Start Here: Who's in the Room?

• Who will be directly involved in evaluating implants, instruments, and OR workflow for this program? Options: Surgeon(s), Orthopedic Service Line Director, OR Manager/Nurse Lead, Value Analysis Committee (VAF) Member, Hospital Procurement/Materials Management, GPO Representative, IDN Contract Manager, Biomedical/ Sterile Processing, Other
• Tell us about the primary surgeon(s) who might adopt a new system—what do they value most in an implant platform and OR support?
• How long does your typical implant evaluation and approval process take from introduction to decision? Options: Less than 1 month, 1–3 months, 3–6 months, 6–12 months, 12+ months, Variable/Unsure
• Historically, which party has driven final decisions on implants and why? Options: Surgeons, VAF, Hospital Procurement, GPO/IDN, Shared decision, Other
• What top three measurable outcomes does your institution use to judge a successful implant program? Options: Revision rate, OR time per case, Per-case implant spend, Length of stay, Readmission rate, PROMs/Functional outcomes, Surgeon adoption rate, Other
• Which vendors have you evaluated or used recently, and what ultimately drove any change (or prevented change)?

Are You Settling for Compromise?

• Which long-standing compromise between surgeon preference and hospital cost pressure do you accept that still frustrates you?
• How often do these surgeon vs. hospital conflicts surface during procurement or VAF reviews? Options: Almost every case, Often, Occasionally, Rarely, Never
• Give a real example where that compromise led to a clinical, financial, or operational problem—what happened and who felt the impact?
• When those disputes occur, who typically gets the final say and why does that party usually prevail? Options: Surgeon - clinical autonomy, VAF - cost governance, Procurement - contract terms, GPO constraints, Shared decision, Other
• If a structured process could resolve these trade-offs without eroding surgeon trust, how willing would your team be to try it? Options: Very willing, Somewhat willing, Skeptical but curious, Not willing
• What emotional or cultural barriers (e.g., fear of losing autonomy, reputational risk) tend to block productive compromise here?

What's Really Costing You?

• If you could eliminate one hidden or tolerated cost in your arthroplasty program tomorrow, what would it be and why?
• Which of the following are the biggest cost drivers for you today? Options: Implant list price, Disposable instruments/consumables, OR time and turnover, Inventory carrying and stockouts, Reprocessing and sterilization labor, Warranty and revision costs, Clinical complications/readmissions, Other
• What is your current target or acceptable range for per-case implant spend for primary arthroplasty? Options: <$2,000, $2,000–$4,000, $4,000–$6,000, $6,000–$8,000, >$8,000, No target/Undisclosed
• How has per-case implant spend trended over the last 12–24 months at your facility? Options: Rising, Stable, Decreasing, Volatile/Uneven, Unknown
• Describe any active standardization efforts (e.g., formulary rules, preferred vendor lists) and the main barriers you've run into.
• What systems or reports do you have today to track cost drivers (choose all that apply)? Options: ERP/Materials Management dashboards, Clinical registry integration, Manual spreadsheets, Periodic finance reports, Real-time OR analytics, Limited or no tracking

When the OR Isn't Moving: Pinpointing Friction

• Which specific OR moment—instrument missing, tray setup, implant fit, rep unavailable—most often turns a routine case into a crisis?
• How frequently do instrument or instrumentation workflow problems cause delays or case cancellations? Options: Daily, Weekly, Monthly, Occasionally, Rarely, Never
• Which intraoperative support model do you rely on today and which pain points does it create? Options: Rep scrubbed in and handling instruments, Rep in room but non-scrubbed, Remote/phone-based support, Dedicated hospital-employed tech, No vendor support, Other
• Have you experienced instrument failures or set incompleteness that changed clinical decisions mid-case? Tell the story and the downstream impact.
• What level of vendor rep involvement in the OR would surgeons and OR staff consider acceptable or ideal? Options: Scrubbed assistance, Non-scrubbed in-room support, On-call remote support, Scheduled proctorship only, No vendor presence
• How does instrument reprocessing or tray complexity affect your sterile processing workflow and turnaround times?

What Would 'Good' Look Like for Each Person?

