What do chicken and spaghetti have to do with buying a surgical boom? Plenty, as you'll see in these 7 tips to consider as you shop for a boom.

1 See the light. Surgeons' main concern with a boom is usually the kind of light the lamps and boom provide. They're most interested in the quality of the light, the shadows created and the amount of heat the lamps generate. If you can't trial the booms and lights during real procedures, you can still give them a look at real tissue. During a boom and light demonstration at the UC Davis Medical Center in Sacramento, Calif., surgeons and OR staff looked at raw chicken in a basin in order to get a sense of what tissue and body structures would look like under the new lamps. The trial, and the chicken, helped hospital administrators make their decision. "There's no heat and no shadows," says Elizabeth Witchel, surgical services project coordinator for the medical center, who recently completed a hospital expansion project with 24 operating rooms.

2 How much do you want to put on the booms? Besides lights and monitors, you can put much more equipment on a boom: suction canisters, smoke evacuators, computer workstations, light sources and disposable supplies. All of this would otherwise be on carts and shelves. "It keeps your room more organized," says Ms. Witchel. The old ORs in her hospital didn't have booms, which meant that all the equipment was parked around the table and OR team members had to slither between devices to get close to the table. "There wasn't a clear path to the patient," says Ms. Witchel.

When shopping for booms, get input from your staff on what should be mounted on them in order to reduce "cord spaghetti," the number of steps a team member has to make during a procedure and the time that room turnaround takes. At the Clovis Community Medical Center in Clovis, Calif., they've added more to the booms at each renovation. "Now we've decided to get everything on the boom," says Drenda Montgomery, RN, BSN, the director of surgical services. That way, staff doesn't have to move around the room as much before, during or after the procedure.

3 Who will own the problems? Getting a boom up and running often involves more than one vendor. There's the boom manufacturer, the boom installer and the manufacturers or distributors of the equipment that will be mounted on the boom. So who's responsible if the wiring to a monitor doesn't work well? You don't want to be stuck in the middle of a pair of companies saying, "It's not our problem." In the old ORs at the Clovis Community Medical Center, Ms. Montgomery had a similar problem with the boom and the monitor. "Nobody wanted to own it," says Ms. Montgomery. Neither manufacturer wanted to fix the problem. Each company said it was the other's fault.

So when Ms. Montgomery and colleagues began shopping for booms for an OR expansion, responsibility for problems with equipment mounted on the booms became an important issue. In the end, the boom manufacturer that stated in writing its responsibility for maintaining the equipment mounted on the boom won the contract, says Ms. Montgomery. "They're going to 'own' the boom and its problems." This is especially important because surgical booms usually outlive the equipment that is mounted on them.

4 Where's the service rep? Purchasing surgical booms should be the beginning of your relationship with the vendor, not the end. The vendor reps should be involved in holding in-service training for all your surgeons and staff. More importantly, the vendor should be there, fast, if something goes wrong. When shopping for booms, consider the home base of the service rep. "How long does it take?" asks Ms. Montgomery. When something breaks, a local rep may be in your facility within an hour. A regional rep might be there by the end of the week. One of the selling points for Ms. Montgomery and her colleagues was the fact that the vendor rep was in the same town as the hospital. If something goes wrong, he can be in the OR to check out the boom in just 20 minutes.

5 Build a mock OR. Of course, this is a luxury. But if you have the space and resources, do it. That's what they did at the Maine Medical Center's Scarborough Surgery Center. The center's executive director, Diane Fecteau, RN, MSA, CASC, and colleagues created a mock operating room in an off-site building owned by the medical center. They marked out the footprint of all the equipment that would go in the new ORs. A boom distributor brought in lights and booms and installed them in the room. To get a sense of how equipment would sit on the booms, Ms. Fecteau and colleagues measured everything and created foam mock-ups that they mounted on the booms. Once the room was set up, the surgeons and OR staff walked through the mockup to try out everything as much as possible and then shared their impressions and opinions. "Creating a mock operating room made a huge difference," said Ms. Fecteau. "We totally redesigned the layout of the room based on input from staff and surgeons."

6 Get your staff involved in the choice. While the surgeons will have their opinions on the booms, they won't really be touching them, so you should consider involving the staff that will be moving the booms into place and adjusting the equipment mounted on them, says Ms. Montgomery. Staff members should try the different booms to see how easy they are to move, lock and unlock. Imagine how the booms will be cleaned at the end of the day, too.

Invite staff members to meetings with vendors and have them fill out evaluation forms, just like the surgeons. If you know you have a boom purchase coming up, encourage your staff to check out, and touch, the different booms in the technical exhibits at medical conferences. If staff and surgeons are involved in the choice from the beginning, they're more likely to be educated in the new equipment and emotionally engaged in the change.

7 Get a package price. Whether you're building a new OR or retrofitting an existing room (see "Retrofitting Your ORs With Booms," August 2009, and "Selecting the Right Boom for Your OR," May 2008), if you're purchasing booms there's a good chance that you're purchasing other equipment such as lights, monitors or an endo system. That's what Ms. Montgomery did. From the same vendor, her hospital purchased 4 booms, lights, monitors and a pair of autoclaves. As a result, the hospital got a better price on the booms and the service contract. Regardless of which booms you, your staff and your surgeons prefer, get quotes from other vendors and research the history of the product and how well it works. "Do your homework," says Ms. Montgomery. "You'll be glad you did."