Becker’s Healthcare Podcast: Advancing Outpatient Joint Replacement Through Technology and Teamwork

Host: Brian Zimmerman
Guest: Dr. Robert Maley, Fellowship-Trained Orthopedic Surgeon
Release Date: July 22, 2025

Introduction

In the episode titled “Advancing Outpatient Joint Replacement Through Technology and Teamwork,” Brian Zimmerman hosts Dr. Robert Maley, a renowned orthopedic surgeon from Pacific Orthopedics in California. The discussion centers around achieving clinical excellence, economic value, and operational support within Ambulatory Surgery Centers (ASCs) through innovative technology and collaborative teamwork.

Dr. Robert Maley’s Professional Background

Dr. Maley opens the conversation by sharing his extensive background in orthopedic surgery. He highlights his residency at Stanford and fellowship in hip and knee replacement at Rush in Chicago, where he honed his skills in minimally invasive and outpatient surgeries. Upon returning to the Bay Area 13 years ago, Dr. Maley played a pivotal role in developing an outpatient total joint replacement program at Pacific Orthopedics, catering to a diverse patient population ranging from young, active individuals to older adults.

“Coming into the Bay Area, I was really kind of eager to apply what I had learned and unfortunately to be part of a big group, there's about 15 of us... we see a lot of patients from the Bay Area.”
— Dr. Robert Maley [00:39]

Selecting and Implementing Technology in the ASC

Dr. Maley emphasizes the importance of adopting technologies that address specific challenges within the ASC. He explains that with the influx of new technologies, discerning which ones add genuine value is crucial.

“Whenever something's presented to you, you have to take into account what could be helpful and what might just be noise.”
— Dr. Robert Maley [02:17]

His approach involves identifying operational inefficiencies and seeking technological solutions that can effectively mitigate these issues. This strategic selection ensures that the technologies implemented are not just trendy but are genuinely beneficial for the practice.

Key Technologies Adopted

1. Advanced Case Management (ACM) with Docsper and JJ Medtech

   • Purpose: To manage and streamline inventory by using preoperative templating to predict patient-specific needs.
   • Impact: Significantly reduced excess inventory and optimized supply usage.

   “One of the original technologies that I was introduced was advanced case management... that was the first time we were able to really, truly quantitate our needs.”
   — Dr. Robert Maley [04:10]

2. Actis

   • Purpose: Further enhanced inventory management initiated alongside ACM.
   • Impact: Drastically cut down the number of surgical trays needed, saving space and resources.

3. DEO Solution

   • Purpose: Recorded surgical workflows to analyze and improve operational efficiency.
   • Impact: Provided granular data on team performance, identifying areas for improvement and increasing the number of cases handled daily.

   “The DEO solution... allowed us to see what our day looks like, step by step... our case numbers improve because you're able to do more cases in the same amount of time.”
   — Dr. Robert Maley [06:00]

4. Vellus Robot for Total Knee Replacements

   • Purpose: Enhance surgical precision and patient outcomes.
   • Impact: Increased patient satisfaction scores by five points without the need for additional advertising.

   “Our CU scores jump up five points compared to where they were prior to the use of the robot... we just try to execute the appropriate surgical plan for a patient and provide them the best outcome.”
   — Dr. Robert Maley [13:30]

Impact of Technology on Operations

The integration of these technologies has revolutionized the operational efficiency and clinical outcomes at Pacific Orthopedics. By optimizing inventory and streamlining surgical workflows, Dr. Maley’s team has been able to:

• Increase Case Volume: Enhanced efficiency allows for more surgeries within the same timeframe.
• Improve Patient Outcomes: Advanced tools and precise surgical techniques lead to better recovery rates and higher patient satisfaction.
• Optimize Resource Management: Reduced inventory clutter and better space utilization within the ASC.

“We started off small and if you look at our 10-year track record, you'll see that it's an exponential improvement in terms of numbers of cases done per year.”
— Dr. Robert Maley [13:15]

Building a Collaborative Team and Culture

Dr. Maley attributes much of their success to fostering a culture of transparency and open communication within the team. By establishing a dedicated total joints team comprising administrators, anesthesiologists, surgeons, data analysts, and nurses, they ensure continuous improvement through regular meetings and honest feedback.

“Open communication is the key to having the honest dialogue that will improve your efficiencies along the way.”
— Dr. Robert Maley [07:37]

This collaborative environment allows team members to present constructive criticism and work together to enhance operational workflows and patient care.

Expansion and Future Projects

With the growing success of the total joint program, Pacific Orthopedics has expanded its facilities by adding two new operating rooms. The focus now is on further optimizing the surgical workflow by tracking patient movements and time spent in various stages of the surgical day. This ongoing project aims to refine efficiency and maximize the use of resources even more effectively.

“One of the most recent projects that we're taking on is tracking where people are in the workflow of a day of surgery... That's our current focus.”
— Dr. Robert Maley [09:34]

Thought Leadership and Sharing Expertise

Recognized as a thought leader in the field, Dr. Maley is passionate about sharing his experiences to help others in the industry. He believes that by disseminating knowledge, other practitioners can avoid common pitfalls and accelerate their own improvement processes.

“I'd rather see somebody be able to improve their learning curve... than have to go through all the trials and tribulations that we went through.”
— Dr. Robert Maley [14:59]

His commitment to education and collaboration underscores his dedication to advancing outpatient joint replacement practices across the healthcare landscape.

Conclusion

Brian Zimmerman and Dr. Robert Maley engage in a comprehensive discussion that underscores the pivotal role of strategic technology adoption and collaborative teamwork in advancing outpatient joint replacement procedures. Dr. Maley’s insights highlight how thoughtful implementation of innovative solutions can lead to significant improvements in operational efficiency, patient outcomes, and overall program growth. This episode serves as an invaluable resource for healthcare professionals aiming to enhance their practices through technology and effective team dynamics.

Notable Quotes:

• “Whenever something's presented to you, you have to take into account what could be helpful and what might just be noise.”
  — Dr. Robert Maley [02:17]

• “Using technology to track our day and see where we are efficient and where we could be more efficient.”
  — Dr. Robert Maley [06:00]

• “It's been 10 years that we've been doing it specifically there. And I'd like to think we were on the front end of the curve.”
  — Dr. Robert Maley [14:30]

For more insights and episodes from Becker’s Healthcare Podcast, visit beckerspodcast.com.