What's on your boom? If you're like those we surveyed, the equipment hanging from your ceiling are those items you use most often. The boom at Hendricks Regional Health in Danville, Ind., houses endoscopic video equipment, HD monitors, arthroscopy pumps, RF ablation generators, electrosurgical units, laptop computers, a laparoscopic insufflator and integrated surgical lights, says OR Director Don Stewart, RN, BSN. Besides clearing the clutter and letting your team move more freely and safely around the OR without tripping over cables, cords and wheels, the most common reason for hanging equipment from your booms is convenience.

"We use our coblator 10 or 12 times a day," says Lynda Dowman-Simon, RN, OR manager at Mercy Medical Center in Springfield, Mo. "If you're moving it that many times a day, you're increasing the chance of tearing up those cords, or tripping over them."

Booms improve the maneuverability and flow of equipment. "Having the camera, light source and insufflation wires/tubing all going to the same location is so much easier and safer," adds Melanie Flynn, RN, BSN, nurse manager for surgical services at Palo Alto County Hospital in Emmetsburg, Iowa.

Keep the dance floor clear
Booms give both safety and efficiency a boost. The boom at Mercy helps the staff maintain a carefully choreographed and well-rehearsed surgical routine.

"If you've ever watched an OR team working a case, the setup becomes like a dance," says Ms. Simon. "Everybody knows where the next person is going to step, and they flow in a pattern that keeps the case moving as quickly as possible."

Mounting equipment — integrated surgical lights, RF ablation generators, electrosurgical units, monitors and endoscopic video equipment — on a boom keeps the dance floor clear and safe, she says.

"There's no cords or wheels on the floor for people to trip over. In the surgery suite, a lot of equipment has a wide wheelbase, and people are tripping over them. Now, those [wheelbases] are out of the way, and there are no carts cluttering up the room."

Midlands Orthopaedics Surgery Center installed booms in all 3 of its ORs nearly 5 years ago. "The setup in all 3 of our ORs is identical, so everything is in the same place for staff to find it. All 3 booms have equipment hung in the same place," says Belinda Rutledge, RN, MN, MBA, CNOR, administrator at the Columbia, S.C.-based center. She adds that the boom can be moved from one side of the room to the other based on patient positioning needs.

A boom system is unique in that it can't really be tried out until it's been built into your OR. And at that point you're committed, for better or worse. Indeed, "difficult to trial" was the most frequently cited disadvantage of boom systems among those we surveyed.

So you can't exactly pick up a boom from a rep and drop it in your OR for a demo. What our respondents suggested instead was visiting several other sites with boom systems before selecting and installing your own, to see comparable systems in action and solicit feedback from users.

"Go to sites that are using [the same boom systems you're considering]," says Ms. Rutledge, "and talk to the staff without having a vendor representative with you."

What about the vendor?
In addition to getting input from other facilities, Ms. Simon relied on a source she already knew fairly well: her surgical light vendor. New lights were part of a recent renovation of a surgical suite Mercy had outgrown. The surgical staff was pleased with the vendor's product and service, before and after the purchase. The lesson? If a vendor with whom you've had positive past experiences also provides boom systems, it may be a logical option, says Ms. Simon.

"I wasn't sure about interfacing with another company's boom system," she says. "It raised a lot of questions: Will it fit in our OR? Will the parts match up? Will I need adapters?" Familiarity "pushed us in the direction" of the vendor who had supplied their surgical lights, says Ms. Simon.

Hendricks found itself in a similar, fortunate position when deciding on a boom system, says Mr. Stewart. "We had recently bought towers for our video equipment. Everybody was happy with what we had on the towers, so we partnered with [the same vendor] for our boom, too," says Mr. Stewart. "I didn't have to gather up our surgeons and staff, and ask them if they liked Vendor A versus Vendor B."

Still, he stressed that doing its due diligence was a must for Hendricks, and should be for other centers. "We did a lot of site visits, we had our engineers do mock-ups. I went through the set-up [of a boom] with our surgeons," he says. "My advice is to do a lot of site visits."

Identifying and visiting facilities with a focus similar to your own is equally important, adds Mr. Stewart. "Know what types of cases you do. We visited a lot of sites similar in size and the types of procedures they perform, and asked what works for them."

What's on your shelves?
Get out your tape measure before installing a boom. Measure the height, width and length of each piece of equipment you plan to house on a boom, says Ms. Simon. "Make sure your boom space is wide enough, tall enough and deep enough," she says. "If you get a boom with 5 shelves, for instance, are all 5 shelves of equipment going to fit on the boom with the amount of space that the shelves take away?"

And give thought to the number of shelves you'll need, she adds.

"Whatever the answer is for this one, go with 1 more shelf," says Ms. Simon. "We brought in a new printer not long after our boom system was installed. By having an extra shelf available, we had room to store the printer without having to decide which piece of important equipment we'd remove."

Mounting HD monitors from booms makes it easier to position them and place the articulating arm in whatever position the surgeon is working in. "A taller physician likes the monitor up higher. A physician that sits down prefers the monitor in a certain place," says Ms. Simon. "Some left-handed surgeons want everything on the left. It all comes down to physician preference, and what creates the best flow for circulators as well."

From a safety and efficiency standpoint, the set-up of the boom is the most crucial factor to consider, she concludes, noting that booms should be staggered carefully on the ceiling "so you don't have things crashing into each other. You don't want lights hitting monitors or vice versa."

Mercy had its boom manufacturer come in during construction to ensure equipment was securely connected to the girders, and that wiring was sufficient.

"You don't want the thing falling off the ceiling, or fuses blowing," says Ms. Simon. "If you have to unplug 2 pieces of equipment to use one, you're adding more stress to your workday. You want to make things easier.

"With one careful placement of a boom, you have your light sources, Bovie, and camera right there at your fingertips, whereas you're usually pushing those things up on their own carts," she concludes. "A boom can be a great timesaver, if you make sure you have what you need on it."