Integration of robotics as standard surgical procedure during residency training for visceral surgery using a balanced scorecard (BSC)

Advancements in robotic assistance systems increased the number of robotic procedures. Successfully integrating robotics requires structured, effective management strategies and comprehensive training programs. The study aimed to develop a Balanced Scorecard (BSC) for the "Robotic Curriculum for young Surgeons" (RoCS) to establish robotic surgery as a standard surgical procedure during residency training for visceral surgery'. Strategic goals, derived from the department's vision, mission, and strategy, were assigned to four perspectives: (1) financial, (2) patient, (3) internal processes, (4) learning and development. Key performance indicators (KPIs) and their allocation to strategic goals were assessed through expert interviews and visualized in a strategy map. Data analysis was performed retrospectively comparing 2023 to 2022. Twenty KPIs were validated as suitable for tracking progress toward the 17 established strategic goals. Four performance indicators were considered susceptible to subjective influences. Expert interviews identified two additional KPI recommendations. The BSC and strategy map show the KPI relationship and their impact on strategic goals. Yearly comparison showed an overall improvement of eight KPIs. The RoCS-BSC represents an adaptable management tool tailored to fulfill the healthcare system's requirements for implementing robotic-assisted surgery, covering patient care, surgical quality, education, and economic considerations. This study places clinical training in visceral surgery within an economic context by integrating healthcare system components. The RoCS-BSC offers a supporting framework to facilitate the systematic integration of robotic operations as a standard procedure in the surgical training of future generations.