Imagine that you are the director for an ambulatory surgery center (ASC). Your A

Imagine that you are the director for an ambulatory surgery center (ASC). Your ASC has historically performed well and it is a recognized leader in patient safety and has outperformed the vast majority of local ASCs on publicly reported quality, patient safety, and patient satisfaction measures. Competing ASCs are planning to expand their operations due to a growing demand for geriatric cases. There has been less demand for pediatric cases in the past 2 years.
Your chief pediatric surgeon approaches you with an idea to purchase a new surgical robot, which suggests that it can improve quality by reducing the size of a required incision, reducing post-op complications, and thereby expediting recovery. The robot, recently approved by the FDA, has wide-ranging applicability to your current cases. No other ASC is currently engaged in discussions with the vendor to purchase the new robot. Unfortunately, third-party payers will not reimburse for the additional consumables required by the robot. Furthermore, your team of surgical pediatricians are not currently certified to perform procedures with the robot. Certification requires completing three 1-hour training sessions and the completion of 20 successful cases under the oversight of a certified surgeon.