It's not too much of a stretch to compare an anesthesia provider's workspace in the OR to the cockpit of an aircraft. Both environments place the items needed for control within arm's reach, immediately accessible for efficiency and ease of use. For anesthesia providers, the right anesthesia cart can assist in the delivery of quality patient care. Here are some factors to consider if you're making that purchasing decision.

At the ready
From the standpoint of effectiveness in the OR, you'll want to select a cart that can house everything that's needed at the point of care: medications for both routine procedures and emergency situations.

Ideally, an anesthesia cart should be able to supply an entire day's schedule of cases without requiring the provider to leave the room to restock the necessary drugs at the storage room or pharmacy. As you know, case flow revolves in large part around room turnover, so a faster turnover equals greater time-and cost-efficiency. At a high-volume surgical facility, or on a high-volume day, the last thing an anesthesia provider wants to do is delay the next case while he's reloading.

For this, you'll need drawers and cabinets big enough to store different medications in different quantities. Consult with your anesthesia staffers for input on what "big enough" is. Carts with flexibility in how they can be configured and organized may also prove useful, especially in larger facilities with ORs dedicated to different specialties. Then they can be set up to serve the supply and accessibility needs of specific types of cases.

Under lock and key
Storage may be the primary purpose of an anesthesia cart, but you can't just stack the trays containing a day's medications inside and leave them there. Facility security and patient safety demand that carts include control measures to protect their contents against theft, unmonitored use and tampering.

A cart's first line of security involves the method by which its authorized users can gain access to its contents. Some models employ manual lock-and-key security while others, especially those that feature integrated information technology, have gone keyless. Automated security systems may require swipe cards, proximity indicators, numeric codes, thumbprint scans or perhaps a combination of these factors to open.

Some even include a separately securable drawer or section that lets providers lock down their morphine, fentanyl and other controlled substances at all times while leaving the cart open during a session for immediate access to such emergency drugs as epinephrine or atropine.

Selecting a cart's security options will be a joint decision. You'll want to refer to your state pharmacy board's regulations, and perhaps your accreditation agency's guidelines, in order to comply with required standards. But you'll also want input on what your staff is able to work with. Find out what features can provide them with safety compliance as well as immediate access.

Smart carts
The information technology platforms integrated into some manufacturers' carts can also play a role in security measures. In some models, for example, the cart's contents are barcoded and scanned to track what is stocked, what is removed, what a provider administered and how much was discarded.

Besides policing, a cart's IT functions can also generate reports for billing, inventory management and ordering; provide an anesthesia provider with access to a patient's electronic medical record to ensure medication safety; or help determine the cost-efficiency of drugs, given their reported volumes of use, cost structures and reported outcomes.

In order to obtain these advantages, however, you'll need to make sure when you're choosing a cart that its information platform is able to interface with your facility's own electronic medical records, inventory system and other relevant aspects of your IT. If you've not gone entirely digital yet, but are exploring the possibility, it's important to consider what will be required for your cart to interact with EMRs and other applications in the near future.

For usability's sake, seek your providers' input on whether the cart's software is organized logically enough to make it easy for them to navigate and perform the functions they want. Also find out whether the software's settings are adaptable to your own providers' and facility's needs. For instance, a system that automatically locks itself every 5 minutes is secure, but hardly efficient.

Whether you're leasing or buying anesthesia carts, whether you're equipping a large or small facility, make sure your contract with the manufacturer spells out a service agreement and accounts for someone who can resolve any cart difficulty — storage, security or information technology — in the event that something goes wrong.

Cardinal Health
Pyxis Anesthesia System
(888) 876-4287
www.cardinalhealth.com/pyxis
List price: not disclosed
FYI: Cardinal Health's Pyxis Anesthesia System streamlines clinical workflow by providing secure, convenient access to OR medications while automatically documenting stored and dispensed drugs, says the company. It gives hospitals the accurate records they need and helps ensure anesthesia providers always have the medications they need.