• Pick a stakeholder—surgeon, VAF rep, OR manager, or procurement—what would a perfect adoption outcome look like to them and why would they care?
• Which of the following best describes stakeholder priorities across your organization right now? Options: Clinical outcomes first, Cost reduction first, Balanced clinical+cost, Operational efficiency prioritized, Surgeon autonomy emphasized, Other
• For surgeons specifically, which of these are absolute non-negotiables when evaluating a new implant system? Options: Implant geometry/kinematics, Proven clinical outcomes, Instrument ergonomics and reliability, Minimal learning curve, Strong intraop support, Specific bearing options, Other
• For hospital/VAF reviewers, what evidence or assurances move the needle fastest? Options: Economic modeling/ROI, High-quality registry data, Peer-reviewed studies, Warranty/registry programs, Standardization potential, Contract/GPO pricing
• What operational deliverables (e.g., tray counts, staff training hours, guaranteed rep coverage) would make your OR manager feel confident?
• Where do you see the greatest misalignment between 'surgeon good' and 'hospital good' that we should address first?

Are You Confident in the Evidence?

• Which missing piece of evidence would cause your team to stop debating and move straight to adoption?
• What types of evidence do you currently rely on when vetting implants? Options: Randomized controlled trials, Registry data, Single-center clinical series, Surgeon peer testimonials, Biomechanical/bench testing, None/Varies by case
• Which clinical outcomes are tracked and reported routinely at your facility for arthroplasty? Options: Revision rate, Infection rate, PROMs/Patient satisfaction, Procedure time/OR efficiency, Readmission/complication rate, Dislocation rate, Other
• How open is your team to sharing outcome data or participating in a vendor-supported registry as part of a pilot? Options: Open to full data sharing, Open to de-identified sharing only, Prefer limited sharing, Not open
• Would peer proctorship, a local pilot, or a multi-center study be most persuasive to your decision-makers? Options: Peer proctorship (surgeon-led), Local pilot (defined cases), Multi-center registry/published study, Randomized trial, Existing evidence sufficient
• What concerns cause you to distrust vendor-provided outcome claims or economic models?

What Would Switching Actually Feel Like?

• Imagine a smooth vendor switch—what specific friction points would still be most likely to derail it before you even start?
• Have you attempted a product or vendor change in the past 3 years? If so, what worked and what stopped full adoption?
• Which instrument or inventory constraints are most likely to block adoption (choose all that apply)? Options: Instrument compatibility with hospital trays, Incomplete or missing instrument sets, Excessive tray counts/sterilization burden, High reprocessing time, Capital cost for new trays/storage, Other
• Which contractual or GPO-related concerns are most likely to prevent a switch? Options: GPO pricing lockouts, IDN master contract limitations, Buy-out or inventory write-off costs, Lengthy procurement approvals, Clinical preference clauses, Other
• How many proctored cases, and of what type, would surgeons expect before feeling comfortable adopting a new system? Options: 1–3 cases, 4–10 cases, 10–25 cases, 25+ cases, Depends on complexity/implant type
• What would your ideal timeline look like from pilot agreement to full roll-out (weeks/months)? Options: Immediate (weeks), 1–3 months, 3–6 months, 6–12 months, 12+ months

Next Steps, Signals, and Mutual Acceptance

• What specific, measurable acceptance criteria would your team require to consider a pilot successful? Options: OR time reduction per case, Per-case implant cost target, No increase in complication/revision rate, Surgeon satisfaction score threshold, Staff competency metrics, Inventory turnover/improvement
• What trial length and case volume would you consider sufficient to judge success? Options: 1 month or 10 cases, 3 months or 25 cases, 6 months or 50 cases, By outcomes rather than time/case count, Unsure
• Who absolutely must sign off on a pilot or adoption (names or roles)? Options: Lead Surgeon(s), Orthopedic Service Line Director, VAF Chair, OR Manager, Materials Management/Procurement, GPO/IDN Rep, Other
• What cadence and format of updates would you prefer during a pilot (e.g., weekly case review, dashboard, monthly executive summary)? Options: Weekly operational huddle, Biweekly clinical review, Monthly executive summary, Real-time dashboard access, Ad-hoc as-needed updates
• Are there regulatory, credentialing, or credentialing documentation hurdles we should address upfront? Options: Surgeon proctoring credentialing, OR staff training certifications, Implant tracking/UDI setup, Insurance/coverage considerations, None/Handled internally
• List any outstanding risks, political dynamics, or hidden constraints we must mitigate before drafting a mutual commitment.
• Realistically, when could we schedule a follow-up to review a pilot proposal and acceptance criteria? Options: Within 1 week, 1–3 weeks, 1–2 months, 3+ months, Undecided

