Parallel processing of regional anesthesia may improve operating room (OR) efficiency in patients undergoes upper extremity surgical procedures. The purpose of this paper is to evaluate whether performing regional anesthesia outside the OR in parallel increases total cases per day, improve efficiency and productivity.
Data from all adult patients who underwent regional anesthesia as their primary anesthetic for upper extremity surgery over a one-year period were used to develop a simulation model. The model evaluated pure operating modes of regional anesthesia performed within and outside the OR in a parallel manner. The scenarios were used to evaluate how many surgeries could be completed in a standard work day (555 minutes) and assuming a standard three cases per day, what was the predicted end-of-day time overtime.
Modeling results show that parallel processing of regional anesthesia increases the average cases per day for all surgeons included in the study. The average increase was 0.42 surgeries per day. Where it was assumed that three cases per day would be performed by all surgeons, the days going to overtime was reduced by 43 percent with parallel block. The overtime with parallel anesthesia was also projected to be 40 minutes less per day per surgeon.
Key limitations include the assumption that all cases used regional anesthesia in the comparisons. Many days may have both regional and general anesthesia. Also, as a case study, single-center research may limit generalizability.
Perioperative care providers should consider parallel administration of regional anesthesia where there is a desire to increase daily upper extremity surgical case capacity. Where there are sufficient resources to do parallel anesthesia processing, efficiency and productivity can be significantly improved.
Simulation modeling can be an effective tool to show practice change effects at a system-wide level.
Financial support for this study was provided by the Department of Anesthesiology and Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota. The funding agreement ensured the authors’ independence designing the study, interpreting data, writing and publishing. The authors thank Dr Yariv Marmor for his assistance with data analysis.
J. Brown, M., Subramanian, A., B. Curry, T., J. Kor, D., L. Moran, S. and R. Rohleder, T. (2014), "Improving operating room productivity via parallel anesthesia processing", International Journal of Health Care Quality Assurance, Vol. 27 No. 8, pp. 697-706. https://doi.org/10.1108/IJHCQA-11-2013-0129Download as .RIS
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