Future Health Concepts
FHC Anesthesia Carts
(800) 282-8644
www.fhcusa.com
List price: $700 to $2,000
FYI: Future Health Concepts offers a full line of anesthesia carts in multiple configurations. The company says each features double-wall construction, built-in antimicrobial properties to protect portions of the product, a stabilizer base to prevent the cart from tipping over, ball-bearing slides with quick release, an ABS plastic top, premium latex-free powder-coat paint and a 5-year warranty.

The Harloff Company
Deluxe 6-Drawer Anesthesia Cart (Model No. 7456)
(800) 433-4064
www.harloff.com
List price: $1,425 to $2,535
FYI: Harloff's anesthesia carts are designed for security, quality and versatility, says the company, which works closely with customers to configure its carts and organizational accessories to their needs. This model features a mechanical combination push-button lock, a hard-baked, powder-coat finish, rails for attaching accessories, a vinyl-padded wraparound bumper and 2 braked casters.

Herman Miller for Healthcare
Anesthesia Cart
(888) 443-4357
www.hermanmiller.com/healthcare
List price: $1,500
FYI: Herman Miller for Healthcare's anesthesia cart offers a suspended shelf above the unit and an attached basket on the side to keep the provider's frequently-used supplies within easy reach, says the company. Its modular components are lightweight and interchangeable to quickly handle new demands. It is available with traditional or keyless locks and includes a 10-year, 24/7 warranty.

Metro
Flexline Anesthesia Cart
(800) 992-1776
www.metro.com
List price: $1,022 to $5,228
FYI: Metro's new Flexline line of carts offers flexible, adaptable storage solutions, says the company. Microban antimicrobial product protection helps to maintain a cleaner cart. Its drawers, interchangeable components and accessories can be configured to meet your specific needs and added or reconfigured at your facility when your needs change. Comes with multiple levels of security features, a spacious work surface and full-access drawers.

MMI Med Carts
4- to 9-Drawer Anesthesia Carts
(800) 437-6633
www.mmimedcarts.com
List price: $1,300 to $2,800
FYI: MMI's full line of anesthesia carts features the company's traditional durability and integrated technology, says the company. The lightweight, vinyl-covered aluminum carts, which feature 4 to 9 drawers, can be customized with storage configurations; entry management systems such as proximity readers and dual keyless entry; the unit's color; and more.

Omnicell
Anesthesia Workstation
(800) 850-6664
www.omnicell.com/solutions/anesthesia_providers
List price: not disclosed
FYI: Omnicell's Anesthesia Workstation is designed to satisfy the unique medication and supply storage needs of anesthesia providers in the OR, says the company. This high-capacity cabinet features an intuitive user interface to increase patient safety, workflow efficiency and security. Providers can focus on patient care, confident that all items are reliably stocked.

Pedigo
P-5091 Anesthesia Cabinet
(800) 822-3501
www.pedigo-usa.com
List price: $1,645
FYI: Pedigo's P-5091 Anesthesia Cabinet features all-welded and polished stainless steel construction, 2 double-ball-bearing swivel casters and a solid stainless steel retaining rail, says the company. The cabinet's overall dimensions are 33 inches high by 28 inches wide by 18 inches deep, with 2 drawers and an internal shelf for convenient storage. An optional locking rod is available for security.

S & S MedCart
Anesthesia Partner Cart
(800) 231-1747
www.medcart.com
List price: $2,200 to $2,500
FYI: S & S's solid metal Anesthesia Partner Cart features an LCD digital touch panel for secured access as well as a 1-hour to 20-hour auto-locking timeout function, says the company. Onboard software includes multi-level administrative and user access points, programmable with 500 unique user IDs. Bluetooth, infrared and RFID access system options are available.

Stanley InnerSpace
Anesthesia Carts
(800) 467-7224
www.stanleyinnerspace.com
List price: starting under $1,000 (accessories extra)
FYI: Versatile and easy to maneuver, Stanley InnerSpace's anesthesia carts feature heavy-duty 5-inch plate casters, central key locking and a pullout writing surface, says the company. Customers can choose from a selection of preconfigured carts, or customize their own from 4 different frame sizes and a full complement of exterior accessories and lock options. The drawers are built to accept InnerSpace's line of modular trays and dividers.