A psychological basis for anesthesiologists' operating room managerial decision-making on the day of surgery

Franklin Dexter, John D. Lee, Angella J. Dow, David Lubarsky

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

BACKGROUND: We investigated whether, without prompting, anesthesiologists tend to make managerial decisions to increase the clinical work per unit time of the sites to which they are assigned during their scheduled time present. Although a sound basis for decision-making involving individual ORs, the heuristic is often suboptimal economically when applied to decisions involving multiple ORs. METHODS: Two studies were performed at one hospital. 1) A retrospective analysis was made of anesthesiologists' managerial decisions when caring for sequential lists of patients. 2) Patients' and surgeons' waiting on nights and weekends were studied before/after education on optimal decision-making. RESULTS: 1) Anesthesiologists' decisions resulted in an increase in their clinical work per unit time, not a reduction in patient waiting. 2) Paradoxically, such efforts on nights and weekends caused increased patient and surgeon waiting. Decisions were unchanged after education on a different way to assign cases. CONCLUSIONS: In a companion article, we showed that clinicians tended to make decisions that increased the clinical work per unit time at each moment in each OR, even when doing so resulted in an increase in overutilized OR time, higher staffing costs, unpredictable work hours, and/or mandatory overtime. The current studies show that such efforts to work fast cannot be explained as a consequence of efforts to reduce surgeon and patient waiting. Rather, the heuristic followed is consistent with increasing one's personal clinical work per unit time at one's assigned anesthetizing location.

Original languageEnglish (US)
Pages (from-to)430-434
Number of pages5
JournalAnesthesia and Analgesia
Volume105
Issue number2
DOIs
StatePublished - Aug 1 2007
Externally publishedYes

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Operating Rooms
Ambulatory Surgical Procedures
Decision Making
Psychology
Education
Anesthesiologists
Costs and Cost Analysis
Surgeons

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

A psychological basis for anesthesiologists' operating room managerial decision-making on the day of surgery. / Dexter, Franklin; Lee, John D.; Dow, Angella J.; Lubarsky, David.

In: Anesthesia and Analgesia, Vol. 105, No. 2, 01.08.2007, p. 430-434.

Research output: Contribution to journalArticle

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