadership, hospital finance, acquisition committees and biomedical engineering—need to work together to determine the optimal operating system to best serve patients’ needs that will fit within the confines of the physical space and budget.

This can be a particularly overwhelming challenge within the Department of Veterans Affairs (VA) system due to the increased level of bureaucracy involved. Like any institution, the utility of a hybrid OR must first be established locally. This often involves cooperation between services that will utilize the system besides vascular surgeons, such as neurosurgeons, interventional radiologists, cardiologists, pulmonologists and nephrologists, to name a few.

In addition to vascular surgery, the progression of struc-