Tell Me About Your Implant Lineup

• Which implant families are you using for most of your cases today (select all that apply)? Options: Primary knee arthroplasty, Primary hip arthroplasty, Revision hip/knee, Shoulder arthroplasty, Trauma fixation (plates/nails), Sports medicine anchors/soft tissue
• Roughly what percentage of your total arthroplasty/trauma volume does each of those families represent? (e.g., 50% knees, 30% hips)
• Which manufacturers supply your primary implants and instrument sets today? (select all that apply) Options: Stryker, Zimmer Biomet, DePuy Synthes (J&J), Smith & Nephew, Exactech, NuVasive/Other specialty vendors, Independent reps/other
• Do you maintain a documented, surgeon-level map of who prefers which systems? Options: Yes — up to date, Yes — but outdated, No formal map, informal knowledge only, No
• Tell me about one recent case where implant choice felt clearly right—or clearly wrong—and why.

Are You Settling for Patchwork Standardization?

• When leadership says 'we've standardized implants,' whose definition of 'standard' usually wins here—clinical preference or cost pressure? Options: Surgeons/clinical preference, Service line admin/hospital leadership, VAC/GPO influence, A hybrid compromise, Other
• What percentage of arthroplasty/trauma cases currently use a single preferred system versus exceptions? Options: >90% standardized, 70–90% standardized, 40–70% standardized, <40% standardized
• How are exceptions handled today when a surgeon requests a non-standard implant? Walk me through the approval and logistics.
• Which factors typically override standardization at your site? (select up to three) Options: Surgeon preference/technique, Complex/revision cases, Lack of clinical data for standard option, Instrument set limitations, Contract/GPO constraints, Other
• If you could change one policy or process to make standardization actually stick, what would it be?

Where Does the OR Slow Down?

• If you had to name the single most frequent cause of intraoperative delay or fragility, what would it be? Options: Missing/incorrect instruments, Implant availability/templating issues, Lengthy trialing/fit adjustments, Communication with rep/tech support, Room turnover/sterile processing delays, Other
• How often do cases exceed your target OR time because of implant or instrument issues? Options: Almost every case, Weekly, Monthly, Rarely, Never tracked
• Describe a recent OR incident tied to instrumentation or implants and the downstream impact (time, staff stress, case cancellation, patient outcome).
• Who in the OR typically escalates when an implant/instrument problem appears (surgeon, RN, tech, rep)? Options: Surgeon, Circulator RN, Scrub tech/sterile processing, Sales rep/vendor tech, Service line admin
• What workarounds have become 'normal' to avoid delays, and how comfortable are teams with those workarounds? Options: Standard workaround used and accepted, Used but creates concern, Used rarely, risky, No consistent workaround

What's Missing From Your Instrument Room?

• How often does the OR discover a required tray, instrument, or implant component only after the patient is prepped? Options: Weekly, Monthly, Quarterly, Rarely, Never tracked
• What percentage of your instrument trays are vendor-owned versus hospital-owned? Options: Mostly vendor-owned (>75%), Mixed (25–75%), Mostly hospital-owned (<25%), Unknown
• How reliable are your sets in terms of completeness and function—do you track missing instruments, broken instruments, or repeated repairs? Options: We track in detail, We track informally, We notice but don't track, We don't track
• What reprocessing turnaround time do you need to keep OR schedules reliable, and do you hit that target now? Options: <6 hours, 6–12 hours, 12–24 hours, >24 hours
• Tell me about one instrument or tray design you wish existed to reduce complexity or setup time.

Who Is Paying — Really?

