A System-Wide Approach to Physician Efficiency and Utilization Rates for Non-Operating Room Anesthesia Sites.

There has been little in the development or application of operating room (OR) management metrics to non-operating room anesthesia (NORA) sites. This is in contrast to the well-developed management framework for the OR management. We hypothesized that by adopting the concept of physician efficiency,...

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Publicado en:Journal of Medical Systems Vol. 41; no. 7; pp. 1 - 6
Autores principales: Tsai, Mitchell, Huynh, Tinh, Breidenstein, Max, O'donnell, Stephen, Ehrenfeld, Jesse, Urman, Richard
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jul2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2017
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      pub: Springer Nature
      place: New York, New York
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        atl: A System-Wide Approach to Physician Efficiency and Utilization Rates for Non-Operating Room Anesthesia Sites.
      aug:
        au:
          Tsai, Mitchell
          Huynh, Tinh
          Breidenstein, Max
          O'donnell, Stephen
          Ehrenfeld, Jesse
          Urman, Richard
        affil: Department of Anesthesiology , University of Vermont Larner College of Medicine , Burlington USA
      sug:
        subj:
          Anesthesia
          Operating Rooms
          Physician Attitudes Evaluation
          Organizational Efficiency Evaluation
          Human
          Productivity
          Utilization Review
          United States
          Research Methodology
      ab: There has been little in the development or application of operating room (OR) management metrics to non-operating room anesthesia (NORA) sites. This is in contrast to the well-developed management framework for the OR management. We hypothesized that by adopting the concept of physician efficiency, we could determine the applicability of this clinical productivity benchmark for physicians providing services for NORA cases at a tertiary care center. We conducted a retrospective data analysis of NORA sites at an academic, rural hospital, including both adult and pediatric patients. Using the time stamps from WiseOR® (Palo Alto, CA), we calculated site utilization and physician efficiency for each day. We defined scheduling efficiency (SE) as the number of staffed anesthesiologists divided by the number of staffed sites and stratified the data into three categories (SE < 1, SE = 1, and SE >1). The mean physician efficiency was 0.293 (95% CI, [0.281, 0.305]), and the mean site utilization was 0.328 (95% CI, [0.314, 0.343]). When days were stratified by scheduling efficiency (SE < 1, =1, or >1), we found differences between physician efficiency and site utilization. On days where scheduling efficiency was less than 1, that is, there are more sites than physicians, mean physician efficiency (95% CI, [0.326, 0.402]) was higher than mean site utilization (95% CI, [0.250, 0.296]). We demonstrate that scheduling efficiency vis-à-vis physician efficiency as an OR management metric diverge when anesthesiologists travel between NORA sites. When the opportunity to scale operational efficiencies is limited, increasing scheduling efficiency by incorporating different NORA sites into a 'block' allocation on any given day may be the only suitable tactical alternative.
      pubtype: Academic Journal
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      ougenre: Article
    language: English
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