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Efficiency and scheduling in the nonoperating room anesthesia suite

implications from patient satisfaction to increased revenue operating room

a common (Dollars and Sense) approach

Navidi, Bijan; Kiai, Kianusch

Current Opinion in Anesthesiology: August 2019 - Volume 32 - Issue 4 - p 498–503
doi: 10.1097/ACO.0000000000000744
NONOPERATING ROOM ANESTHESIA: Edited by Mark S. Weiss
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Purpose of review Although the NORA setting continues to outgrow the main operating room in cases, there are few studies addressing efficiency metrics, and even fewer studies addressing those of a single specialty outpatient gastroenterology facility. In order to capitalize on this growing trend, gastrointestinal endoscopies must be scheduled in a way that prevents lost potential revenue while maintaining patient convenience, comfort, safety, and satisfaction. By standardizing our scheduling for procedure block time among various endoscopists and converting our sedation practices from conscious sedation to solely Propofol sedation in a 4 : 1 CRNA to Anesthesiologist model, we increased revenue while maximizing physician efficiency and site utilization.

Recent findings The commonly used main operating room efficiency benchmarks cannot effectively be applied in NORA as these two locations have widely different procedure times, turn-around-times, and recovery times. In fact, procedures in gastrointestinal endoscopy suites can be completed in less time than a typical operating room takes for turnover.

Summary By adapting our sedation practices to solely Propofol sedation and by standardizing our procedural schedule times among all the endoscopists, we maximized the number of cases and revenue in our outpatient gastrointestinal endoscopy suite while increasing patient satisfaction through reduction in overall patient facility time and procedure to discharge time.

Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA

Correspondence to Bijan Navidi, MD, Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles David Geffen School of Medicine, 757 Westwood Plaza Suite 3325, Los Angeles, CA 90095, USA. Tel: +1 310 267 3218; fax: +1 310 267 3899; e-mail: bnavidi@mednet.ucla.edu

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