• When the finance team looks at total cost per case, which line item causes the most surprise or debate? Options: Implant per-case cost, OR time and staffing, Instrument repair and replacement, Inventory carrying costs, Revision/readmission costs, GPO/fee structures
• What's your estimated average implant spend per primary hip/knee case today? If ranges vary by surgeon or case type, please specify.
• How much variability do you see in implant cost between surgeons for the same case type? Options: Minimal (<10%), Moderate (10–25%), High (25–50%), Very high (>50%), Not sure
• Which purchasing mechanics are in place today? (select all that apply) Options: GPO contracts, IDN master agreements, Facility-level purchasing, Surgeon buy-in with exception process, Value-analysis committee oversight, Direct negotiation with vendors
• Are there hidden or recurring costs tied to your implants (e.g., instrument repair, special sterilization, warranty fees)? Please list and estimate impact if possible.

When Teams Tried to Change, What Broke?

• Think of the last time you introduced a new implant or tried to standardize—what failed first and why do you think it failed?
• Which stakeholder most commonly resists adoption of new implants or instruments? Options: Surgeons, OR staff, Sterile processing, Procurement/VAC, GPO partners, Other
• How long did it take for the team to either adopt or abandon the change in that example? Options: <1 month, 1–3 months, 3–6 months, 6–12 months, >12 months
• What support or intervention would have changed the outcome in that attempt (training, dedicated reps, guaranteed outcomes, financial incentives)? Options: Focused surgeon training/proctorship, Dedicated intraop rep/tech, Clear outcome guarantees/warranty, Financial incentives or shared savings, Better data tracking/metrics, Other
• Describe any emotional or cultural barriers you noticed—what made people reluctant beyond the practical issues?

If We Could Build the Perfect Case Together

• Imagine an ideal day in your OR—what single outcome change would make surgeons feel clinically confident and administrators feel the spend is justified?
• Which measurable success signals matter most to you for any new implant solution? (select up to three) Options: Reduced OR time, Lower per-case implant spend, Reduced revision/readmission rates, Fewer instrument-related delays, Improved patient-reported outcomes, Registry participation/warranty
• Would you be open to a structured pilot (defined case mix, proctorship, tracked metrics) to validate a new system? If yes, who would need to sign off? Options: Yes — clinical and admin signoff required, Yes — clinical signoff only, Maybe — need more info, No
• What guarantees or supports would switch the balance for you (inventory assurance, instrument ownership models, intraop rep coverage hours, financial guarantees)? Options: Guaranteed instrument availability, Vendor-owned instrument sets, Dedicated intraop rep coverage, Outcome/warranty commitments, Training/proctorship included, Other
• Realistically, what timeline would your team need to pilot and decide on a new implant solution? Options: 1–3 months, 3–6 months, 6–12 months, 12+ months, Unsure

Quick Introductions — Who are we solving this for?

• Tell us which roles are joining this conversation today (pick all that apply). Options: Arthroplasty Surgeon, Trauma Surgeon, Sports Medicine Surgeon, OR Nurse/Manager, Service Line Administrator, Value Analysis Committee (VAF) Member, Supply Chain/Materials Manager, GPO Representative, Other
• Which implant families does your team currently use most frequently (brand or platform names)?
• How would you describe the overall appetite here for product change right now? Options: Actively seeking alternatives, Open if clinical case is strong, Conservative — only incremental changes, No interest
• What is the typical decision timeline from evaluation to first case in your organization? Options: 6–12 months, > 12 months, < 1 month, 1–3 months, 3–6 months
• Who ultimately signs off on implant selection and contracts in your setting? Options: Surgeon(s) alone, Surgeon committee, Service line director, VAF committee, Supply chain / materials management, Multi-stakeholder (combination)

What Would a Bad Day in the OR Reveal About Your System?

• When a case goes poorly because of implants or instruments, what usually breaks down first? Options: Instrument availability/quality, Implant fit/compatibility, Rep intraop support, Reprocessing delays, Tray completeness, Other
• How often in the past 6 months have you experienced intraoperative delays tied to instrument or implant issues? Options: Weekly or more, Monthly, A few times, Rarely, Never
• Give a specific example of a recent OR problem related to implants/instruments — what happened and who felt the consequences most?
• When these problems occur, how do they typically affect patient flow, staff morale, or surgeon confidence (select all that apply)? Options: Extended case time, Case cancellation, Extra staff overtime, Surgeon frustration, Patient dissatisfaction, Downstream scheduling issues
• What workarounds have you put in place that feel fragile or unsustainable?

