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Role of Communication Systems in Coordinating Supervising Anesthesiologists’ Activities Outside of Operating Rooms

Smallman, Bettina Dr Med*; Dexter, Franklin MD, PhD; Masursky, Danielle PhD*; Li, Fenghua MD*; Gorji, Reza MD*; George, Dave MBA; Epstein, Richard H. MD, CPHIMS§

doi: 10.1213/ANE.0b013e3182771cea
Economics, Education, and Policy: Research Reports

BACKGROUND: Theoretically, communication systems have the potential to increase the productivity of anesthesiologists supervising anesthesia providers. We evaluated the maximal potential of communication systems to increase the productivity of anesthesia care by enhancing anesthesiologists’ coordination of care (activities) among operating rooms (ORs).

METHODS: At hospital A, data for 13,368 pages were obtained from files recorded in the internal alphanumeric text paging system. Pages from the postanesthesia care unit were processed through a numeric paging system and thus not included. At hospital B, in a different US state, 3 of the authors categorized each of 898 calls received using the internal wireless audio system (Vocera®). Lower and upper 95% confidence limits for percentages are the values reported.

RESULTS: At least 45% of pages originated from outside the ORs (e.g., 20% from holding area) at hospital A and at least 56% of calls (e.g., 30% administrative) at hospital B. In contrast, requests from ORs for urgent presence of the anesthesiologist were at most 0.2% of pages at hospital A and 1.8% of calls at hospital B.

CONCLUSIONS: Approximately half of messages to supervising anesthesiologists are for activity originating outside the ORs being supervised. To use communication tools to increase anesthesia productivity on the day of surgery, their use should include a focus on care coordination outside ORs (e.g., holding area) and among ORs (e.g., at the control desk).

From the *Department of Anesthesiology, State University of New York Upstate, Syracuse, New York; Department of Anesthesia, Division of Management Consulting, University of Iowa, Iowa City, Iowa; Department of Telecommunications, Division of Information Management & Technology, State University of New York Upstate, Syracuse, New York; and §Department of Anesthesiology, Jefferson Medical College, Philadelphia, Pennsylvania.

Accepted for publication September 27, 2012.

Supported by departmental funding.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Franklin Dexter, MD, PhD, Department of Anesthesia, Division of Management Consulting, University of Iowa, 200 Hawkins Dr., 6JCP, Iowa City, IA 52242. Address e-mail to or

© 2013 International Anesthesia Research Society