Who You Are in the OR — Quick Intro

• Tell us your primary role and typical caseload (specialty, avg cases/week).
• Which procedure types make up the majority of your minimally invasive volume? Options: General laparoscopic, Bariatric, Thoracic (VATS), Gynecologic laparoscopy, Colorectal, Mixed/Other
• Roughly what percent of cases are performed with laparoscopy/thoracoscopy vs open? Options: 0-25%, 26-50%, 51-75%, 76-100%
• What's one thing about your current instrument set or vendor relationship that you appreciate?

Are You Settling for 'Good Enough' When It Should Be Great?

• If you’re honest, where does current instrument performance most fall short at critical moments?
• How often do those shortcomings change your intraoperative decisions or slow a case? Options: Almost every case, Regularly (weekly), Occasionally (monthly), Rarely
• Tell me about a specific case where an instrument’s handling or tissue effect altered the outcome—what happened and how did it feel?
• What trade-offs are you tolerating today (e.g., ergonomics vs cost, single-use convenience vs waste/reuse reliability)? Options: Prioritizing surgeon ergonomics, Prioritizing lowest per-case cost, Prioritizing sterility/single-use, Prioritizing familiarity with instruments, Other
• How worried are you about variability between instruments or vendors affecting patient safety metrics? Options: Very worried, Somewhat worried, Rarely worried, Not worried

What Keeps Your Team Up at Night?

• What operational problems related to instruments drive the most OR delays or set-up errors?
• Which of these issues has the biggest financial impact on your service line? Options: High per-case disposable cost, Excess instrument breakage/repair, Long turnover times, Non-standardized sets, Reprocessing costs
• How do nurses and OR techs describe the most frequent frustrations with current instrument sets?
• How long has your team been tolerating these issues? Options: Less than 6 months, 6-18 months, 1-3 years, More than 3 years
• If someone asked your OR director what they would change first about instruments, what would they say?

What Would Perfect Actually Feel Like in the OR?

• Imagine peak operative flow: what instrument performance or set-up changes would make you confident to standardize across cases?
• Which clinical outcomes would you prioritize improving with a new instrument solution? Options: Reduced intra-op bleeding, Shorter operative time, Fewer conversions to open, Improved tissue handling, Reduced complications/readmissions
• Beyond clinical metrics, what would a meaningful improvement look like for your OR team day-to-day?
• What level of surgeon buy-in would you need to make a hospital-wide change feel safe and sustainable? Options: All key surgeons, Majority (60-80%), Core high-volume surgeons only, Unsure
• Which one change would produce the largest morale boost for your clinical staff?

How Will You Know This Solution Actually Worked?

• What are the top 3 measurable success signals you would need from an evaluation to recommend adoption? Options: Reduced per-case cost, Improved surgeon satisfaction scores, Lower OR time per case, Fewer instrument-related complications, Simpler tray configuration
• What magnitude of change (percent or absolute) in those metrics would be sufficient to move forward?
• Who needs to sign off on those metrics—surgeons only, OR leadership, value committee, finance, or all of the above? Options: Surgeons, OR leadership, Value analysis committee, Procurement/Finance, All of the above, Other
• Have you used formal acceptance criteria in past trials? If so, what were they and did you meet them?
• Would you prefer predefined pass/fail thresholds or a more qualitative surgeon-led assessment for trial success? Options: Predefined quantitative thresholds, Surgeon-led qualitative assessment, Combination of both, Unsure

Who's Really Steering This Ship?

• List all stakeholders who influence instrument selection and purchasing at your facility. Options: Chief of Surgery, High-volume surgeons, OR Director/Manager, Perioperative Nurse Leadership, Value Analysis Committee, Procurement/Materials Management, Infection Control, Other
• How does your value analysis committee weigh surgeon preference against per-case cost targets? Options: Surgeon preference prioritized, Cost prioritized, Balanced with clinical evidence, Depends on procedure/committee
• Are there explicit budget or per-procedure cost caps that would block adoption even if clinical performance is better? Options: Yes—strict caps, Flexible caps with justification, No explicit caps, Unsure
• Who within your team will be the day-to-day owner of a trial (logistics, data capture, training)?
• What decision timelines does leadership usually expect for device evaluations (weeks, months)? Options: <1 month, 1-3 months, 3-6 months, 6+ months