Where Institutional Pressure and Surgeon Preference Collide — What’s the Real Tension?

• If you had to name the single biggest source of pressure to change implants or standardize, what would it be? Options: Cost reduction initiatives, GPO contract changes, Clinical outcome concerns, Inventory constraints, Leadership directives, Other
• How much influence does the VAF carry compared with lead surgeons when final choices are made? Options: VAF majority, Surgeon majority, Even influence, Varies by case or surgeon
• Has the facility recently run competitive bidding or a standardization program? If yes, what was the outcome and how did surgeons react? Options: Yes — successful (surgeon buy-in), Yes — met resistance, No — not recently, Currently underway
• Tell us about any internal incentives or metrics driving standardization (e.g., target per-case implant spend, SKU reduction goals).
• What would have to change in the procurement process for surgeons to feel comfortable switching systems?

What Do You Track That Actually Tells You If Patients Are Better Off?

• Which clinical outcomes are considered most meaningful here when evaluating an implant (pick up to three)? Options: Revision rate, Infection rate, Dislocation/instability, PROMs (patient-reported outcomes), Functional scores (e.g., WOMAC), Periop complication rates
• What operational/financial metrics influence purchasing decisions (select all that apply)? Options: OR time per case, Length of stay, Per-case implant spend, Inventory carrying costs, Implant warranty/consumable costs, Reprocessing/retrieval costs
• Where do you currently pull these metrics from (EHR, EMR, registry, manual logs, GPO reports)? Options: EHR/EMR, National registry, Internal analytics, GPO reports, Manual spreadsheets, Other
• What baseline numbers would you share today for revision rate, OR time (average), and per-case implant cost?
• How confident are you in the integrity and timeliness of the data you use to judge success? Options: Very confident, Somewhat confident, Questionable, Not confident

If Everything Worked Perfectly for 12 Months, What Would Be Different?

• Paint a picture: what three measurable changes would convince you the new implant program is a success?
• Beyond metrics, what changes in day-to-day experience would indicate success to OR staff and surgeons? Options: Fewer case delays, Simpler trays, Higher surgeon satisfaction, Smoother turnover, Less instrument damage
• How quickly would you expect to see early signs of clinical or operational improvement after launch? Options: Immediate (first 1–3 cases), Short term (1–3 months), Medium (3–6 months), Longer (>6 months)
• What level of improvement would you need to justify broader adoption (e.g., % reduction in OR time, $ saved per case)?
• Who else would you bring in to validate that these outcomes are real and sustained? Options: Clinical data team, VAF, Surgeon champions, External registry, Hospital leadership

What Could Sabotage Adoption Even If the Data Looks Good?

• What non-clinical issues have sunk past adoption efforts here (start with the most surprising or frustrating)?
• How reliable is your instrument reprocessing and sterilization cycle when new trays are introduced? Options: Very reliable, Occasionally problematic, Frequently problematic, Unknown
• What are your worst-case concerns about vendor support in the OR (select up to three)? Options: No rep available, Inexperienced rep, Inadequate instruments, Poor intraop troubleshooting, Late tray delivery, Other
• Has a previous vendor's promised education or proctorship failed to materialize? Tell us what happened and the impact.
• Which contractual or supply-chain constraints would be immediate red flags (e.g., exclusivity clauses, restocking penalties, GPO pass-through issues)?

How Would You Like a Vendor to Prove They Can Deliver?

• Which of the following proof points would most increase your willingness to trial a new implant system? Options: Peer-reviewed clinical data, Real-world registry data, Live proctorship cases, On-site instrument validation, Cost modeling with transparency, Warranty/registry guarantees
• What format of training works best for your team (select all that apply)? Options: Hands-on cadaver lab, In-service in your OR, Virtual modular training, Peer-led sessions, Proctorship in first cases
• How important is having the same rep present for the first 10 cases versus an on-call model? Options: Same rep present for all, Shared coverage acceptable, On-call is fine, Depends on case complexity
• Would you require implant tracking and registry reporting before starting a pilot? Options: Yes — mandatory, Preferable but not mandatory, Not required
• What operational support (instrument loaners, extra trays, dedicated sterile tech) would you insist on for initial cases?

Commitment Signals — What Would Make This Easy to Say Yes To?

