Impact of a Pediatric Anesthesiologist on Operating Room Efficiency during Pediatric Tonsillectomies and Adenotonsillectomies

Dewyer, Nicholas A.; Kram, Yoseph A.; Long, Stephen P.; Russell, Marika D.

doi:10.1177/014556131709600605

Cited by 6 publications

(5 citation statements)

References 6 publications

(5 reference statements)

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“…fellowship-trained pediatric anesthesiologists may improve efficiency by decreasing ACT (3)(4)(5)(6). Dewyer et al (4) demonstrated a decrease in ACT of 15 minutes, when operative cases were performed under the supervision of pediatric anesthesiologists.…”

Section: What Is Newmentioning

confidence: 99%

“…In some cases, health care systems have developed specialized OR teams or working groups to both minimize costs and improve efficiency (2–4). Current research indicates that fellowship‐trained pediatric anesthesiologists may improve efficiency by decreasing ACT (3–6). Dewyer et al (4) demonstrated a decrease in ACT of 15 minutes, when operative cases were performed under the supervision of pediatric anesthesiologists.…”

mentioning

confidence: 99%

“…Specifically, a lower occurrence of complications such as hypoxia or oxygen desaturation was observed, especially among patients of higher American Society of Anesthesiologists (ASA) class for endoscopy procedures (7–9). Furthermore, for otolaryngology procedures, fellowship‐trained pediatric anesthesiologists have demonstrated both improved efficiency and patient satisfaction through reductions in ACT (5,6). Our goal is to investigate this evidence within the field of gastroenterology and whether similar reductions in ACT can be found.…”

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confidence: 99%

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Pediatric Fellowship-Trained Anesthesiologists Improve Anesthesia-Controlled Time in a Pediatric Endoscopy Suite

Carlson

McElrath

Herrera

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives:The objective of this study was to determine the difference in anesthesia-controlled time (ACT) between subspecialty-trained pediatric anesthesiologists and general anesthesiologists during esophagogastroduodenoscopy (EGD) and colonoscopy. We hypothesized pediatric anesthesiologists would demonstrate a shorter ACT compared to general anesthesiologists. Methods: We conducted a retrospective analysis of pediatric endoscopy cases requiring general endotracheal anesthesia within our pediatric sedation unit from 2017 to 2020. Demographic and procedural variables were collected and assessed for potential confounding. The imbalance in baseline variables was controlled for utilizing a generalized linear model (GLM). The GLM had a model fit of adjusted R 2 = 0.146 and was statistically significant with P < 0.001. A priori power analysis was performed for a 2-tailed independent means t test with alpha = 0.05, and Power = 0.80, which revealed a minimum sample size of 64 patients per group to detect a mean difference of 3 minutes of ACT. Results: A total of 269 cases met inclusion criteria. Adjusted results demonstrated fellowship-trained pediatric anesthesiologists were associated with a 3.7-minute (95% CI: 2.005-5.478; P < 0.001) reduction in ACT when compared to general practice anesthesiologists. Patient age was associated with a 0.4-minute (95% CI: -0.558 to -0.243; P < 0.001) decrease in ACT for each advancing year in age. Conclusions:We observed an association between the subspecialty training of the anesthesiology provider and ACT for EGDs and colonoscopies. When EGDs and colonoscopies are performed under the supervision of pediatric anesthesiologists, ACT reduction potentially reduces cost and improves efficiency.

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Section: What Is Newmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Pediatric Fellowship-Trained Anesthesiologists Improve Anesthesia-Controlled Time in a Pediatric Endoscopy Suite

Carlson

McElrath

Herrera

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…They reported that, despite having no major differences in anesthesia practice, the anesthesiacontrolled time (sum of time spent for induction and emergence) was shorter during the cases performed by the pediatric anesthesiologist compared with the general anesthesiologists (33 vs. 47 min). 58…”

Section: Impact Of Trainees and Clinical Expertisementioning

confidence: 99%

“…Dewyer and colleagues evaluated whether an Accreditation Council for Graduate Medical Education (ACGME) fellowship-trained pediatric anesthesiologist improves OR efficiency for pediatric tonsillectomies and adenotonsillectomies in a hospital without dedicated pediatric ORs. They reported that, despite having no major differences in anesthesia practice, the anesthesia-controlled time (sum of time spent for induction and emergence) was shorter during the cases performed by the pediatric anesthesiologist compared with the general anesthesiologists (33 vs. 47 min) 58…”

Section: Impact Of Trainees and Clinical Expertisementioning

confidence: 99%

Efficiency in the operating room: optimizing patient throughput

Robertson

Kla

Yaghmour

2021

International Anesthesiology Clinics

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The operating room (OR) is a complex environment that accounts for a significant proportion of total hospital revenue and expenses. Efficient management of patient throughput is necessary to optimize this valuable resource. Accurate scheduling of surgical cases can improve OR efficiency, and yet, it is fraught with inherent challenges. Various strategies aimed at first case ontime starts, OR turnover times, and delays in postanesthesia care unit (PACU) admissions are used to manage patient throughput and will be discussed in detail. The impact of perioperative teams, trainees, and clinical expertise are some of the additional considerations for OR efficiency. Machine learning methods, in combination with large electronic health databases, are a more recent approach to further optimize patient throughput from the preoperative arena to the PACU.

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Improving Operating Room Efficiency in Otolaryngology–Head and Neck Surgery: A Scoping Review

Hathi,

Nam,

Fowler

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveOne minute of operating room (OR) time costs $36 to 37. However, ORs are notoriously inefficient. There is growing literature on improving OR efficiency, but no formal review of this topic within otolaryngology has been performed. This study reviews and synthesizes the current literature on improving OR efficiency within otolaryngology.Data SourcesMEDLINE, EMBASE, Web of Science, CINAHL, Cochrane Library, preprints.org, and medRxiv were searched on November 4, 2022.Review MethodsPublished English studies were included if they reported on metrics for improving OR efficiency within otolaryngology. There were no publication date restrictions. Articles were screened by 2 reviewers. Preferred Reporting Items for Systematic Reviews and Meta‐analysis reporting for scoping reviews was followed.ResultsThe search yielded 9316 no‐duplicate articles; 129 articles were included. Most of the studies reported on head and neck procedures (n = 52/129). The main tactics included surgical considerations: hemostatic devices, techniques, and team/simultaneous approaches; anesthetic considerations: local anesthetic and laryngeal mask airways; procedure location considerations: procedures outside of the OR and remote technologies; standardization: equipment, checklists, and personnel; scheduling considerations: use of machine learning for booking, considering patient/surgeon factors, and utilizing dedicated OR time/multidisciplinary teams for on‐call cases.ConclusionThe current literature brings to attention numerous strategies for improving OR efficiency within otolaryngology. Applying these strategies and implementing novel techniques to manage surgical cases may assist in offloading overloaded health care systems and improving access to care while facilitating patient safety and outcomes. Anticipated barriers to implementation include resistance to change, funding, and the current strain on health care systems and providers.

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Impact of a Pediatric Anesthesiologist on Operating Room Efficiency during Pediatric Tonsillectomies and Adenotonsillectomies

Cited by 6 publications

References 6 publications

Pediatric Fellowship-Trained Anesthesiologists Improve Anesthesia-Controlled Time in a Pediatric Endoscopy Suite

Pediatric Fellowship-Trained Anesthesiologists Improve Anesthesia-Controlled Time in a Pediatric Endoscopy Suite

Efficiency in the operating room: optimizing patient throughput

Improving Operating Room Efficiency in Otolaryngology–Head and Neck Surgery: A Scoping Review

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