Talk to Me About Cost — The Real Tradeoffs

• Are you more concerned about immediate per-case disposable cost or the total cost of care across episodes (repairs, reprocessing, OR time)? Options: Per-case disposable cost, Total cost of care, Both equally, Unsure
• What is your current average allocated instrument cost per case (ballpark)? Options: <$50, $50-$150, $151-$300, >$300, Unsure
• How open are you to hybrid models (mix of reusable and single-use) to balance cost and performance? Options: Very open, Somewhat open, Prefer one model only, Unsure
• Which cost levers are available to you during procurement (volume discounts, standardization incentives, bundled contracts)? Options: Volume discounts, Standardization rebates, Consignment programs, Bundled device contracts, None available, Other
• If a high-performance device raised per-case cost by X but reduced OR time or complications, how would you evaluate that trade-off?

What Would a Real-World Trial Need to Look Like Here?

• If we ran an in-OR trial, what success criteria and case mix would you require to feel the data are credible?
• Which cases should we include or exclude for initial trials (complexity, patient BMI, specific procedures)? Options: Low complexity elective cases, High complexity cases, High BMI/bariatric, Oncology cases, Mixed representative sample
• Who would you want scrubbed vs observing during the first 10 trial cases? Options: Lead surgeon only, Resident/fellow included, Dedicated proctor + surgeon, OR techs present, Mixed team
• What logistical barriers do you foresee for instrument trials (sterile processing, inventory, sterilization cycles, tray space)?
• How would you prefer data be collected during the trial (automated case metrics, brief surgeon surveys after each case, observational audit)? Options: Automated metrics, Surgeon post-case survey, OR staff observational audit, Combination, Other

Training, Support, and the Human Side of Adoption

• What training formats have worked best for your surgeons and OR teams (simulation lab, in-OR proctoring, video modules)? Options: Simulation center, In-OR proctoring, Short video modules, Hands-on workshops, Peer-to-peer training
• How much proctoring do your surgeons typically want before they feel comfortable with a new device? Options: None, 1–2 cases, 3–5 cases, >5 cases, Depends on device
• Describe the best vendor clinical support experience you’ve had—what made it work?
• What are your top concerns about vendor presence in the OR during adoption (distraction, liability, workflow)? Options: Distraction, Liability concerns, Infection control, Workflow disruption, No concerns
• Would your team prefer bundled support (training + data analysis + supply logistics) or modular options? Options: Bundled support, Pick-and-choose modules, Start modular then bundle, Unsure

Evidence and Risk — What Will Move the Needle?

• What types of clinical evidence persuade your value committee most (RCTs, registry data, surgeon testimonials, cost modeling)? Options: Randomized trials, Real-world registry data, Peer surgeon testimonials, Health economic models, Systematic reviews
• How much weight does local surgeon preference carry versus published evidence? Options: Surgeon preference > evidence, Evidence > surgeon preference, Equal weight, Varies by committee
• What residual risks do you worry about after a positive trial (scalability, supply continuity, long-term costs)?
• If we committed to an evidence package and a warranty/guarantee, what would you need to see contractually to feel comfortable?

Practical Next Steps — What Would Make This Easy to Start?

• What is the simplest pilot we could run here that would meaningfully de-risk a larger decision?
• Who should be in the kickoff meeting to ensure quick momentum? Options: Lead surgeon(s), OR Director, Value Analysis rep, Sterile Processing rep, Procurement rep, Clinical Specialist/CS
• What timeline would feel realistic for a pilot to produce defensible results? Options: 2–4 weeks, 1–3 months, 3–6 months, 6+ months
• What would make you say “yes” to starting a pilot this quarter—what assurances or resources do you need?
• Any initial logistical constraints or blackout dates we should avoid when scheduling training or trials?

