Design and implementation of a composite performance score to drive cost efficiency in robotic-assisted surgery: the Orlando Score.

This study describes and evaluates the implementation of a composite performance score, an integrated metric designed to enhance performance in robotic surgery by focusing on three domains: operational efficiency, cost control, and clinical outcomes. Quarterly feedback meetings to discuss the evaluations based on the score and individualized reports fostered active surgeon engagement in cost-reduction strategies. The project compared two cohorts: an intervention group where surgeons adopted the score and a control group where it was not implemented. Two periods, pre-implementation (Q1 2024) and post-implementation (Q4 2024), were analyzed to assess the financial impact of the score. The findings showed a 7.5% cost reduction per procedure in the intervention group, while the control group experienced an increase in costs. No differences were observed in operative time, length of stay, or readmission rates, confirming that cost optimization did not compromise the quality of care. This approach highlights the value of the composite performance score as a tool for promoting cost-efficient resource management in robotic procedures, demonstrating that with appropriate data, surgeons can effectively participate in initiatives aimed at lowering costs in robotic surgery.