In the traditional anesthesia staffing model, you assign each anesthesia provider to a specific operating room for a given day's schedule. The staggered staffing method alternates provider coverage on a first-available basis, resulting in anesthesia providers working in different ORs throughout the day. Then there's a hybrid model that combines both approaches. We prefer it because it reduces turnover times and keeps staff engaged with varied assignments all day long. Here are 3 keys to making it work.

Start out in OR 1, then go to the next available case. Assign providers to a specific OR only for the first case of the day. After the first case, they'll assume care of the next available surgical case, regardless of operating room. Having an anesthesia provider immediately available to perform pre-op assessments and provide anesthesia services in the first available OR greatly improves turnover times. This also improves safety by giving the anesthesia provider transporting the patient to PACU more time to complete a thorough PACU sign-out and remain with a patient who may benefit from additional anesthesia care.

Be willing to make exceptions. Remain flexible and willing to assign individual providers to single rooms when surgeon preference and anesthesia subspecialty experience dictate. For instance, a surgeon and a particular anesthetist may work together particularly well. A surgeon may even request to work with that anesthetist as much as possible. In this event, you can assign that anesthetist and surgeon to a single room for the day, while staggering staff in the remaining ORs. Alternatively, if you have an anesthetist with valuable subspecialty expertise in, say, pediatrics, you can dedicate her to a single room to handle the day's pediatric cases.

Ensure proper communication. This hybrid staffing approach can present communication dilemmas. For example, an anesthetist is doing a knee scope with a surgeon who's discussing the next planned case in that room. The surgeon may mention that it's a shoulder case, and that he doesn't want a nerve block done. Since the anesthetist may not be following in the same room, make sure he contacts the pre-op area to ensure that this message is relayed to the next available anesthesia provider who'll be following in that surgeon's room.

PATIENT WARMING

Keep Warming Blankets on Patients During Recovery
To save money on warming blankets and to keep post-op patients comfortable, ask your OR nurses to keep the warming blanket on the patient (if it's not soiled) so that it may be used in the recovery room.
Marty Odom, RN, BSN
Bainbridge, Ga.
Memorial Hospital and Manor
[email protected]