• Solution Experience Alignment
• In-OR Trial Planning Workshop
• Tissue Handling & Clinical Simulation
• Cost-Per-Case Modeling & Value Workshop
• Results Validation & Surgeon Confidence Decision

• Align procurement and value committee expectations for decision criteria post-trial.
• Produce the final trial protocol document and checklist and circulate for stakeholder sign-off within 48 hours.
• Create and distribute data capture templates (electronic or paper) and test the capture workflow in a dry run.
• Schedule the first N cases and confirm instrument inventory, sterile sets, and proctor availability.
• Arrange brief pre-trial simulation or OR dry-run for the surgical team and clinical support staff.
• Objective Recap & Forced Validation Rule
• Collect objective tissue-effect data and ergonomics measurements mapped to success signals.
• Obtain explicit surgeon validation (or rejection) of clinical fit using forced validation questions.
• Identify any immediate technique or configuration changes required prior to live-trial cases.
• Deliver recorded video, measurement logs, and surgeon scoring to the project folder within 24 hours.
• If adjustments are required, create a short retraining checklist and schedule a focused simulation session.
• Surgeon champion to sign an interim clinical-fit statement (pass/conditional/fail) against each success signal.
• Present Baseline Cost-Per-Case
• Produce a shared and adjustable cost-per-case model with transparent assumptions.
• Set explicit financial acceptance thresholds that map to the trial's success signals.
• Introductions & Objectives
• Deliver the working cost model spreadsheet with editable assumptions and scenario tabs.
• Procurement to provide current pricing and contract constraints; vendor to supply pricing scenarios for the agreed volumes.
• Value committee rep to define required documentation and approvals needed for adoption if trial meets thresholds.
• Recap Success Signals & Acceptance Criteria
• Verify whether trial results meet each success signal and financial thresholds.
• Capture explicit surgeon confidence levels and a documented decision (adopt/extend/iterate) with rationale.
• If adopting, agree a concrete implementation timeline and immediate next steps to operationalize change.
• Publish a results packet (data, video clips, surgeon statements, cost model) and an objective recommendation memo.
• If adopt: procurement to prepare PO/contract options and training to schedule proctoring and simulation sessions.
• If extend/iterate: create an adjusted protocol addressing observed gaps and schedule the extension with owners and timelines.
• Capture a post-implementation monitoring plan outlining KPIs, review cadence, and issue escalation paths.
• Achieve collective agreement on a precise current-state sentence that will guide the entire Solution Experience.
• Document quantifiable consequences (financial, time, clinical) that create urgency for change.
• Define a single future-state outcome and 3–5 measurable success signals the trial must prove.
• Align owners, timelines, and required data sources to execute the trial.
• Publish the agreed one-sentence current state, consequence statement, future-state sentence, and success signals to the shared project channel.
• Owner to draft initial trial hypothesis and circulate trial metric list and data capture requirements within 48 hours.
• Assign trial lead, surgeon champion, OR coordinator, and value committee rep with contact and preliminary timeline.
• Review Hypothesis & Acceptance Criteria
• Finalize a written trial protocol with clear inclusion criteria, metrics, and acceptance thresholds.
• Assign roles and schedule the first set of trial cases with owners for each logistic element.
• Agree and distribute data capture templates and select tools for measurement and storage.
• Confirm safety and escalation processes so clinical teams feel supported during trials.
• Model Scenario: Reusable vs Single-Use Mix
• Baseline Technique Demonstration
• Case Selection & Scheduling
• Data Presentation: Clinical & Operational Metrics
• One-Sentence Current State (Diagnosis)
• Explicit Consequence Statement
• Include Clinical Outcome Sensitivity
• Trial Protocol & Roles
• Financial Results: Cost-Per-Case Outcomes
• Hands-On Surgeon Simulation
• Data Capture Plan & Tools
• Pricing, Discount & Contract Scenarios
• Surgeon Review & Forced Validation
• Objective Tissue Effect Measurements
• Define Future State & Success Signals
• Break-Even & ROI Analysis
• Logistics: Sets, Stock, Sterility & Training
• Decision & Rationale
• Structured Qualitative Feedback & Validation
• Metrics, Data Sources & Validation Methods
• Hypothesis & Next Steps

• Deliver prepackaged procedure-specific disposable instrument kits
• Supply sterilized reusable laparoscopic hand instruments
• Deploy trocar and access device sets to the OR
• Provide single-use energy sealer per case
• Provide reusable energy sealer with sterilization turnover
• Deliver endoscopic stapler and reload cartridges to the OR
• Install and commission insufflation console and tubing
• Install smoke evacuation unit and disposable filters
• Provide in-OR clinical specialist support during live cases
• Run hands-on simulation training on instruments and stapling
• Assemble and deliver surgeon-configured instrument sets
• Perform point-of-care sterilization and maintenance for reusables

