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Coordination of appointments for anesthesia care outside of operating rooms using an enterprise-wide scheduling system.

Abstract：

BACKGROUND:An anesthesia department implemented scheduling of anesthetics outside of operating rooms (non-OR) by clerks and nurses from other departments using its hospital's enterprise-wide scheduling system. METHODS:Observational studies chronicled the change over 2 yr as non-OR time was allocated by specialty, and nonanesthesia clerks and nurses scheduled anesthesia teams. Experimental studies investigated how tabular and graphical displays affected the scheduling of milestones (e.g., NPO times) and appointments before anesthetics. RESULTS:Anesthetics performed in allocated time increased progressively from 0% to 75%. Scheduling of anesthetics by nonanesthesia clerks and nurses increased progressively from 0% to 77%. Consistency of patient instructions was improved. The quality of resulting schedules was good. Implementation was not associated with worsening of multiple operational measures of performance such as cancellation rates, turnover times, or complaints. However, schedulers struggled to understand fasting and arrival times of patients, despite using a web site with statistically generated values in tabular formats. Experiments revealed that people ignored their knowledge that anesthetics can start earlier than scheduled. Participants made good decisions with both tabular and graphical displays when scheduling appointments preceding anesthesia. CONCLUSIONS:Enterprise-wide scheduling can coordinate anesthetics with other appointments on the same date and improve consistency and accuracy of patient instructions customized to the probability of an anesthetic starting early. The usefulness of implementation depends on the value in having more patient-centered care and/or in having patients arrive just in time for non-OR anesthesia, surgery, or regional block placement (e.g., at facilities with limited physical space).

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Dexter F,Xiao Y,Dow AJ,Strader MM,Ho D,Wachtel RE

doi

10.1213/01.ane.0000287686.23187.3f

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

1701-10, table of contents

issue

eissn

0003-2999

issn

1526-7598

pii

105/6/1701

journal_volume

105

pub_type

杂志文章

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Coordination of appointments for anesthesia care outside of operating rooms using an enterprise-wide scheduling system.