• What single contractual or program element would most lower your risk perception (choose one)? Options: Short pilot agreement, Performance-based pricing, Comprehensive warranty, Guaranteed rep coverage SLA, Registry-backed outcomes
• What acceptance criteria do you need to see at the case-level to call a pilot successful (select up to three)? Options: Clinical fit/templating success, No instrument failures, OR time within target, No adverse events related to implant, Surgeon-stated satisfaction
• Who needs to sign off immediately after the pilot for a wider roll-out? Options: Lead surgeon(s), VAF, Service line director, Supply chain, Hospital executive leadership
• What's an acceptable timeline from pilot completion to wider adoption in your setting? Options: Immediate (within 1 month), 1–3 months, 3–6 months, 6+ months
• What communication cadence do you prefer during a pilot (select all that apply)? Options: Daily check-ins first week, Weekly summaries, Monthly executive reviews, Ad-hoc if issues arise, Real-time dashboard access

Practical Details — Logistics That Make or Break Launch

• What storage and inventory constraints should we know about for instrument and implant trays?
• Which sterilization and reprocessing cycles or capacity limits are likely to influence tray design or scheduling?
• Do you have any vendor access rules for the OR (badging, vaccination, credentialing) we should account for? Options: Strict — full credentialing required, Moderate — standard badging, Minimal — vendor passes are fine, Varies by facility
• How do you prefer implant usage and lot-tracking to be handled (select one)? Options: Vendor-managed tracking integrated w/EHR, Hospital-run with vendor reporting, Manual logs + periodic reconciliation, Registry-only reporting
• Are there specific risk mitigations you'd require before first case (e.g., backup implants on-site, second experienced rep, guaranteed OR time window)?

Final Reflection — If We Could Take One Thing Off Your Plate, What Would It Be?

• Thinking about everything discussed, what single operational burden would have the biggest positive effect if solved?
• Which stakeholder’s daily life would improve most from that change (pick one)? Options: Surgeon, OR nurse/charger, Service line admin, Supply chain manager, VAF member
• How would you like us to follow up—what would be the most useful next step from our side? Options: Detailed cost/clinical model, On-site instrument validation, Schedule a proctorship, Draft pilot agreement, Provide peer references/data
• What’s the best way and timeframe to reconnect once we’ve acted on this input? Options: Email in 1 week, Call in 2 weeks, On-site visit in 1 month, Submit proposal for review

Start Here: What Matters Most to You?

• Which role best describes you in this conversation? Options: Orthopedic surgeon, Service line administrator, Value Analysis Committee member, Procurement/GPO representative, OR manager/staff, Other
• Which two outcomes are highest priority for your team right now? Options: Revision/reoperation rates, OR time per case, Per-case implant spend, Standardization of portfolio, Surgeon satisfaction, Staff efficiency/turnover, Patient functional outcomes, Other
• When you think about past vendor partnerships that felt successful, what one thing made the biggest difference?
• How would you describe your team's tolerance for changing implant systems today? Options: Very high — eager to try new options, Somewhat open with conditions, Cautious — requires significant evidence, Very resistant — prefer status quo
• How soon do you need to see measurable improvement after a change in implants or OR support? Options: Within 30 days, 30–90 days, 3–6 months, 6–12 months, Unsure
• Is there anything specific about your team's culture or history with device partners we should know up front?

Are You Settling for Familiar Even When It Costs More?

• How often do you keep using an implant because of habit—even when evidence or price suggests a better option exists? Options: Almost always, Often, Sometimes, Rarely, Never
• Can you share a recent example where surgeon preference and VAF cost goals clashed? What was the outcome?
• How do surgeons and procurement typically resolve disagreements—fast escalation, committee review, or informal negotiation? Options: Rapid escalation to leadership, VAF committee review, Negotiation between surgeon and rep, Procurement enforces policy, Other
• What is the emotional tone when cost containment is presented to surgeons—defensive, curious, collaborative, or something else? Options: Defensive, Curious, Collaborative, Dismissive, Mixed
• How long has the tension between surgeon preference and standardization been an active issue for your team? Options: Months, 1–2 years, 3–5 years, 5+ years, Not applicable
• Who typically bears the clinical risk when standardization is pushed—surgeons, administrators, or both? Tell us how that feels.