Deliver prepackaged procedure-specific disposable instrument kits

• Which procedure types should the prepackaged kits cover? Options: General laparoscopy (chole, appendectomy), Bariatric (gastric bypass, sleeve), Colorectal, Thoracic (VATS), Gynecology (hysterectomy, oophorectomy), Other
• What is the average number of cases per week for each procedure type? Options: 1-5, 6-15, 16-30, 30+
• Do you require surgeon-specific kit variations (surgeon-configured preferences)? Options: Yes, No
• List mandatory and optional items that must appear in each kit (e.g., graspers, scissors, trocars).
• What is your preferred delivery cadence and stocking location for kits (e.g., per-case cart, central sterile, satellite storage)? Options: Per-case delivery to OR, Daily restock to OR supply room, Central sterile pickup, Satellite storage
• Are there labeling, barcoding, or tray-sterility documentation requirements for your kits? Options: Yes, No

Supply sterilized reusable laparoscopic hand instruments

• Which reusable instrument types are required (e.g., atraumatic graspers, needle drivers, scissors)? Options: Graspers, Needle drivers, Scissors, Dissectors, Retractors, Other
• How many instruments of each type are needed per OR/procedure set?
• What sterilization method(s) does your facility use or prefer (e.g., steam autoclave, low-temp H2O2, EtO)? Options: Steam autoclave, Low-temp H2O2 plasma, Ethylene oxide (EtO), Other
• What is the typical case turnover time and the maximum acceptable instrument sterilization turnaround? Options: <4 hours, 4-8 hours, 8-24 hours, 24+ hours
• Do you require tracking and asset-tagging for reusable instruments (serial numbers, maintenance logs)? Options: Yes, No
• What are your acceptance criteria for reusables (e.g., functional lifespan in cases, failure rate thresholds)?

Deploy trocar and access device sets to the OR

• Which trocar types and sizes are required in the sets (e.g., 5 mm, 8 mm, 10 mm, 12 mm; optical vs bladeless)? Options: 5 mm, 8 mm, 10 mm, 12 mm, Optical trocars, Bladeless/tapered
• How many ports are typically used per procedure and which port positions do you standardize? Options: 1-2 ports, 3-4 ports, 5+ ports
• Do you require pre-assembled trocar/access trays delivered to each OR or loose inventory for central processing? Options: Pre-assembled trays to OR, Loose inventory to central sterile, Mixed approach
• Are specialized access devices needed (e.g., balloon trocars, dilation systems, single-incision ports)? Options: Yes, No
• Are there specific fixation or sealing accessories required (e.g., valve assemblies, insufflation seals)? Options: Yes, No
• Do any ORs require pre-staged sets for emergency cases or trauma packs? Options: Yes, No

Provide single-use energy sealer per case

• Which procedures and case volumes will use single-use energy sealers? Options: General laparoscopic, Bariatric, Colorectal, Thoracic, Gynecology
• What per-case cost target or allowable range do you have for single-use energy devices? Options: <$150, $150-$300, $300-$500, >$500
• Do surgeons require specific jaw styles or staple/seal lengths from the sealer? Options: Yes, No
• How many single-use sealers are typically used per case on average? Options: 1, 2, 3+, Varies by surgeon
• Are there waste-disposal or sharps protocols we should observe for single-use devices? Options: Yes, No
• Do you require clinical evidence or comparative cost-per-case analysis for single-use options? Options: Yes, No

Provide reusable energy sealer with sterilization turnover

• Do you have on-site capacity to process and turn over reusable energy devices between cases? Options: Yes, No, Partial/only some ORs
• How many reusable sealing units and handpieces would you require to support peak daily case volume?
• What maintenance and preventive service contract expectations do you have for reusable energy sealers? Options: Onsite repairs, Depot repairs, Loaner units during repair, Predictive maintenance
• What is the acceptable downtime threshold for a reusable sealer before a loaner is required? Options: <24 hours, 24-72 hours, >72 hours
• Do you require sterilization validation documentation for each turnover of the reusable sealer accessories? Options: Yes, No
• List measurable performance targets for the reusable sealer (e.g., seal burst pressure, staple line integrity, failure rate).

