Scheduling medical professionals is always difficult, but anesthesia scheduling may be the most challenging of all. According to the American Association of Nurse Anesthetists, there are close to 53,000 Certified Registered Nurse Anesthetists (CRNAs) in the U.S. Together with the approximately 31,000 physician anesthesiologists, CRNAs provide millions of patients with anesthesia both in and outside of a hospital setting.
It’s these out-of-hospital encounters that pave the way for vexing anesthesia scheduling problems. Over the past decade, the use of Non-Operating Room Anesthesia (NORA) has skyrocketed. Patients undergoing procedures including endoscopy, cardiac catheterization, defibrillator implantation, and bronchoscopy – and even some diagnostic imaging – rely on anesthesiologists and CRNAs for sedation and general anesthesia. Medical systems, CMA, and insurers rely on improved technology, provider skill, and NORA to deliver cost savings for medical treatments that were previously provided in an operating room setting.
Achieving those value-based metrics is dependent upon proper anesthesia scheduling. If an anesthesiology group is servicing several locations, poor scheduling can prematurely cap the number of procedures that can be performed. For example, if endoscopies are scheduled at 1:00 p.m. and 3:00 p.m. at one location, the anesthesiologist or CRNA has more than an hour of under-utilized time. While they’re cooling their heels waiting for the next scheduled procedure, they have significant opportunity cost because they cannot be present at another location. The institution is also taking a financial hit because they have likely contracted for anesthesia coverage that they aren’t using.
Researchers at the University of Vermont utilized an innovative shared block time schedule to create NORA efficiencies for elective procedures performed by three different gastroenterology groups. Instead of adding to institutional costs by increasing anesthesiology staffing at the request of the physician groups, they created shared block allocations released seven days in advance. Allocations not reserved at the 48-hour mark were then added to a general scheduling pool. They were able to increase the number of procedures per month by 23 percent without adding another anesthesiologist. In addition, block utilization increased by 13 percent and under-utilized time decreased by 15 percent.
Anesthesia scheduling – whether for NORA or for the operating room – is rife with complexities. Anesthesiologist and CRNA scheduling are equally complicated – an issue that is highlighted when they don’t come in to work. Researchers from the University of Miami examined unscheduled CRNA absences to see if they could detect patterns that would pinpoint specific personnel who were disproportionately responsible for absences. While the researchers found that doing so was impractical, they did note that unscheduled absences disrupts the operating room schedule. While the study didn’t touch on NORA procedures, it would follow that anesthesiologists’ and CRNAs' unscheduled absences would disrupt those as well.
Whatever the configuration of a facility’s block schedule or the frequency of unexpected absences, it’s clear that having timely, accessible anesthesia scheduling is critical. MDsyncNET provides cloud-based anesthesia scheduling that can be updated in real-time and accessed by authorized anesthesiologists and CRNAs from any internet connected device. To learn more about how MDsyncNET’s anesthesia scheduling solution can help you achieve your value metrics, call 888-506-5061.
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