Show Me the Current Playbook

• If you mapped a typical arthroplasty case from scheduling through discharge, where do the most costly inefficiencies hide?
• Which parts of the perioperative process are most prone to delays or rework in your setting? Options: Pre-op templating, Instrument availability in OR, OR scheduling/turnover, Implant restocking, Sterile processing/SSU delays, Intraop troubleshooting, Other
• List the implant systems you currently use and approximate annual volume for each (cases/year).
• Approximately what percentage of cases follow a standardized implant pathway versus surgeon-specific selection? Options: <25%, 25–50%, 51–75%, 76–100%, Unsure
• Where do instrument gaps or failures appear most often—set completeness, broken instruments, missing heads, or reprocessing delays? Options: Set completeness, Broken/failed instruments, Missing pieces/head sizes, Reprocessing delays, Tray damage/loss, Other
• Tell the story of a recent case where equipment or instrumentation issues affected flow—what happened and how did the team respond?

What Keeps You Up at Night?

• Which single outcome would make you regret a device change the fastest—revision rate, intraoperative complication, OR time increases, or financial overruns? Options: Revision/reoperation rate, Intraoperative complications, Increased OR time, Financial overruns/cost per case, Other
• Which clinical metrics do you track regularly (monthly/quarterly)? Options: Revision/reoperation rate, Infection rate, Length of stay, Readmissions, Patient-reported outcomes, Other
• Which financial KPIs get the most scrutiny from hospital leadership? Options: Implant spend per case, Total episode cost, OR utilization, Cost per surgeon, Return on investment (ROI), Other
• Have you experienced a measurable uptick in complications tied to a product or process change? Describe what happened.
• How does staff confidence with instrumentation and rep support affect your willingness to adopt a new system?
• What would be an acceptable threshold for early complication signals before you'd pause or escalate a pilot? Options: Any increase triggers pause, >5% increase, >10% increase, >25% increase, Depends on case mix, Unsure

Where Would You Tolerate Risk — and Where You Wouldn't

• What trade-off would you accept: lower implant cost with modestly longer OR time, or higher cost to preserve OR efficiency? Options: Accept lower cost with longer OR time, Prefer higher cost to preserve OR time, Depends on magnitude of trade-off, Unsure
• Which surgeon technical features are absolute must-haves (select all that apply)? Options: Trial fidelity/fit, Broach/tactile feel, Range of sizes/options, Instrumentation ergonomics, Ease of conversion intraop, Other
• Which service elements are non-negotiable for adoption: in-OR rep, proctorship, training, warranty/registry, or something else? Options: In-OR rep coverage, Proctorship by vendor/peers, Comprehensive staff training, Registry participation/warranty, Instrument support/loaners, Other
• How many proctored cases do surgeons typically require before feeling comfortable without hands-on rep support? Options: 1–2, 3–5, 6–10, 10+, Varies by surgeon
• If the first few cases show instrument reliability issues, what is your preferred immediate action—repair, replace, pause, or escalate? Options: Repair and continue, Replace instruments immediately, Pause program for root cause, Escalate to vendor leadership, Other
• Who on your team is most likely to advocate for tolerating short-term risk in exchange for long-term gain? Name role and why.

Imagine a Case That Goes Exactly as Planned — What Does That Look Like?

• If your ideal first 20 pilot cases went perfectly, what measurable differences would you see versus today?
• Which three metrics would you point to as proof we are delivering value? Options: Revision/reoperation rate, OR time per case, Implant spend per case, Staff satisfaction/turnover, Room turnover time, Patient functional outcomes, Other
• What phrasing from surgeons would signal success—what would you want them to say after a successful pilot case?
• How should early outcome data be presented to make decisions straightforward for your VAF? Options: Benchmarked dashboards, Case-level reports, Aggregate monthly summaries, Peer comparisons, Raw data export, Other
• What timeline feels realistic to evaluate a pilot and decide on broader rollout? Options: 30–90 days, 3–6 months, 6–12 months, 12+ months, Unsure
• Who needs to sign off before we move from pilot to standardization? Options: Surgeon(s), Service line administrator, VAF chair, CFO/finance, Supply chain/procurement, GPO, Other

If We Were to Work Together, What Would a Fair Pilot Look Like?

