divide and concur….

Once you visually see the requirements for anesthesia presence during a case, you can also see the potential for saving down-time and better utilizing particular skills when personnel are scarce.   I did leave out the pre-op visit in this graph since most everyone (groups) is aware of and coordinates that task among themselves (well, almost everyone) since it is a major source of time waste if not jointly handled.  During anesthesia training, one person will follow the patient through all these events for the sake of continuity and learning, but in the real world that doesn’t need to be the case.

And…believe it or not, some people are much better and faster at specific tasks than others.  A good inducer may not be a good wakeup person; and some people take three times as long as another to hand off a patient.

If the physician anesthesiologist is the constraint, the setup, maintenance, and handoff durations can be handled by others.  This is commonly done by CRNAs, sometimes by anesthesia techs, OR nurses, PACU nurses…   It can make a big difference in expense and throughput in the OR.

About Brian D Gregory MD, MBA

Board Certified Anesthesiologist for 30 years. TOC design and implement for 30 years. MBA from U of Georgia '90: Finance, Data Management, Risk Management. Practiced in multiple US states and Saudi Arabia at KFSH&RC and KFMC Taught residents in two locations. Worked with CRNAs for 20 years.
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