Deliver endoscopic stapler and reload cartridges to the OR

• Which stapler platforms and reload sizes must be supported (e.g., 45 mm, 60 mm; curved vs linear)? Options: 45 mm, 60 mm, Curved reloads, Linear reloads, CK/tri-staple equivalents
• What is the average number of reloads used per procedure by specialty? Options: 1, 2, 3, 4+
• Do you require compatibility checks with existing stapling platforms or only supply our proprietary systems? Options: Must be compatible with existing, Proprietary only, Evaluate compatibility case-by-case
• How do you prefer cartridges be staged for cases (pre-charged tray, on-call reorder, OR cabinet)? Options: Pre-charged tray, On-call reorder, OR cabinet storage
• Are there expiration tracking or inventory rotation processes we must follow for reload cartridges? Options: Yes, No
• Do you require backup/standby staplers available in the OR for device failures? Options: Yes, No

Install and commission insufflation console and tubing

• How many ORs will require a new insufflation console installation? Options: 1, 2-3, 4-10, 10+
• Do you need integration with existing surgical platforms or hospital gas/monitoring systems? Options: Yes, full integration, Partial integration, No integration required
• Are there space, mounting, or power constraints in the ORs we should plan for? Options: Yes, No
• What tubing lengths and connector types are required for your OR layouts?
• What commissioning timeline do you need (dates) and do you require zero-downtime installations between cases? Options: Specific dates provided, Flexible within month, As soon as possible
• Do you require training and competency sign-off for staff operating the insufflation console? Options: Yes, No

Install smoke evacuation unit and disposable filters

• How many ORs need smoke evacuation units and what are peak simultaneous uses? Options: 1, 2-3, 4-10, 10+
• Do you prefer portable bedside units, ceiling-mounted systems, or centralized smoke evacuation? Options: Portable bedside, Ceiling-mounted, Centralized system
• What filter type/filtration rating is required (e.g., ULPA, HEPA, charcoal + ULPA)? Options: ULPA, HEPA, Charcoal + ULPA, Other
• What is your expected disposable filter replacement cadence (per case, daily, weekly)? Options: Per case, Daily, Weekly, Monthly
• Are there noise-level or surgeon-acceptance constraints for units placed in ORs? Options: Yes, No
• Do you require connection/compatibility between smoke evacuation and insufflation consoles? Options: Yes, No

Provide in-OR clinical specialist support during live cases

• How many proctored/live-support cases do you anticipate during initial rollout? Options: 1-5, 6-15, 16-30, 30+
• Do you require in-person clinical specialist presence, remote support, or a hybrid model? Options: In-person, Remote, Hybrid
• Which roles should the clinical specialist perform (e.g., device setup, troubleshooting, surgeon coaching, data capture)? Options: Device setup, Troubleshooting, Surgeon coaching, Data capture/metrics
• What scheduling windows are acceptable for clinical specialist coverage (weekdays, nights, weekends)? Options: Weekdays, Evenings, Weekends, On-call only
• What key metrics or observations should the specialist record during each supported case?
• Who will be the internal point-of-contact and escalation pathway for clinical support requests?

Run hands-on simulation training on instruments and stapling

• How many surgeons and OR staff do you expect to train per session? Options: 1-4, 5-10, 11-20, 20+
• Which training formats do you prefer (wet lab, dry-lab box trainers, virtual simulation, proctoring in OR)? Options: Wet lab, Dry-lab box trainers, Virtual simulation, In-OR proctoring
• What learning objectives or competencies must be demonstrated to consider the training successful?
• Do you require formal assessment and certificates of competency after training? Options: Yes, No
• Are there preferred dates or windows for scheduling training (e.g., quarter start, weekends)?
• Do you require training materials or takeaways (checklists, quick reference guides)? Options: Yes, No

