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 language | English (US) |
|---|---|
| Pages (from-to) | 430-434 |
| Number of pages | 5 |
| Journal | Anesthesia and Analgesia |
| Volume | 105 |
| Issue number | 2 |
| DOIs | |
| State | Published - Aug 1 2007 |
| Externally published | Yes |
Fingerprint
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 journal › Article
}
TY - JOUR
T1 - A psychological basis for anesthesiologists' operating room managerial decision-making on the day of surgery
AU - Dexter, Franklin
AU - Lee, John D.
AU - Dow, Angella J.
AU - Lubarsky, David
PY - 2007/8/1
Y1 - 2007/8/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=34547590228&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34547590228&partnerID=8YFLogxK
U2 - 10.1213/01.ane.0000268540.85521.84
DO - 10.1213/01.ane.0000268540.85521.84
M3 - Article
C2 - 17646501
AN - SCOPUS:34547590228
VL - 105
SP - 430
EP - 434
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 2
ER -