Scheduling non-operating room anesthesia cases in endoscopy: Using the sandbox analogy

Area of Science:

• Anesthesiology
• Healthcare Management
• Surgical Services

Background:

• The workload for non-operating room anesthesia (NORA) is expanding in many hospitals.
• Effective scheduling is crucial for managing NORA services and optimizing operating room utilization.

Purpose of the Study:

• To develop and evaluate a new NORA scheduling process utilizing shared block time among gastroenterology groups.
• To measure the impact of this intervention on operating room management metrics and overall efficiency.

Main Methods:

• Prospective analysis using statistical process control at an academic, rural hospital's endoscopy suite.
• Implementation of a shared block time scheduling system for adult and pediatric gastroenterology procedures.
• Monitoring of case volumes, under-utilized time, elective time-in-block, and over-utilized time.

Main Results:

• Case volumes increased by 23% (from 107 to 131 cases/month) post-intervention (p<0.01).
• Elective time-in-block increased by 13% (p=0.09), while under-utilized time decreased by 15% (p=0.03).
• Over-utilized time significantly decreased by 84.5% (from 101 min/month to 16 min/month).

Conclusions:

• A multidisciplinary, team-based approach to NORA scheduling can increase throughput and efficiency without compromising resource utilization.
• The shared block time model proved effective in accommodating increased case volumes and reducing inefficiencies.
• Effective communication, interdepartmental collaboration, and flexible scheduling are vital for optimizing anesthesia services in NORA environments.