• What would make a pilot feel fair—skin in the game from the vendor, limited scope, or a guarantee if outcomes miss targets? Options: Vendor skin in the game (e.g., discounts/rebates), Limited scope/time-bound pilot, Performance guarantees/warranty, Shared data ownership and transparency, Other
• Would you prefer a head-to-head case-matched pilot, an elective-only rollout, or a block-scheduled proctor model? Options: Head-to-head case-matched, Elective-only phased rollout, Block-scheduled proctorship, Combination, Unsure
• What minimum case volume and duration would you require to make a meaningful judgment? Options: 10–20 cases, 21–50 cases, 51–100 cases, 100+ cases, Unsure
• What specific fields must be captured on each pilot case (implant LOT, OR time, complications, surgeon notes, etc.)? Options: Implant model/LOT, OR start/finish times, Complications/adverse events, Surgeon qualitative notes, Sterile processing issues, Patient-reported outcomes, Other
• Who on your staff will be responsible for collecting and validating pilot data? Options: Clinical coordinator/registry lead, OR manager/supervisor, Sterile processing manager, Vendor rep support, Other
• What would success look like for patients, surgeons, and finance at the pilot's end? Please give one line per stakeholder.

Decisions, Timing, and Who Holds the Keys

• If a new implant met your clinical bar but saved only 5% on cost, would that accelerate or stall your decision? Options: Accelerate decision, Stall decision, Depends on surgeon buy-in, Unsure
• Who are the formal decision-makers and the informal influencers we should know about? List names/roles.
• How does your GPO/IDN contract structure constrain or enable new product adoption? Options: Strict GPO-only, Allows exceptions with VAF approval, Open contracting with negotiation, Other
• What procurement or legal timelines typically determine when a new contract can start? Options: Immediate upon agreement, 30–60 days, Quarterly renewal windows, Annual contract cycle, Depends—case-by-case
• What internal approval hurdles have surprised you in past device rollouts?
• What level of pricing transparency and contracting flexibility do you expect from vendors? Options: Line-item pricing, Bundled pricing options, Performance-based rebates, Warranty/registry support, Custom contract language, Other

Early Signals That Will Tell Us We're Winning — or Not

• If the first 10 cases show a 10% slower OR time but a 15% lower implant cost, do you call that a win? Options: Yes, No, Depends on complication rates, Need more context
• Which early signals would make you recommend expanding immediately? Options: Improved OR flow, High surgeon satisfaction, No uptick in complications, Lower per-case implant spend, Positive patient feedback, Other
• How should negative early signals be handled—stop the program, pause for root cause analysis, or continue with mitigations? Options: Stop the program immediately, Pause and perform root cause, Continue with mitigations in place, Escalate to steering committee, Other
• Who will review early pilot data and at what cadence (weekly, monthly, real-time)? Options: Clinical leadership weekly, OR manager weekly, VAF monthly, Vendor weekly, Real-time alerts + monthly review, Other
• What absolute thresholds (e.g., % increase in complications or OR time) would trigger an immediate pause?
• How quickly do you expect a vendor rep to respond to intraop issues during the pilot? Options: Immediate (<15 minutes), Within 1 hour, Same day, Next day, Other

Keeping the Conversation — How We Stay Aligned

• If alignment depended on one mechanism—data dashboards, regular huddles, or a named escalation path—which would you pick and why? Options: Data dashboards, Regular cross-functional huddles, Named escalation/escalation SLA, Combination, Other
• What format and frequency of updates would make you feel informed but not burdened? Options: Weekly emails, Monthly dashboards, Quarterly review meetings, Ad hoc incident reports, Real-time alerts, Other
• Who should sit on a standing steering committee for this partnership (roles preferred)? Options: Lead surgeon(s), Service line admin, VAF chair, OR manager, Finance/CFO rep, Supply chain/procurement, GPO rep, Other
• How would you prefer to capture qualitative surgeon feedback after each pilot case? Options: Brief post-case survey, Short verbal debrief with rep, Structured interview, EMR-embedded rating, Other
• What would make you confident a vendor is a true partner versus 'just another sales rep'?
• Are there any remaining concerns or hidden obstacles we haven't surfaced that could block progress?