Articles from Journal of clinical anesthesia 2017 November

J Clin Anesth · Nov 2017

With directed study before a 4-day operating room management course, trust in the content did not change progressively during the classroom time.

A 4-day course in operating room (OR) management is sufficient to provide anesthesiologists with the knowledge and problem solving skills needed to participate in projects of the systems-based-practice competency. Anesthesiologists may need to learn fewer topics when the objective is, instead, limited to comprehension of decision-making on the day of surgery, We tested the hypothesis that trust in course content would not increase further after completion of topics related to OR decision-making on the day of surgery. ⋯ Trust in the course content did not increase after the end of the 1st day. Therefore, statistics review, reading, and the 1st day of the course appear sufficient when the objective of teaching OR management is not that participants will learn how to make the decisions, but will comprehend them and trust in the information underlying knowledgeable decision-making.

At most hospitals in the state of Iowa, most surgeons' daily lists of elective cases include only 1 or 2 cases: Individual surgeons' percentage operating room utilization is a consistently unreliable metric.

Percentage utilization of operating room (OR) time is not an appropriate endpoint for planning additional OR time for surgeons with high caseloads, and cannot be measured accurately for surgeons with low caseloads. Nonetheless, many OR directors claim that their hospitals make decisions based on individual surgeons' OR utilizations. This incongruity could be explained by the OR managers considering the earlier mathematical studies, performed using data from a few large teaching hospitals, as irrelevant to their hospitals. The important mathematical parameter for the prior observations is the percentage of surgeon lists of elective cases that include 1 or 2 cases; "list" meaning a combination of surgeon, hospital, and date. We measure the incidence among many hospitals. ⋯ Accurate confidence intervals for raw or adjusted utilizations are so wide for individual surgeons that decisions based on utilization are equivalent to decisions based on random error. The implication of the current study is generalizability of that finding from the largest teaching hospital in the state to the other hospitals in the state.