Getting a patient on and off the operating table is a tricky task that takes time and puts patients and staff in harm's way. Stretcher chairs eliminate lifting and transferring patients throughout the perioperative process. Already hot in ophthalmology and gaining popularity in ENT and podiatric facilities, these hybrid chairs can also improve throughput because once the patient is on the stretcher, there's no need for him to get up until discharge. Here are 9 tips to consider as you shop for stretcher chairs.

1 Compare manual vs. electric. Units that can be moved or positioned manually don't have batteries that need to be charged. But then you need to make sure that everyone who'll be using the devices can easily push the stretcher chair with a patient in it and use the manual controls to position the patient. With electric models, consider whether the device has a battery or needs to be plugged into the wall to position a patient or power a vital signs monitor that stays on the stretcher with the patient.

"Look for ease of use," says Tiffany Yount Kenyon, RN, BSN, OR coordinator at the Physicians Surgery Center in Williamsport, Md. The positioning controls on non-electric units can be a challenge to manipulate for some staff members. Remember the repetition involved. If you have 30 patients a day, someone on your staff may be using the controls 30 times a day to raise or lower patients. Make sure that 1 or 2 team members are well-educated in how the controls work and that they're strong enough to use the controls for positioning patients, she adds.

At Ms. Kenyon's facility, eye surgery patients are transferred to a stretcher table in the pre-op area. While waiting for the patient's eyes to dilate, the anesthesia provider and a nurse position the patient. Once the patient is ready, he is wheeled into the OR, already in position. "All they have to do is tape the head and prep the eye," says Ms. Kenyon.

2 Run the trial when you're busy. Bringing in demo equipment during a high-volume period may sound counterintuitive, but you need to run a trial in a real-life setting. "You'll find out if it will work well for you when you're busy," says Brian Moser, MBA, assistant administrator at HEA Surgery Center in Houston, Texas. Tell each rep that you'd like to demo the stretchers for 2 or 3 weeks. When the demo units arrive, have the rep teach everyone who'll be using the units how they work. Then run mock cases, so that your staff isn't trying to figure out how the units work during real cases, which will bog down your patient flow. If you plan on attaching a vital signs monitor, figure out how it will attach and how it plugs in for power.

When you start using the demo units for real, run a mini-benchmarking study of all phases of the perioperative process when the patient is on the stretcher. Especially with cataract surgery, saving or adding a couple of minutes can greatly affect your efficiency. "We sit there with a timer," says Mr. Moser, whose facility began using stretcher chairs designed for eye surgery about 18 months ago. "We're saving a minimum 2 minutes per case and avoiding high-risk events."

3 Demo several units at the same time. If you trial a single stretcher at a time, you won't be able to get a true sense of how the new units will affect your efficiency. You'll need at least a pair of stretchers from the same manufacturer, especially if you have eye surgeons who work 2 rooms at the same time. Ideally, you should ask to demo as many as you'll need. Mr. Moser suggests at least 1 per working OR, 1 per pre-op room and a half per post-op bay. For example, if your center has 3 ORs, 3 pre-op rooms and 4 post-op bays, you'll need 8 units or more.

4 Run the whole course. If you don't use the stretchers during procedures, at least push the demo unit, with a mock patient in it, wherever you take patients. "Drive it down the path that it's going to go," says Carrie McCown, RN, director of the NovaMed Surgery Center of Warrensburg, Mo. Measure any doorways that aren't double doors to make sure that the stretcher will fit without banging into the walls and door jambs. Make sure that the stretcher fits into the pre-op room where the patient will get in the stretcher. Also, figure out where you're going to stow the units when they're not being used and make sure that they'll fit there. "Other-wise, you'll have all the stretchers backed up [in the hallway]," says Mr. Moser.

5 Know the maximum weight. Patients are getting heavier, so find out the maximum weight the stretcher chair can handle. If the device can handle heavier patients, consider how easy, or difficult, it may be for your staff to help an obese patient in or out of the stretcher chair. Also, consider how wide the stretcher is, says Ms. Kenyon, whose facility has used stretcher tables for about 2 years. Over-weight or large patients may be wider than the stretcher. "The top of the bed is a little narrow," says Ms. Kenyon. "Sometimes we have to tape the patients' shoulders down." Similarly, make sure that the stretcher goes low enough for elderly or weak patients to get into it.

6 Ask about the batteries. Find out how long the batteries last and how long it takes to recharge them. Just as important, find out whether the batteries are included in the cost of the unit. "That can be a hidden charge. You may need to buy the batteries and the charger," says Mr. Moser.

7 Get surgeon input. Although the surgeons won't be pushing the units or positioning patients, they'll spend a lot time hunched over the stretchers. During the trial, find out how much legroom the surgeon has. "They'll want it to be high enough so that their knees are free," says Lisa Galloway, RN, clinical director of the Snowden River Surgery Center in Ellicott City, Md.

Ask them what they like and don't like. For some it may be the headrest. Stability of the stretcher is very important to eye surgeons. "If it moves, the microscope goes out of focus," says Jason Jones, MD, president of Jones Eye Clinic in Sioux City, Iowa.

8 Consider maintenance. Headrests, rails and positioning controls can fail after repetitive use. If something breaks on the units, who's going to fix it? Whether your planning on buying new or refurbished products, ask about the warranty and the service plan. If you have a contract with a biomedical services company, find out if they're authorized to fix the units, says Mr. Moser.

9 Strike a deal. Once you've decided on which model is best suited for your facility, work up a deal. "Tell the company that you're interested in buying more than one," says Mr. Moser. When you buy in volume, you may be able to get a discount on the units themselves or the service plan. Incorporating the new stretcher into your system shouldn't be very difficult if your staff has run through the trials and feels comfortable.