Keys to Spine Table Selection

When evaluating your options, find the right fit for your facility in terms of surgeon preference, intended use and budget.

Purchasing a big-ticket item like a spine table — a crucial piece of equipment for any spine surgery service line — is a decision that goes well beyond that upfront investment.

There’s surgeon preference, vendor service considerations, standardization capabilities and plenty of other factors. That’s why you want someone with a proven track record at the helm when it comes time to make such a critical purchasing decision. Michelle Craig is that type of person. 

Ms. Craig is a perioperative and OR capital asset manager responsible for researching, negotiating and renewing contracts with vendors at UCHealth in Aurora, Colo., a health system that consists of 12 hospitals, four ambulatory surgery centers and about 140 operating rooms. “At any given time, I am managing a list of 1,000 vendors throughout the hospital network, ensuring that vendors meet strict adherence to pre-negotiated contract price points and service delivery agreements,” she says.

That’s a lot to stay on top of, especially for a health system that is continuously expanding. But when it comes time to purchase critical equipment like spine tables, Ms. Craig never takes any shortcuts. Here’s how she and her team tackle purchasing spine tables — and how she balances a surgeon’s preferences with her facility’s capital asset needs.

A long process

It can take Ms. Craig and her team up to nine months from the time the request is made for new spine tables until the moment they are available to position that first patient. That may sound like a long time, but every step along the way is crucial. “When a request comes in, I immediately reach out to the other care sites to see if they have a need for the same spine table,” she says. “I then look at the current state of our inventory and evaluate the competitors to see if they have an equivalent table that we might want to test and purchase.”

A request for proposal is then created and sent to all the potential vendors. Then Ms. Craig invites all the vendors to come in and demonstrate their products to everybody whose affected by the decision. “We ask our surgeons, nurses, supply chain staff and sometimes members of our IT department to form a committee and to view the products and evaluate each vendor using a scorecard,” says Ms. Craig. The systemwide scoring matrix is an objective analysis used to compare various vendors and their respective equipment. Committee members  rank each item on a scale of one to 10 based on several criteria, including:

• Cost competitiveness (30%)
• Availability and depth of resources for administrative and project support (20%)
• Competitive contract terms (15%)
• Ability to meet Key Performance Indicators for services and uptime (10%)
• Technology for the organization and ability to expand into patient engagement (10%)
• Quality of reporting and invoicing tools; ability to escalate issues (10%), and
• Best overall value (5%).

Like buying decisions at virtually every facility, cost plays a major role, but it’s not as simple as it sometimes seems. For Ms. Craig and her team, it’s about looking at whether all the features are in the best interest of the entire system’s long-term financial health. “We must look at pricing and make sure we are not spending more than we should on something just because it is brand new or state of the art,” she says. “We want to make sure that whatever we end up purchasing helps our health system in the long run.”

Surgeon preference

PROVIDER PREFERENCE Dr. Sielatycki says the versality of specialized spine tables and their corresponding attachments mallows surgeons like himself to perform any type of spine surgery.  |  Elisa Maines Photography

J. Alex Sielatycki, MD, is an orthopedic spine surgeon who performs roughly 15 spine procedures a week at both UCHealth Yampa Valley Medical Center and Steamboat Surgery Center, which is a partnership between UCHealth and Steamboat Orthopaedic & Spine Institute. The surgery center opened in 2019 and has two ORs, each of which are around 400 square feet. The surgery center purchased one specialized spine table with attachments when it opened, which allows Dr. Sielatycki to perform laminotomies, microdiscectomies, transforaminal lumbar interbody fusions (TLIFs) and anterior cervical disc replacements as safely and as efficiently as possible. “With a flat top and open frame attachment, I can perform any spine operation,” he says. For anterior and posterior procedures, the table can roll or tilt the patient side to side, which is a helpful feature.

The versality of this table was a big draw for Dr. Sielatycki, but he says most spine tables are based on the same design principles as the specialized table he uses. “The key is the open frame for prone positioning, which allows for the abdomen to be free of compression,” he says, adding that the specialized table is important for proper lumbar positioning when performing fusions to ensure appropriate lordosis is maintained. “Some of the newer tables have the ability to adjust lumbar positioning (flexion vs. lordosis) with the patient on the table,” says Dr. Sielatycki.

Balancing act

As important as surgeon preference is in the purchasing decision of items like spine tables, Ms. Craig says some physicians will come in and want certain specific items that just aren’t feasible. Her team can’t always give surgeons what they want when there’s a 140-OR health system to manage. That’s one of the reasons why Ms. Craig is such a strong proponent of standardization.

“Standardization plays a huge role in what equipment we purchase,” she says, adding that the practice also helps the health system with its economies of scale while allowing her team to build in fixed pricing for a period of time and create a master agreement for about three to five years so the vendor cannot raise its prices. The practice of standardization also minimizes the number of contracts that will need to be managed, something that no doubt helps when you’re managing relationships with upwards of 1,000 vendors like Ms. Craig. “Instead of having different contracts for each facility, we can do one contract, which really does help manage the supply chain,” she says.

On the personnel side of things, standardization helps with staff training. “If we can standardize that table across the health system, then all of our nurses, clinicians and staff are trained on that one item, instead of training everyone on multiple tables,” says Ms. Craig.  

It’s also important to view your decision through the eyes of the patient, something that is always a consideration for Ms. Craig and her team for spine tables as well as all their other purchases. “We are always concerned with patient preference, and regularly ask, ‘Is this item the best thing for our patient’s safety and surgical outcomes?’” she says.
Despite these factors, Ms. Craig reminds surgical leaders that the decision must always focus on the end users of the equipment: the surgeons. That’s why you want to communicate as clearly as possible so they have all the facts. “My team doesn’t make the final decision on what item to purchase,” she says. “We can give a recommendation and put all of the important information in front of the surgeons, but in the end, they are the final decision makers.”

Do your homework

Ultimately, taking a little extra time to research products pays off in the end. “You don’t want to go and buy something until you have done all the necessary research,” says Dr. Craig. “We also utilize the help of the ECRI Institute, whose interdisciplinary staff offers invaluable advice.” 

In the end, Ms. Craig says your surgeons want to work with a spine table that provides the access and control they need, and your goal should be to provide them with the necessary equipment they need to obtain safe and successful patient outcomes. OSM