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ECONOMICS, EDUCATION, AND POLICY

Holiday and Weekend Operating Room On-Call Staffing Requirements

Franklin Dexter, MD, PhD^*, and Richard H. Epstein, MD

From the *Department of Anesthesia and Health Management and Policy, University of Iowa, Iowa City, Iowa; and Department of Anesthesiology, Jefferson Medical College, Philadelphia, Pennsylvania.

Address correspondence and reprint requests to Franklin Dexter, Anesthesia 6-JCP, University of Iowa, Iowa City, IA 52242. Address e-mail to Franklin-Dexter{at}UIowa.edu.

Abstract

BACKGROUND: Every facility that performs cases on holidays has in some way decided on its operating room (OR) and anesthesia staffing for holidays. Previous studies have not examined how best to calculate appropriate holiday staffing.

METHODS: We analyzed weekend and holiday data from a university hospital.

RESULTS: There were high rank correlations between the number of cases starting during each 12-h period of a holiday, the total hours of OR time used, and the patients and surgeons waiting for cases to start. Weekend and holiday 12-h periods were divided into 8 categories (e.g., Saturday 7:00 am to 7:00 pm). There was perfect rank correlation between the mean number of cases starting during each 12-h period and appropriate staffing during the 12-h period, whether quantified by total hours of cases or by the under-utilized and over-utilized OR time resulting from staffing decisions.

CONCLUSIONS: The number of cases starting during each period of a holiday is a statistically valid end point for OR managers to use to evaluate how busy holidays are relative to weekend days. To be useful, the statistic must be combined with mathematically valid assessments of appropriate weekend staffing on-call, whether in-house, or from home.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999