Anesth Analg 2007;104:992
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000261438.49250.ee
LETTER TO THE EDITOR
Section Editor:
Lawrence Saidman
Teaching and Operating Room Efficiency
Evan G. Pivalizza, MBChB, FFASA,
Steven I. Abramson, MD,
Ralf Gebhard, MD,
Peter Szmuk, MD, and
Robert D. Warters, MD
Department of Anesthesiology; University of Texas Health Science Center; Houston, TX; evan.g.pivalizza{at}uth.tmc.edu (Pivalizza, Abramson)
Department of Anesthesiology; University of Miami-Miller School of Medicine; Miami, FL (Gebhard)
University of Texas Southwestern Medical School and Children's Medical Center at Dallas; Dallas, TX (Szmuk)
Department of Anesthesia and Perioperative Medicine; Division Veterans Affairs; Ralph H. Johnson Medical Center; Charleston, SC (Warters)
To the Editor:
The study of Davis et al. (1) on the effects of teaching on the operating room (OR) schedule will facilitate necessary interactions that academic anesthesiology departments have with both medical school and hospital administrators who are frequently unfamiliar with some of the practical issues in OR management and efficiency.
It is gratifying to note the minimal impact of teaching (4.5 min), especially in the context of mean surgical preparation times (22 min) and surgeon-related delays (9.6 min in subgroup with delay) in another study of the same patient cohort (2).
The Yale department is fortunate to have 69% of cases and 77% of total teaching units (Table 1) (1) in situations where faculty coverage is in a 1:1 ratio. For many academic departments such as ours, only a minority of cases are staffed by faculty covering a single OR. Based on the data of Davis et al. (Table 2), this would imply shorter teaching times and therefore anesthesia release times (ART) by ±25%, favorable for efficiency although detrimental for teaching¡
With the current high level of medical student interest in anesthesiology, we often have a large number of students on our service as well as residents from other disciplines and paramedical staff requiring airway management instruction. We suspect that meeting these requirements will unfavorably impact ART and we are interested if Davis et al., have any data from their large cohort specifically addressing this issue.
REFERENCES
- Davis EA, Escobar A, Ehrenworth J, et al. Resident teaching versus the operating room schedule: an independent observer-based study of 1558 cases. Anesth Analg 2006;103:932–7.[Abstract/Free Full Text]
- Escobar A, Davis EA, Ehrenworth J, et al. Task analysis of the preincision surgical period: An independent observer-based study of 1558 cases. Anesth Analg 2006; 103:922–7.[Abstract/Free Full Text]
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