• Commercial Terms & Order Form
• Statement of Work (SOW)
• Clinical Trial Agreement / Evaluation Protocol
• Evidence & Publication Commitment
• Training, Proctoring & Implementation Plan
• Logistics & Supply Agreement
• Acceptance Criteria & Performance Sign-off
• Warranty, Service & Clinical Support Agreement
• Standardization & Adoption Roadmap
• Master Terms & Indemnification
• Change Order & Scope Amendment Process
• Data Use & Privacy Agreement (DUA/DPA)
• Purchase Order / Financing & Payment Schedule
• Rebate, Discount & Volume Incentive Schedule

• Outcome Validation Review
• Surgeon & OR Feedback Roundtable
• Issue Triage & Rapid Resolution
• Standardization & Value Governance
• Continuous Improvement & Shared Channel Handoff

• Document financial and clinical rationale so procurement and VAB can finalize commercial terms.
• Add prioritized product change requests or set reconfiguration items to the shared enhancements channel.
• Roll-call of Open Issues
• Resolve high-consequence issues within agreed SLAs to avoid derailing adoption.
• Ensure each issue has a clear owner, mitigation plan, and communication path.
• Document decisions in the shared channel so progress is visible to all stakeholders.
• Open prioritized incident tickets in the shared channel with owners and SLA timestamps.
• Deploy immediate mitigations (e.g., temporary instrument swaps, checklists) and confirm efficacy after X cases.
• Escalate any safety/regulatory issues to appropriate internal teams within 24 hours.
• One-line Executive Summary
• Obtain formal approval for the recommended standardization package or define required modifications.
• Agree on an adoption roadmap with measurable KPIs and governance owners to track outcomes.
• Opening & Objective Statement
• Finalize the Standardization Proposal with SKU lists, set configurations, and expected cost impact for procurement sign-off.
• Create a Rollout Plan with owners, milestones, and KPI dashboards for monthly tracking.
• Update contracts or purchasing agreements to reflect approved product mix and pricing commitments.
• Handoff Statement (Current State -> Ongoing State)
• Ensure a functioning shared channel with clear rules, owners, and SLAs so issues and enhancements are managed transparently.
• Prioritize the initial backlog and schedule the first recurring backlog-review meeting.
• Confirm access and provide training so all clinical and operational stakeholders can contribute reliably.
• Create the shared channel (or workspace) and migrate all open issues, feedback, and decision documents into it.
• Assign channel moderators and define SLA timers for response and resolution.
• Schedule recurring review cadence (e.g., weekly triage, monthly governance) and invite all owners.
• Determine whether trial outcomes meet the pre-defined success signals and formally document the acceptance decision.
• Ensure every variance is tied to a measurable consequence and assigned an owner for remediation or follow-up.
• Agree on next steps, timelines, and a communication plan for stakeholders (surgeons, OR leadership, VAB).
• Produce a one-page Outcome Summary showing baseline vs trial metrics, decision rationale, and sign-offs.
• Assign owners for each identified gap with clear mitigation steps and deadlines.
• Schedule a follow-up acceptance checkpoint (date & attendees) if remediation is required.
• One-sentence Current State from Surgeons' Perspective
• Capture actionable surgeon and OR feedback tied to specific case moments and metrics.
• Prioritize training, workflow, and product adjustments that will most effectively close gaps.
• Establish owners and a feedback-to-resolution pathway so clinicians see progress.
• Create a consolidated Feedback Log that links each comment to trial cases and metrics.
• Assign training sessions or proctoring dates for identified technique gaps.
• Shared Channel Structure & Rules
• Per-Case Cost & Clinical Benefit Trade-off
• Structured Surgeon Feedback (Handling & Tissue Effect)
• Recap of Success Signals & Acceptance Criteria
• Prioritization by Consequence
• Proposed Standardization Package
• Quantitative Metrics Review
• Root Cause & Proposed Immediate Fixes
• OR Team Workflow & Set Management
• Backlog Triage & Prioritization Process
• Consequence & Variance Assessment
• Decision & Owner Assignment
• Adoption Roadmap & KPIs
• SLAs, Escalation Paths & Reporting Cadence
• Validation: Tie Feedback to Metrics
• Escalation & Communication Plan
• Deviations & Root Observations
• Co-create Fixes and Training Needs
• Approval & Governance Assignments
• Training & Access
• Confirm Ownership & Communication
• Decision & Next Steps